Orally and transdermally replaced estradiol improves endothelial function equally in middle-aged women after surgical menopause.
OBJECTIVE
Improvement in endothelial function may be an important mechanism by which estrogen replacement therapy protects postmenopausal women against coronary artery disease. We determined whether the vascular effects of estradiol depend on the route of administration.


METHODS
Six weeks after surgically induced menopause, 43 healthy women were assigned randomly to 28 weeks of treatment by either orally or transdermally replaced estradiol. Endothelium-dependent and endothelium-independent dilation were calculated with the use of the diameters of the brachial artery that were measured at rest by high resolution ultrasound scanning after reactive hyperemia and after sublingual glyceryl trinitrate.


RESULTS
Endothelium-dependent dilation increased after oral estradiol replacement from 6% +/- 3.9% to 13.2% +/- 4.4% (P <.0001) and after transdermal estradiol replacement from 7% +/- 4.9% to 14.9% +/- 5.6%(P <.0001). Endothelium-independent dilation did not change significantly in either group. The improvements in endothelium-dependent dilation after estrogen substitution were independent of the changes in blood lipids and lipoproteins.


CONCLUSIONS
Both oral and transdermal long-term replacement of estradiol lead to improved endothelial function in healthy middle-aged women after surgically induced menopause.
Clinical Department of Gynecology and Obstetrics, Maribor Teaching Hospital, Ljubljanska 5, 2000 Maribor, Slovenia. branka.segura@guest.arnes.si
Branka
B
Zegura
Irena
I
Keber
Miran
M
Sebestjen
Elko
E
Borko
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000286:Administration, Sublingual; D000290:Adnexa Uteri / Q000601:surgery; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D007044:Hysterectomy; D008055:Lipids / Q000097:blood; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D011379:Prognosis; D012039:Regional Blood Flow; D014463:Ultrasonography; D014664:Vasodilation
D000970:Antineoplastic Agents; D008055:Lipids; D004958:Estradiol; D005996:Nitroglycerin