Effect of low-dose estrogen on hemodynamic response to stress

Objective: To determine the effect of low-dose esterified estrogen on hemod ynamic responses at rest and during stress in postmenopausal women, and to compare the changes with those seen with conjugated equine estrogen. Design: Open-label study of esterified estrogen compared with a double-blin d, placebo-controlled investigation of conjugated equine estrogen. Setting: Healthy volunteers in an academic research environment. Patient(s): Postmenopausal women with normal endometrium, not currently usi ng hormones. Intervention(s): Cardiovascular parameters at rest and in response to stres sors were assessed in 11 post menopausal women before and 6 months after re ceiving 0.3 mg esterified estrogen. Responses were compared with 42 postmen opausal women randomized to 0.625 mg conjugated equine estrogen or placebo. Main Outcome Measure(s): Changes in mean arterial pressure (MAP) and vascul ar resistance index from before to after treatment. Result(s): At rest, MAP increased 3.3 +/- 1.5 mm Hg (+/-SD) in the placebo group, while declining 2.3 +/- 1.5 mm Hg and 3.8 +/- 1.4 mm Hg, respectivel y, in the esterified estrogen and conjugated equine estrogen groups after t reatment. During mental stressors, MAP dropped significantly in both treatm ent groups. At rest and during mental stressors, vascular resistance index decreased with estrogen treatment. Conclusion(s): Low-dose esterified estrogen improved hemodynamic patterns s imilar to standard doses of conjugated equine estrogen in postmenopausal wo men. (C)2001 by American Society for Reproductive Medicine.