Effect of medroxyprogesterone on depressive symptoms in depressed and nondepressed perimenopausal and postmenopausal women after discontinuation of transdermal estradiol therapy

Abstract Background The arterial effects of hormone therapy remain controversial. This study tested the effects of transdermal estradiol plus intermittent micronized progesterone (TE + IMP) in healthy perimenopausal and early postmenopausal women on several mechanisms involved in the pathophysiology of arterial disease. Methods Healthy perimenopausal and early postmenopausal women, ages 45 to 60 years, were enrolled in this randomized, double-blind, placebo-controlled trial. Women were randomized to receive TE (0.1 mg/day) + IMP (200 mg/day for 12 days) or identical placebo patches and pills for 12 months. Outcomes included: change in stress reactivity composite z-score (combining inflammatory, cortisol, and hemodynamic responses to a standardized psychological laboratory stressor); flow-mediated dilation (FMD) of the brachial artery (an index of vascular endothelial function); baroreflex sensitivity; and metabolic risk (presence of the metabolic syndrome or insulin resistance), all assessed at baseline and at months 6 and 12. Results Of 172 women enrolled, those assigned to TE + IMP tended to have higher resting baroreflex sensitivity than those assigned to placebo across the 6- and 12-month visits. Although treatment groups did not differ in terms of the other prespecified outcomes, a significant treatment-by-age interaction was found for FMD and stress reactivity such that an age-related decrease in FMD and increase in stress reactivity were seen among women assigned to placebo but not those assigned to TE + IMP. Women on TE + IMP also had lower resting diastolic blood pressure, lower levels of low-density lipoprotein cholesterol, and higher baroreflex sensitivity during stress testing. Conclusions TE + IMP tended to improve cardiac autonomic control and prevented age-related changes in stress reactivity and endothelial function among healthy perimenopausal and early postmenopausal women.

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Efficacy, acceptability, and metabolic effects of transdermal estradiol in the management of postmenopausal women

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(85)90567-8 ◽

1985 ◽

Vol 152 (8) ◽

pp. 1085-1091 ◽

Cited By ~ 85

Author(s):

M.L. Padwick ◽

J. Endacott ◽

M.I. Whitehead

Keyword(s):

Postmenopausal Women ◽

Metabolic Effects ◽

Transdermal Estradiol

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Depressive symptoms affect outcomes of pessary use in postmenopausal women with uterine prolapse

Climacteric ◽

10.1080/13697137.2018.1430130 ◽

2018 ◽

Vol 21 (2) ◽

pp. 184-188 ◽

Cited By ~ 4

Author(s):

F.-F. Ai ◽

L. Zhu ◽

M. Mao ◽

Y. Zhang ◽

J. Kang

Keyword(s):

Depressive Symptoms ◽

Postmenopausal Women ◽

Uterine Prolapse

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Effects of Hormone Replacement Therapy Type and Route of Administration on Plasma Matrix Metalloproteinases and Their Tissue Inhibitors in Postmenopausal Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2005-2789 ◽

2006 ◽

Vol 91 (8) ◽

pp. 3123-3130 ◽

Cited By ~ 34

Author(s):

K. C. Lewandowski ◽

J. Komorowski ◽

D. P. Mikhalidis ◽

M. Bienkiewicz ◽

B. K. Tan ◽

...

Keyword(s):

Cardiovascular Disease ◽

Hormone Replacement Therapy ◽

Matrix Metalloproteinases ◽

Replacement Therapy ◽

Postmenopausal Women ◽

Hormone Replacement ◽

Serum Levels ◽

Tissue Inhibitors ◽

Healthy Women ◽

Transdermal Estradiol

Abstract Background: Matrix metalloproteinases (MMPs) are implicated in numerous disease states including cardiovascular disease and cancer. Because recent studies have shown a detrimental effect of hormone replacement therapy on cardiovascular disease and breast cancer, we investigated whether there are any differences in the concentrations of MMPs and their tissue inhibitors (TIMPs) in women receiving various forms of postmenopausal therapy. Material and Methods: A total of 195 healthy postmenopausal women were assessed: 46 were taking tibolone, 47 were taking transdermal estradiol, 46 were taking conjugated equine estrogens (CEE), and 56 were not taking any menopausal therapy (CTR). Plasma levels of MMP-2 and -9 and TIMP-1 and TIMP-2 were measured by ELISA methods. Results: MMP-9 levels were significantly higher in the CEE group in comparison with healthy women not receiving menopausal therapy (P < 0.05). In contrast, MMP-9 levels in the tibolone group were significantly lower than in any other group (P < 0.01, compared with transdermal estradiol and CTR, and P < 0.001, compared with CEE). MMP-9 to TIMP-1 ratio was also significantly higher in the CEE, compared with CTR (P < 0.05), and lower in the tibolone group (P < 0.01, compared with all groups). MMP-2 levels were higher in the CEE group, compared with healthy women not receiving any menopausal therapy, and women taking tibolone (P < 0.05). Conclusions: Our study demonstrates differential effects of various forms of postmenopausal therapy on serum levels of MMP-9 and MMP-2. It remains to be established whether these differences might be associated with differences in risks of cardiovascular disease and cancer in these women.

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