Hormone replacement therapy for oxidative stress in postmenopausal women with hot flushes

Objective: To assess the association of hot flushes during postmenopause wi th oxidative stress and to determine whether hormone replacement therapy (H RT) affects the plasma redox status of postmenopausal women. Methods: We conducted a prospective clinical study of 49 postmenopausal wom en who have (n = 29) or do not have (n = 20) hot flushes. Twelve of the pos tmenopausal women with hot flushes and six without were treated with HRT (e stradiol patches and medroxyprogesterone acetate) for 4 months. Plasma leve l of estradiol, total antioxidant status, reduced sulfhydryl groups, lipope roxides, total cholesterol, and triglycerides were measured at 4-month inte rvals in both groups, before and after treatment. Results: postmenopausal women who have hot flushes, had lower total basal a ntioxidant status in plasma (.9 +/- .01 compared with 1.14 +/- .01 mmol/L), lower concentration of reduced sulfhydryl groups (145 +/- 4 compared with 200 +/- 3 mu mol/L), and higher concentration of lipoperoxides (2.88 +/- .0 4 compared with 2.61 +/- .04 mu mol/L) than women without hot flushes. Afte r HRT, total antioxidant status and reduced sulfhydryl groups increased, an d lipoperoxides decreased similarly in both groups. Hormone replacement the rapy decreased the frequency of hot flushes per day from 11.2 +/- 0.8 to 1. 4 +/- 0.3. Conclusion: Hot flushes in postmenopausal women were associated with the ox idative process. Hormone replacement therapy decreases oxidative stress and the number of episodes of hot flushes. Because oxidative stress is associa ted with a high risk for cardiovascular diseases, HRT might protect women w ith hot flushes. (Obstet Gynecol 2000;95: 804-9. (C) 2000 by The American C ollege of Obstetricians and Gynecologists).