The effects of transdermal estradiol on the response to mental stress in postmenopausal women: A randomized trial

PURPOSE: Estrogens inhibit adrenomedullary catecholamine release and catech olamine-mediated responses to stress. We examined whether estrogen suppleme ntation reduces the sympathoadrenal response to mental stress in postmenopa usal women. MATERIALS AND METHODS: We compared the effects of 3-week treatment with tra nsdermal 17-beta-estradiol and placebo in 10 postmenopausal women using a r andomized, blinded, crossover design. We measured plasma catecholamine leve ls and the cardiovascular and metabolic responses to a 15-minute stress wit h mental arithmetic. Treatments were compared using repeated measures analy sis of variance. RESULTS: During placebo treatment, mean (+/- SD) epinephrine levels reached a peak of 431 +/- 135 pmol/liter after 15 minutes of stress; the epinephri ne response was blunted during estradiol treatment, with a peak of 357 +/- 77 pmol/liter (P <0.05). Estradiol also blunted the diastolic blood pressur e response to stress (baseline levels of 78 +/- 15 mm Hg vs peak of 90 +/- 6 mm Hg during placebo; baseline of 80 +/- 8 mm Hg vs peak of 84 +/- 6 mm H g during estradiol; P <0.05). Estradiol treatment also blunted the decrease in the standard deviation of the mean of the electrocardiographic RR inter vals and the increase in the ratio between the low-frequency and high-frequ ency bandwidths. CONCLUSION: We observed a moderate, although significant, reduction in mark ers of the stress response to mental arithmetic in postmenopausal women tre ated with transdermal 17-beta-estradiol. Am J Med. 2000;109:463-468. (C) 20 00 by Excerpta Medica, Inc.