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Kirby NV, Meade RD, Richards BJ, Notley SR, Kenny GP. Hormonal intrauterine devices and heat exchange during exercise. J Physiol 2024; 602:875-890. [PMID: 38367251 DOI: 10.1113/jp285977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/22/2024] [Indexed: 02/19/2024] Open
Abstract
Synthetic progestins in oral contraceptives are thought to blunt heat dissipation by reducing skin blood flow and sweating. However, whether progestin-releasing intrauterine devices (IUDs) modulate heat loss during exercise-heat stress is unknown. We used direct calorimetry to measure whole-body total (dry + evaporative) heat loss in young, physically active women (mean (SD); aged 24 (4) years,V ̇ O 2 peak ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{peak}}}}$ 39.3 (5.3) ml/kg/min) with (IUD; n = 19) and without (Control; n = 17) IUDs in the follicular and luteal phases of the menstrual cycle during light- and moderate-intensity exercise at fixed rates of heat production (∼175 and ∼275 W/m2 ) in 30°C, ∼21% relative humidity. Between-group and -phase differences were evaluated using traditional hypothesis testing and statistical equivalence testing within pre-determined bounds (±11 W/m2 ; difference required to elicit a ±0.3°C difference in core temperature over 1 h) in each exercise bout. Whole-body total heat loss was statistically equivalent between groups within ±11 W m-2 (IUD-Control [90% CIs]; Light: -2 [-8, 5] W/m2 , P = 0.007; Moderate: 0 [-6, 6] W/m2 , P = 0.002), as were dry and evaporative heat loss (P ≤ 0.023), except for evaporative heat loss during moderate-intensity exercise (equivalence: P = 0.063, difference: P = 0.647). Whole-body total and evaporative heat loss were not different between phases (P ≥ 0.267), but dry heat loss was 3 [95% CIs: 1, 5] W/m2 greater in the luteal phase (P ≤ 0.022). Despite this, all whole-body heat loss outcomes were equivalent between phases (P ≤ 0.003). These findings expand our understanding of the factors that modulate heat exchange in women and provide valuable mechanistic insight of the role of endogenous and exogenous female sex hormones in thermoregulation. KEY POINTS: Progestin released by hormonal intrauterine devices (IUDs) may negatively impact heat dissipation during exercise by blunting skin blood flow and sweating. However, the influence of IUDs on thermoregulation has not previously been assessed. We used direct calorimetry to show that IUD users and non-users display statistically equivalent whole-body dry and evaporative heat loss, body heat storage and oesophageal temperature during moderate- and high-intensity exercise in a warm, dry environment, indicating that IUDs do not appear to compromise exercise thermoregulation. However, within IUD users and non-users, dry heat loss was increased and body heat storage and oesophageal temperature were reduced in the luteal compared to the follicular phase of the menstrual cycle, though these effects were small and unlikely to be practically meaningful. Together, these findings expand our understanding of the factors that modulate heat exchange in women and have important practical implications for the design of future studies of exercise thermoregulation.
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Affiliation(s)
- Nathalie V Kirby
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Brodie J Richards
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Fabunmi OA, Dludla PV, Nkambule BB. Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis. Front Cardiovasc Med 2023; 10:1127104. [PMID: 37180788 PMCID: PMC10167286 DOI: 10.3389/fcvm.2023.1127104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/09/2023] [Indexed: 05/16/2023] Open
Abstract
Background The use of oral contraceptives (OCs) is associated with an increased risk of cardiovascular events such as arterial and venous thrombosis (VTE). Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with low- and middle-income nations accounting for over three-quarter of CVD deaths. The aim of this systematic review is to provide a comprehensive synthesis of the available evidence on the link between OC use and CVD risk in premenopausal women and to further assess the role of geographic disparities in the reported prevalence of CVD risk in women on OCs. Methods A comprehensive search of databases such as MEDLINE, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition was conducted, right from the inception to the present, by using the EBSCOhost search engine. The Cochrane Central Register of Clinical trials (CENTRAL) was also searched to augment relevant sources of information. OpenGrey, which is a repository of information providing open access to bibliographical references, was searched and the reference list of the selected studies was also scanned. The potential risk of bias of the included studies was assessed using the modified Downs and Black checklist. Data analysis was performed using the Review Manager (RevMan) version 5.3. Results We included 25 studies that comprised 3,245 participants, of which 1,605 (49.5%) are OC users, while 1,640 (50.5%) are non-OC users. A total of 15 studies were included for meta-analysis, and the overall pooled estimates suggested a significant increase in the traditional cardiovascular risk variables [standardized mean difference (SMD) = 0.73, (0.46, 0.99) (Z = 5.41, p < 0.001)] and little to no difference in endothelial activation among OC users when compared with non-OC users [SMD = -0.11, (-0.81, 0.60) (Z = 0.30, p = 0.76)]. Europe [SMD = 0.03, (-0.21, 0.27), (Z = 0.25 p = 0.88)] had the least effect size, while North America had the highest effect size [SMD = 1.86, (-0.31, 4.04), (Z = 1.68 p = 0.09)] for CVD risk in OC users when compared with non-OC users. Conclusion The use of OCs suggests a significant increase in the prevalence of traditional cardiovascular risk variables with little to no difference in the risk of endothelial dysfunction when compared with non-OC users, and the magnitude of CVD risks varies across different geographical regions. Registration and protocol This systematic review was registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42020216169.
