The effects of transdermal estradiol on the response to mental stress in postmenopausal women: a randomized trial.
OBJECTIVE
Estrogens inhibit adrenomedullary catecholamine release and catecholamine-mediated responses to stress. We examined whether estrogen supplementation reduces the sympathoadrenal response to mental stress in postmenopausal women.


METHODS
We compared the effects of 3-week treatment with transdermal 17-beta-estradiol and placebo in 10 postmenopausal women using a randomized, blinded, crossover design. We measured plasma catecholamine levels and the cardiovascular and metabolic responses to a 15-minute stress with mental arithmetic. Treatments were compared using repeated measures analysis of variance.


RESULTS
During placebo treatment, mean (+/- SD) epinephrine levels reached a peak of 431 +/- 135 pmol/liter after 15 minutes of stress; the epinephrine response was blunted during estradiol treatment, with a peak of 357 +/- 77 pmol/liter (P <0.05). Estradiol also blunted the diastolic blood pressure response to stress (baseline levels of 78 +/- 15 mm Hg vs peak of 90 +/- 6 mm Hg during placebo; baseline of 80 +/- 8 mm Hg vs peak of 84 +/- 6 mm Hg during estradiol; P <0.05). Estradiol treatment also blunted the decrease in the standard deviation of the mean of the electrocardiographic RR intervals and the increase in the ratio between the low-frequency and high-frequency bandwidths.


CONCLUSIONS
We observed a moderate, although significant, reduction in markers of the stress response to mental arithmetic in postmenopausal women treated with transdermal 17-beta-estradiol.
Ceresini
G
G
Department of Internal Medicine and Biomedical Sciences (GC, MF, SM, IR, CM, GV), University of Parma, Parma, Italy.
Freddi
M
M
Morganti
S
S
Rebecchi
I
I
Modena
A B
AB
Rinaldi
M
M
Manca
C
C
Amaducci
A
A
Del Rio
G
G
Valenti
G
G
D000279:Administration, Cutaneous; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects*; D002395:Catecholamines / Q000097:blood*; D018592:Cross-Over Studies; D004837:Epinephrine / Q000097:blood; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008433:Mathematics; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D017698:Postmenopause / Q000097:blood / Q000523:psychology*; D013315:Stress, Psychological / Q000517:prevention & control*
D002395:Catecholamines; D004958:Estradiol; D009638:Norepinephrine; D004837:Epinephrine