title: Endogenous sex steroids and cardio- and cerebro-vascular disease in the postmenopausal period.
abstract: OBJECTIVE
  Cardio- and cerebro-vascular diseases are two leading causes of death and long-term disability in postmenopausal women. The acute fall of estrogen in menopause is associated with increased cardiovascular risk. The relative contribution of androgen to this risk is also being recognized. The use of more sensitive assays for estradiol measurement and the study of receptor and carrier protein gene polymorphisms have provided some new information on the clinical relevance of endogenous sex steroids. We provide an update on the role of endogenous sex steroids on cardio- and cerebro-vascular disease in the postmenopausal period.
  
  
  METHODS
  We performed a PubMed search using the terms 'endogenous estrogen', 'androgen', 'cardiovascular disease', 'cerebro-vascular disease', 'stroke', 'carotid artery disease', and 'subclinical atherosclerosis'.
  
  
  RESULTS
  The majority of studies show a beneficial effect of endogenous estrogen on the vasculature; however, there are a few studies reporting the contrary. A significant body of literature has reported associations of endogenous estrogen and androgen with early markers of atherosclerosis and metabolic parameters. Data on the relevance of endogenous sex steroids in heart disease and stroke are inconclusive.
  
  
  CONCLUSIONS
  Most studies support a beneficial role of endogenous estrogens and, probably, an adverse effect of androgens in the vasculature in postmenopausal women. However, the described associations may not always be considered as causal. It is possible that circulating estrogen might represent a marker of general health status or alternatively reflect the sum of endogenous androgens aromatized in the periphery. Elucidating the role of sex steroids in cardio- and cerebro-vascular disease remains an interesting field of future research.
authors.affiliation: Endocrine Unit, Department of Medical Therapeutics, Athens University School of Medicine, Alexandra Hospital, 80 Vassilissis Sofias Avenue, 11528 Athens, Greece. dorispappas@hotmail.com
authors.forename: Theodora
authors.initials: T
authors.lastname: Pappa
authors.forename: Maria
authors.initials: M
authors.lastname: Alevizaki
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood* / Q000378:metabolism; D006801:Humans; D017698:Postmenopause / Q000097:blood* / Q000378:metabolism / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D012739:Gonadal Steroid Hormones