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Affiliation(s)
- Oyesanmi A. Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Physiology, Ekiti State University, Ado-Ekiti, Nigeria
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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3
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Province VM, Szeghy RE, Stute NL, Augenreich MA, Behrens CE, Stickford JL, Stickford ASL, Ratchford S. Tracking peripheral vascular function for six months in young adults following SARS-CoV-2 infection. Physiol Rep 2022; 10:e15552. [PMID: 36541342 PMCID: PMC9768737 DOI: 10.14814/phy2.15552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023] Open
Abstract
SARS-CoV-2 infection is known to instigate a range of physiologic perturbations, including vascular dysfunction. However, little work has concluded how long these effects may last, especially among young adults with mild symptoms. To determine potential recovery from acute vascular dysfunction in young adults (8 M/8F, 21 ± 1 yr, 23.5 ± 3.1 kg⋅m-2 ), we longitudinally tracked brachial artery flow-mediated dilation (FMD) and reactive hyperemia (RH) in the arm and hyperemic response to passive limb movement (PLM) in the leg, with Doppler ultrasound, as well as circulating biomarkers of inflammation (interleukin-6, C-reactive protein), oxidative stress (thiobarbituric acid reactive substances, protein carbonyl), antioxidant capacity (superoxide dismutase), and nitric oxide bioavailability (nitrite) monthly for a 6-month period post-SARS-CoV-2 infection. FMD, as a marker of macrovascular function, improved from month 1 (3.06 ± 1.39%) to month 6 (6.60 ± 2.07%; p < 0.001). FMD/Shear improved from month one (0.10 ± 0.06 AU) to month six (0.18 ± 0.70 AU; p = 0.002). RH in the arm and PLM in the leg, as markers of microvascular function, did not change during the 6 months (p > 0.05). Circulating markers of inflammation, oxidative stress, antioxidant capacity, and nitric oxide bioavailability did not change during the 6 months (p > 0.05). Together, these results suggest some improvements in macrovascular, but not microvascular function, over 6 months following SARS-CoV-2 infection. The data also suggest persistent ramifications for cardiovascular health among those recovering from mild illness and among young, otherwise healthy adults with SARS-CoV-2.
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Affiliation(s)
- Valesha M. Province
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Rachel E. Szeghy
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Nina L. Stute
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Marc A. Augenreich
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Christian E. Behrens
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Jonathon L. Stickford
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | | | - Stephen M. Ratchford
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
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4
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Eagan LE, Chesney CA, Mascone SE, Shenouda N, Ranadive SM. Interleukin-6 is higher in naturally menstruating women compared with oral contraceptive pill users during the low-hormone phase. J Appl Physiol (1985) 2021; 131:544-552. [PMID: 34138651 DOI: 10.1152/japplphysiol.00921.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Endogenous sex hormone concentrations vary between healthy naturally menstruating (non-OCP) and oral contraceptive pill-using (OCP) women, as well as across cycles. The aim of this study was to investigate potential differences in concentrations of inflammatory cytokine interleukin-6 (IL-6) and vasoconstrictive substance endothelin-1 (ET-1) and measures of vascular function among relatively lower- and higher-hormone phases of non-OCP and OCP women. Concentrations of estrogen, progesterone, IL-6, and ET-1 and measures of vascular function were collected in 22 women (22 ± 1 yr, OCP: n = 12) during the early follicular (EF, ≤5 days of menstruation onset) and early luteal (EL, 4 ± 2 days postovulation) phases of non-OCP subjects and were compared to the placebo pill (PP, ≤5 days of PP onset) and active pill (AP, ≤5 days of highest-dose AP) phases of OCP subjects. Vascular function was assessed via brachial artery flow-mediated dilation (%FMD). Concentrations of endogenous estrogen and progesterone were higher in the EL phase compared with the EF phase of non-OCP (P = 0.01) but were similar between phases of OCP (P > 0.05). IL-6 was higher in non-OCP during the EF phase compared with the EL phase (P = 0.03) as well as compared with OCP during the PP phase (P = 0.002) but was similar between groups during the EL and AP phases, respectively (P > 0.05). Concentrations of ET-1 and measures of %FMD were similar between groups and unaffected by phase (P > 0.05). Thus, there exists variation in inflammation between young, healthy non-OCP and OCP women during the lower-hormone phase, despite similarities in vascular function and concentrations of ET-1 between groups and phases.NEW & NOTEWORTHY We demonstrate that despite having similar macrovascular function and concentrations of the vasoconstrictive substance endothelin-1 (ET-1) healthy naturally menstruating women display higher concentrations of circulating IL-6 during the lower-hormone phase of their menstrual cycle compared with 1) the higher-hormone phase of their menstrual cycle and 2) the lower-hormone phase of healthy women using oral contraceptive pills.
