title: Depot-medroxyprogesterone acetate and endothelial function before and after acute oral, vaginal, and transdermal estradiol treatment.
abstract: Young women using depot-medroxyprogesterone acetate (DMPA) contraception have low circulating estrogen and elevated synthetic progestin. Low estrogen and certain progestins have been shown to impact endothelial function even in young healthy women. The purpose of this study was to investigate how DMPA affects endothelial function and serum biomarkers of cardiovascular risk before and after acute oral, vaginal, and transdermal estradiol treatments. Seven young women participated on 3 study days during a normal 12-week DMPA cycle, during weeks 3, 6, and 9. An additional 8 young women participated on 6 separate days during a 12-week DMPA cycle, 3 times on DMPA only and 3 times when using DMPA plus acute estradiol treatments. Wall tracking of high-resolution ultrasound images of the brachial artery were used during endothelium-dependent flow-mediated dilation and nitroglycerin administration to test endothelial function. Serum samples were analyzed for cardiovascular indexes at each study visit. All of the estradiol treatments increased endothelium-dependent flow-mediated dilation compared with DMPA only (P<0.001). Endothelium-dependent flow-mediated dilation was not different among DMPA-only treatment days. Endothelium-independent vasodilation and cholesterol levels were unchanged across DMPA-only and DMPA plus estradiol cycles. These data suggest that acute estradiol treatments improve endothelium-dependent flow-mediated dilation in young hypoestrogenic women using DMPA.
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, OR 97403-1240, USA.
authors.forename: Britta N
authors.initials: BN
authors.lastname: Torgrimson
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Meendering
authors.forename: Paul F
authors.initials: PF
authors.lastname: Kaplan
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Minson
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004333:Drug Administration Routes; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects*; D004958:Estradiol / Q000008:administration & dosage* / Q000097:blood; D004967:Estrogens / Q000008:administration & dosage*; D004970:Estrone / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007118:Immunoassay; D016014:Linear Models; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects
chemical_list: D003271:Contraceptive Agents, Female; D019332:Endothelin-1; D004967:Estrogens; D004970:Estrone; D004958:Estradiol; D017258:Medroxyprogesterone Acetate