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Am J Physiol Endocrinol Metab 292: E1401-E1409, 2007. First published January 16, 2007; doi:10.1152/ajpendo.00547.2006
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Long-term estrogen deficiency lowers regional blood flow, resting systolic blood pressure, and heart rate in exercising premenopausal women

Emma O'Donnell,1 Paula J. Harvey,2 Jack M. Goodman,3 and Mary Jane De Souza1

1Women's Exercise and Bone Health Laboratory and 3Cardiovascular Research Laboratory, Department of Exercise Sciences and 2Division of Cardiology, Department of Medicine, University of Toronto, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada

Submitted 9 October 2006 ; accepted in final form 12 January 2007

The cardiovascular consequences of hypoestrogenism in premenopausal women are unclear. Accordingly, the influence of menstrual status and endogenous estrogen (E2) exposure on blood pressure (BP), heart rate (HR), and calf blood flow in young (18–35 yr) regularly exercising premenopausal women with exercise-associated menstrual aberrations was investigated. Across consecutive menstrual cycles, daily urinary ovarian steroid levels were analyzed, and the area under the curve was calculated to determine menstrual status and E2 exposure. BP, HR, blood flow, vascular conductance, and resistance were measured at baseline and following ischemic calf exercise. Exercising subjects consisted of 14 ovulatory (ExOv), 10 short-term (anovulatory and ≤100 days amenorrhea; ST-E2 Def), and 8 long-term (>100 days amenorrhea; LT-E2 Def) E2-deficient women. Nine sedentary ovulatory subjects (SedOv) were also studied. All groups were similar in age (24.8 ± 0.7 yr), height (164.8 ± 1.3 cm), weight (57.9 ± 0.9 kg), and body mass index (21.3 ± 0.3 kg/m2). E2-deficient groups had lower (P < 0.002) E2 exposure compared with ovulatory groups. Resting systolic BP, HR, blood flow, and vascular conductance were lower (P < 0.05) and vascular resistance higher (P < 0.05) in LT-E2 Def compared with both ovulatory groups. Peak ischemic blood flow, vascular conductance, and HR were also lower (P < 0.05) and vascular resistance higher (P < 0.05) in LT-E2 Def compared with all other groups. Our findings show that exercising women with long-term E2 deficiency have impaired regional blood flow and lower systolic BP and HR compared with exercising and sedentary ovulatory women. These cardiovascular alterations represent markers of altered vascular function and autonomic regulation of which the long-term effects remain unknown.

exercise-associated amenorrhea; menstrual aberrations; vascular resistance



Address for reprint requests and other correspondence: M. J. De Souza, Women's Exercise and Bone Health Laboratory, Dept. of Exercise Sciences, Univ. of Toronto, 55 Harbord St., Toronto, ON, Canada, M5S 2W6 (e-mail: maryjane.desouza{at}utoronto.ca)




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M.J. De Souza, R.J. Toombs, J.L. Scheid, E. O'Donnell, S.L. West, and N.I. Williams
High prevalence of subtle and severe menstrual disturbances in exercising women: confirmation using daily hormone measures
Hum. Reprod., February 1, 2010; 25(2): 491 - 503.
[Abstract] [Full Text] [PDF]




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