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Affiliation(s)
- Lauren E Eagan
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Catalina A Chesney
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Sara E Mascone
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, Delaware
| | - Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
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5
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High-sodium diet does not worsen endothelial function in female patients with postural tachycardia syndrome. Clin Auton Res 2021; 31:563-571. [PMID: 33689063 DOI: 10.1007/s10286-021-00772-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/13/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Postural tachycardia syndrome (POTS), a syndrome characterized by orthostatic symptoms and a heart rate increase of at least 30 beats per minute in the absence of hypotension upon standing, is often accompanied by increased sympathetic activity and low blood volume. A common non-pharmacologic recommendation for patients with POTS is a high-sodium (HS) diet with the goal of bolstering circulating blood volume. The objective of this study is to assess the effects of 6 days of a HS diet on endothelial function in POTS. METHODS A total of 14 patients with POTS and 13 age-matched healthy controls, all females, were studied following 6 days on a low-sodium (LS) diet (10 mEq/day) and 6 days on a HS diet (300 mEq/day) in a crossover design. We measured endothelial function following reactive hyperemia in the brachial artery using flow-mediated dilation (FMD), leg blood flow (LBF) using strain gauge plethysmography in the calf, and reactive hyperemic index (RHI) in the microcirculation of the hand using pulsatile arterial tonometry. RESULTS On the LS diet, FMD% did not differ between patients with POTS and the healthy controls although peak brachial artery diameter was lower for the patient group. RHI was higher for the patient group than for the controls, but there were no differences in post-ischemic LBF increase. On the HS diet, there were no between-group differences in FMD%, LBF increase, or RHI. CONCLUSION In summary, a HS diet for 6 days did not induce endothelial dysfunction. This non-pharmacologic treatment used for patients with POTS does not negatively affect endothelial function when used for a sub-acute duration. TRIAL REGISTRATION ClinicalTrials.gov NCT01550315; March 9, 2012.
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Turner CG, Stanhewicz AE, Wong BJ. Female Sex Hormone Effects on the Vasculature: Considering the Validity of Restricting Study Inclusion to Low-Hormone Phases. Front Physiol 2020; 11:596507. [PMID: 33192613 PMCID: PMC7652897 DOI: 10.3389/fphys.2020.596507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022] Open
Abstract
Many studies of vascular function limit the testing of premenopausal female participants to periods when female sex hormones, either endogenous or exogenous, are at their lowest concentration. This practice, when not part of the specific research question, may limit data surrounding the predominant physiological state of premenopausal females and pose a threat to external validity. In this Perspective, we briefly review the literature on the effect of female sex hormones on vascular function and discuss when limiting experimental testing to a certain phase of the menstrual cycle (MC) or oral contraceptive (OC) use may be appropriate. The goal of this Perspective is to open a dialog that may enhance data validity and the overall understanding of vascular function in premenopausal females.
