Uterine and cerebral vascularization in postmenopausal women treated with hormone-replacement therapy

The effects of hormone-replacement therapy on the Doppler flow parameters o f the ophthalmic artery in postmenopausal women were studied and compared w ith those register ed at the level of the internal carotid and uterine arte ries. Fifty-seven postmenopausal patients were submitted to continuous estradiol transdermal supplementation and 12-day courses medroxyprogesterone one acet ate. During the estrogen phase of hormone-replacement therapy all patients underwent (at 1, 3 and 6 months after the beginning of hormone-replacement therapy) transvaginal ultrasonographic evaluation of the pelvic organs and of endometrial thickness. On the same day, they underwent color Doppler ana lysis of the blood flow impedance of the uterine, internal carotid and opht halmic arteries. Estradiol plasma concentrations were assayed on the day th at ultrasonographic and Doppler examinations rook place. The pulsatility index of all the arteries improved, from baseline values, d uring the therapy and attained stable values compared to those after the fi rst month of treatment Furthermore, at the level of the internal carotid an d ophthalmic arteries, a significant increase of the peak systolic bloodflo w velocity (V-max) was observed over the 6 months of therapy. Doppler studies of the ophthalmic artery ave capable of affording specific and precise pathophysiologic information to assess peripheral intracranial blood flow variations. Furthermore, such studies may be useful in monitorin g hormone-replacememt therapy effects on cerebral perfusion.