Effects of menstrual cycle and menopause on internal carotid artery shear-mediated dilation in women

This study aimed to elucidate the effects of change in estrogen during the menstrual cycle and menopause on shear-mediated dilation of the internal carotid artery (ICA), a potential index of cerebrovascular endothelial function. Shear-mediated dilation of the ICA and serum estradiol were measured in 11 premenopausal (Pre-M, 21 +/- 1 yr), 13 perimenopausal (Peri-M, 49 +/- 2 yr), and 10 postmenopausal (Post-M, 65 +/- 7 yr) women. Measurements were made twice within the Pre-M group at their early follicular (EF, lower estradiol) and late follicular (LF, higher estradiol) phases. Shear-mediated dilation was induced by 3min of hypercapnia (target PETCO2 + 10 mmHg from individual baseline) and was calculated as the percent rise in peak diameter relative to baseline diameter. ICA diameter and blood velocity were simultaneously measured by Doppler ultrasound. In Pre-M, shear-mediated dilation was higher during the LF phase than during the EF phase (P < 0.01). Comparing all groups, shear-mediated dilation was reduced across the menopausal transition (P < 0.01), and Pre-M during the LF phase showed the highest value (8.9 +/- 1.4%) compared with other groups (Pre-M in EF, 6.4 +/- 1.1%; Peri-M, 5.5 +/- 1.3%; Post-M, 5.2 +/- 1.9%, P < 0.05 for all). Shear-mediated dilation was positively correlated with serum estradiol even after adjustment of age (P < 0.01, r= 0.55, age-adjusted; P = 0.02, r= 0.35). Collectively, these data indicate that controlling the menstrual cycle phase is necessary for the cross-sectional assessments of shear-mediated dilation of the ICA in premenopausal women. Moreover, current findings suggest that a decline in cerebrovascular endothelial function may be partly related to the reduced circulating estrogen levels in peri- and postmenopausal women. NEW & NOTEWORTHY The present study evaluated the effects of the menstrual cycle and menopause stages on the shearmediated dilation of the ICA, a potential index of cerebrovascular endothelial function, in pre-, peri-, and postmenopausal women. Shear-mediated dilation of the ICA was increased from the low- to high-estradiol phases in naturally cycling premenopausal women and was reduced with advancing menopause stages. Furthermore, lower estradiol was associated with reduced shear-mediated dilation of the ICA, independent of age.

Automated summary

This study found that shear-mediated dilation of the ICA is higher during the late follicular phase compared to the early follicular phase in premenopausal women. As menopause progresses, shear-mediated dilation decreases. Lower levels of estradiol are associated with reduced shear-mediated dilation of the ICA, regardless of age.