THE ASSOCIATION-OF-ESTROGEN-REPLACEMENT-THERAPY AND THE RAYNAUD PHENOMENON IN POSTMENOPAUSAL WOMEN

Background: Hormonal factors may play an important role in the pathoph ysiology of the Raynaud phenomenon. Experimental studies have shown an increased vasoconstrictor response to estrogen, a response that can b e prevented by the addition of progesterone. Objective: To measure the association between estrogen replacement therapy (alone and with prog esterone) and the Raynaud phenomenon. Design: Cross-sectional study. S etting: Framingham Offspring Study. Participants: 497 postmenopausal w omen. Measurements: Prevalence of the Raynaud phenomenon according to hormone use. Covariates measured included age, body mass index, smokin g, alcohol consumption, and p-blocker use. Results: Forty-nine women w ere classified as having the Raynaud phenomenon (9.9%). The prevalence of this phenomenon was 8.4% among women who did not receive estrogen, 19.1% among women receiving estrogen alone, and 9.8% among women rece iving estrogen plus progesterone. The adjusted odds ratio for the Rayn aud phenomenon was 2.5 (95% CI, 1.2 to 5.3) for unopposed estrogen and 0.9 (CI, 0.3 to 2.6) for estrogen plus progesterone, with nonusers as the reference group.Conclusions: Unopposed estrogen therapy was assoc iated with the Raynaud phenomenon in postmenopausal women. This associ ation was not present in women who were receiving combined hormone the rapy.