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Hum. Reprod. Advance Access published online on June 28, 2006
Human Reproduction, doi:10.1093/humrep/del245
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received February 15, 2006
Revised April 6, 2006
Accepted April 14, 2006

Article

Differential effects of oral conjugated equine estrogen and transdermal estrogen on atherosclerotic vascular disease risk markers and endothelial function in healthy postmenopausal women

Jason Yen-Ping Ho 1, Ming-Jer Chen 2, Wayne Huey-Herng Sheu 3, Yu-Chiao Yi 4, Andy Chi-Wei Tsai 5, Hwa-Fen Guu 5, and Esther Shih-Chu Ho 4 *

1 Department of Obstetrics and Gynecology, Taichung, Taiwan; Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan; Central Taiwan University of Science and Technology, Taichung, Taiwan
2 Department of Obstetrics and Gynecology, Taichung, Taiwan; School of Medicine, National Yang Ming University, Taipei, Taiwan
3 Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan; 5Chung Shan Medical University, Taichung, Taiwan
4 Department of Obstetrics and Gynecology, Taichung, Taiwan; Chung Shan Medical University, Taichung, Taiwan
5 Department of Obstetrics and Gynecology, Taichung, Taiwan

* To whom correspondence should be addressed.
Esther Shih-Chu Ho, E-mail: bamboo{at}vghtc.gov.tw


  Abstract

BACKGROUND: Recent studies have revealed that HRT may increase the risk for atherosclerotic vascular disease (ASVD). METHODS: We investigated the effects of HRT via different administration routes on the markers for ASVD and endothelial function in healthy postmenopausal women. The oral HRT group (n = 18) received conjugated equine estrogen 0.625 mg/day; the transdermal HRT group (n = 18) received 17{beta}-estradiol (E2) gel 0.6 mg/day for 6 months. The control group (n = 30) had no treatment for 6 months. RESULTS: The C-reactive protein (CRP) rose from 0.129 ± 0.116 to 0.752 ± 0.794 mg/dl (P < 0.01) in the oral HRT group but remained unchanged in the transdermal HRT and control groups. The flow-mediated vasodilation (FMD) in the brachial artery was increased significantly by HRT from 6.0% before oral HRT to 14.7% after oral HRT (P < 0.001) and from 5.9% before transdermal HRT to 13.9% after transdermal HRT (P = 0.001). CONCLUSIONS: These data suggest that oral estrogen induces ASVD risk by increasing acute inflammation; however, transdermal estrogen avoids this untoward effect. Additionally, transdermal estrogen exerts a positive effect on endothelial function similar to that of oral estrogen. Therefore, the transdermal route might be favourable in terms of ASVD risks.

Keywords: atherosclerotic vascular disease/C-reactive protein/estrogen/homocysteine/vasodilation.
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