Serum vascular endothelial growth factor concentrations in postmenopausal women: the effect of hormone replacement therapy

Objective: To assess serum. vascular endothelial growth factor (VEGF) conce ntrations in healthy postmenopausal women in relation to hormone replacemen t therapy (HRT) and the presence or absence of a uterus. Design: Cross-sectional study. Setting: The Middlesex Hospital. Patient(s): A total of 199 postmenopausal women were enrolled: 132 had uter us in situ and 67 had had hysterectomies. Of the 67 women who had had hyste rectomies, 6 received no HRT, 20 received tibolone, 25 received transdermal E-2, and 16 received conjugated equine estrogens. Of the 132 women with ut eri in situ, 34 received no HRT, 56 received tibolone, 24 received transder mal E, with sequential norethisterone acetate, and 18 received conjugated e quine estrogens with sequential levonorgestrel. Intervention(s): Serum. VEGF level measurement. Main Outcome Measure(s): Serum. VEGF concentrations. Result(s): Women who received HRT had higher VEGF concentrations than those not receiving HRT. Among women who received no HRT, those with uterus in s itu had higher VEGF levels than did those who had had hysterectomies. Among women who had had hysterectomies, VEGF concentrations were higher in those who received conjugated equine estrogens than in those who did not receive HRT and those who received tibolone or transdermal E-2. Among women with u terus in situ, no difference was found between subgroups. Conclusion(s): Postmenopausal women with uterus in situ and those who recei ved HRT had higher VEGF concentrations than did those who had had hysterect omies and who did not receive HRT. Among women receiving HRT, those who rec eived conjugated equine estrogens alone had higher VEGF concentrations. Thi s estrogen-mediated increase in serum VEGF concentrations may be a mechanis m by which HRT benefits the cardiovascular system (Fertil Steril(R) 2000;73 :56-60. (C) 1999 by American Society for Reproductive Medicine.)