Effect of estrogen replacement therapy with or without concomitant nonsteroidal anti-inflammatory drugs on pulsatility and resistance index of uterine arteries in healthy postmenopausal women.

OBJECTIVE

This study assesses the existence of a prostaglandin-mediated effect of estrogen on uterine arteries.

METHODS

The pulsatility index (PI) and the resistance index (RI) of 10 postmenopausal women aged 50 to 65 who had not been on estrogen replacement therapy (ERT) for the 6 weeks preceding the study were measured at baseline level (T1), after randomization for either placebo or nonsteroidal anti-inflammatory drug (NSAID) (600 mg of Sulindac for one day) (T2), after 1 week of washout and cross-over (T3). They were then supplemented with ERT (transdermal system 50 micrograms/d, twice a week, Systen) for a period of 3 months. PI and RI of uterine arteries were assessed again while using ERT (T4), after either placebo or NSAID for one day (T5) and after 1 week of placebo-NSAID cross-over (T6). Assays of total cholesterol as well as the HDL, HDL2, LDL, triglycerides, endothelin-1, lipoprotein (a), estradiol and FSH were also obtained at baseline before receiving ERT and after 3 months of ERT.

RESULTS

A small but significant increase of the PI was observed after NSAID intake as compared to the baseline measurement (P < .05), but no difference was observed for the RI. After estrogen treatment for 12 weeks, no difference was found between baseline measurements and the placebo intake or the NSAID intake.

CONCLUSION

These results do not confirm a modulation by prostaglandin of the estrogen cardioprotective effect, although it is possible that the study lacks power.