The association of estrogen replacement therapy and the Raynaud phenomenon in postmenopausal women.
BACKGROUND
Hormonal factors may play an important role in the pathophysiology of the Raynaud phenomenon. Experimental studies have shown an increased vasoconstrictor response to estrogen, a response that can be prevented by the addition of progesterone.


OBJECTIVE
To measure the association between estrogen replacement therapy (alone and with progesterone) and the Raynaud phenomenon.


METHODS
Cross-sectional study.


METHODS
Framingham Offspring Study.


METHODS
497 postmenopausal women.


METHODS
Prevalence of the Raynaud phenomenon according to hormone use. Covariates measured included age, body mass index, smoking, alcohol consumption, and beta-blocker use.


RESULTS
Forty-nine women were classified as having the Raynaud phenomenon (9.9%). The prevalence of this phenomenon was 8.4% among women who did not receive estrogen, 19.1% among women receiving estrogen alone, and 9.8% among women receiving estrogen plus progesterone. The adjusted odds ratio for the Raynaud phenomenon was 2.5 (95% CI, 1.2 to 5.3) for unopposed estrogen and 0.9 (CI, 0.3 to 2.6) for estrogen plus progesterone, with nonusers as the reference group.


CONCLUSIONS
Unopposed estrogen therapy was associated with the Raynaud phenomenon in postmenopausal women. This association was not present in women who were receiving combined hormone therapy.
Fraenkel
L
L
Boston University Arthritis Center, Massachusetts 02118, USA.
Zhang
Y
Y
Chaisson
C E
CE
Evans
S R
SR
Wilson
P W
PW
Felson
D T
DT
D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D017698:Postmenopause; D011374:Progesterone / Q000627:therapeutic use; D011928:Raynaud Disease / Q000503:physiopathology*; D014661:Vasoconstriction / Q000502:physiology
D011374:Progesterone