Changes in serum vascular endothelial growth factor following initiation of estrogen replacement after hysterectomy and oophorectomy

Background. Vascular endothelial growth factor has been shown to play an im portant role in preservation and restoration of endothelial integrity. Simi lar effects on endothelial function have been described with estrogen repla cement. This poses the question whether some of the mechanisms ascribed to estrogen are in fact vascular endothelial growth factor mediated. The objec tive of this study was to examine the effect of continuous transdermal estr ogen replacement on serum levels of secreted vascular endothelial growth fa ctor in women following hysterectomy and oophorectomy. Methods. In a nonrandomized, prospective study, 40 hysterectomized and ooph orectomized women were treated with transdermal estrogen. Their serum vascu lar endothelial growth factor levels were measured before and six months fo llowing estrogen treatment, using a commercially available ELISA kit. Results. The mean serum vascular endothelial growth factor level fell from 328 ng/ml (s.d. 164) before treatment to 285 ng/ml (s.d. 124) following six months of estrogen replacement. This decrease was statistically significan t (p<0.03). Conclusion. Transdermal estrogen replacement in hysterectomized and oophore ctomized women appears to be associated with a significant reduction in sec reted serum vascular endothelial growth factor. However, the effect of hyst erectomy and oophorectomy pel se needs to be explained in appropriately des igned trials.