HORMONE REPLACEMENT AND SONOGRAPHIC STATUS OF PERIPHERAL ARTERIES

Human and nonhuman oral and transdermal estrogens are capable of produ cing a generalized improvement of perfusion in the uterine, carotid an d cerebral arteries and the abdominal aorta in early and late postmeno pausal women and young women with ovarian failure. Effects of progesto gens are less well-defined. Conflicting results of investigations of t he uterine arteries demonstrate at best the lack of any adverse effect s on blood flow. However, there is evidence that an attenuation of the increased blood flow due to estrogen replacement therapy may be count eracted by 17-hydroxyprogesterone as well as 19-nortestosterone deriva tives. Natural progesterone apparently lacks the potential to diminish blood flow. The specific effects of common oral and transdermal estro gen and progestogen replacement regimens need to be defined in longitu dinal studies. At present there are no data to confirm that the reduct ion of the pulsatility index definitely leads to a reduction of cardio vascular disease. The specific impact of different estrogen and proges togen compounds as regards to type, dose and route of administration o n blood flow in women with estrogen deficiency remains to be establish ed to allow more definite conclusions beyond the speculation that decr eased vascular resistance is an important factor in the protection aga inst arterial atherosclerotic disease.