PROSPECTIVE, RANDOMIZED, CONTROLLED-STUDY OF THE EFFECT OF HORMONE REPLACEMENT THERAPY ON PERIPHERAL-BLOOD FLOW VELOCITY IN POSTMENOPAUSAL WOMEN

Objective: To investigate the effect of different types and methods of delivery of hormone replacement therapy (HRT) on peripheral vascular flow velocity in postmenopausal women. Design: A prospective, randomiz ed, operator-blinded, controlled study. Setting: A hormone replacement clinic in a university teaching hospital. Patient(s): Sixty-eight wom en who had undergone surgical menopause. Intervention(s): No treatment , oral estrogen, continuous combined estrogen and progestogen, or perc utaneous estrogen. Main Outcome Measure(s): The pulsatility indices of the brachial, dorsalis pedis, popliteal, and radial arteries were mea sured under standardized conditions before the commencement of HRT and after 2 and 6 months of treatment. Serum E-2 levels were measured at each visit. Result(s): There was an inverse correlation between the se rum E-2 levels and the pulsatility indices. There was a significant re duction in the pulsatility index in at least one of the four arteries after 2 months of HRT in all the treatment groups but not in the contr ol group. The effect of HRT on the pulsatility index persisted until t he completion of the study in all the treatment groups. Conclusion(s): These results confirm that the administration of HRT is associated wi th a reduction of the pulsatility index, and hence an increase in bloo d flow in the peripheral arteries; this change in the pulsatility inde x is related directly to serum E-2 levels. The percutaneous route of a dministration of estrogen was at least as effective as oral treatment in improving peripheral vascular flow velocity. The beneficial effect of estrogen was not affected by the addition of a progestogen. (Fertil Steril(R) 1998:70:284-8. (C)1998 by American Society for Reproductive Medicine.).