Estrogen and cerebrovascular regulation in menopause.
Estrogen (E2), classically viewed as a reproductive steroid hormone, has non-reproductive functions throughout the body including in the brain and vasculature. Studies report diminished neuroprotection with declining E2 levels, corresponding with higher incidence of cerebrovascular and neurological disease. However, the effects of menopausal hormone therapy (MHT) on the cerebral vasculature and brain function remain controversial. This review will focus on evidence of 17β-estradiol actions in the cerebral vasculature, with a particular emphasis on the vasoactive, anti-inflammatory, anti-oxidant, metabolic and molecular properties. Controversies surrounding MHT in relation to cerebrovascular disease and stroke risk will be discussed, particularly the emerging evidence from clinical trials supporting the critical period hypothesis of estrogen protection.
Department of Neurology, University of New Mexico, Albuquerque, NM, United States. Electronic address: raz@salud.unm.edu.
Limor
L
Raz
D001921:Brain / Q000187:drug effects* / Q000378:metabolism*; D002561:Cerebrovascular Disorders / Q000188:drug therapy* / Q000378:metabolism*; D002986:Clinical Trials as Topic; D015914:Estrogen Replacement Therapy / Q000379:methods; D004967:Estrogens / Q000378:metabolism* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects / Q000378:metabolism*
D004967:Estrogens
17β-Estradiol; Cardiovascular; Cerebrovascular; Menopausal hormone therapy; Review; Stroke