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Affiliation(s)
- Casey G Turner
- Cutaneous Microvascular and Sensory Nerve Function Laboratory, Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States
| | - Anna E Stanhewicz
- Microvascular Physiology Laboratory, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - Brett J Wong
- Cutaneous Microvascular and Sensory Nerve Function Laboratory, Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States
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7
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Williams JS, MacDonald MJ. Influence of hormonal contraceptives on peripheral vascular function and structure in premenopausal females: a review. Am J Physiol Heart Circ Physiol 2020; 320:H77-H89. [PMID: 33164574 DOI: 10.1152/ajpheart.00614.2020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hormonal contraceptives are one of the most widely used prescriptions for premenopausal women worldwide. Although the risk of venous and arterial cardiovascular events (e.g., deep vein thrombosis, arterial clotting) with hormonal contraceptives, specifically oral contraceptive pills, has been established, the literature on early risk indicators, such as peripheral vascular structure and function has yet to be consolidated. The purpose of this review is to summarize literature examining the impact of different hormonal contraceptives on vascular function and structure, including consideration of phasic differences within a contraceptive cycle, and to propose future directions for research. It is evident that hormonal contraceptive use appears to impact both macrovascular and microvascular endothelial function, with phasic differences in some contraceptive types dependent on progestin type, the ratio of ethinyl estradiol-to-progestin, and route of administration. However, hormonal contraceptives do not appear to impact smooth muscle function in the macrovasculature or microvasculature, arterial stiffness, or vascular structure. Underlying mechanisms for observed impacts and areas of future research are discussed. This review provides timely consolidation of research examining hormonal contraceptives and peripheral vascular function and structure and provides guidance on considerations for hormonal contraceptive use in study design.
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Affiliation(s)
- Jennifer S Williams
- Vascular Dynamics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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8
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O’Brien MW, Johns JA, Al-Hinnawi A, Kimmerly DS. Popliteal flow-mediated dilatory responses to an acute bout of prolonged sitting between earlier and later phases of natural menstrual and oral contraceptive pill cycles. J Appl Physiol (1985) 2020; 129:637-645. [DOI: 10.1152/japplphysiol.00424.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We compared changes in popliteal artery endothelial function to a 3-h bout of sitting in females across their natural menstrual or oral contraceptive pill cycles. Pre-sitting endothelial-dependent vasodilation was greater in females who naturally menstruate during the later versus earlier phase but unchanged among contraceptive pill phases. Neither menstrual nor oral contraceptive pill phases attenuated the robust decline in conduit artery health following an acute period of uninterrupted sitting in young females.
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Affiliation(s)
- Myles W. O’Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jarrett A. Johns
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amera Al-Hinnawi
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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9
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Mattu AT, MacInnis MJ, Doyle‐Baker PK, Murias JM. Effects of the menstrual and oral contraceptive cycle phases on microvascular reperfusion. Exp Physiol 2019; 105:184-191. [DOI: 10.1113/ep088135] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Anmol T. Mattu
- Faculty of Kinesiology University of Calgary Calgary Alberta Canada
| | | | - Patricia K. Doyle‐Baker
- Faculty of Kinesiology University of Calgary Calgary Alberta Canada
- Faculty of Environmental Design University of Calgary Calgary Alberta Canada
| | - Juan M. Murias
- Faculty of Kinesiology University of Calgary Calgary Alberta Canada
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10
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Shenouda N, Priest SE, Rizzuto VI, MacDonald MJ. Brachial artery endothelial function is stable across a menstrual and oral contraceptive pill cycle but lower in premenopausal women than in age-matched men. Am J Physiol Heart Circ Physiol 2018; 315:H366-H374. [DOI: 10.1152/ajpheart.00102.2018] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Sex hormone concentrations differ between men, premenopausal women with natural menstrual cycles (NAT), and premenopausal women using oral contraceptive pills (OCP), as well as across menstrual or OCP phases. This study sought to investigate how differences in sex hormones, particularly estradiol, between men and women and across cycle phases might influence brachial artery endothelial function. Fifty-three healthy adults (22 ± 3 yr, 20 men, 15 NAT women, and 18 second-, third-, or fourth-generation OCP women) underwent assessments of sex hormones and endothelial [flow-mediated dilation (FMD) test] and smooth muscle [nitroglycerin (NTG) test] function. Men were tested three times at 1-wk intervals, and women were tested three times throughout a single menstrual or OCP cycle (NAT: menstrual, midfollicular, and luteal phases and OCP: placebo/no pill, “early”, and “late” active pill phases). Endogenous estradiol concentration was comparable between men and women in their NAT menstrual or OCP placebo phase ( P = 0.36) but increased throughout a NAT cycle ( P < 0.001). Allometrically scaled FMD did not change across a NAT or OCP cycle but was lower in both groups of women than in men ( P = 0.005), whereas scaled NTG was lower only in NAT women ( P = 0.001). Changes in estradiol across a NAT cycle were not associated with changes in relative FMD ( r2 = 0.01, P = 0.62) or NTG ( r2 = 0.09, P = 0.13). Duration of OCP use was negatively associated with the average relative FMD for second-generation OCP users only ( r = −0.65, P = 0.04). Our findings suggest that brachial endothelial function is unaffected by cyclic hormonal changes in premenopausal women but may be negatively impacted by longer-term use of second-generation OCPs. NEW & NOTEWORTHY We demonstrate that brachial artery flow-mediated dilation does not change across a menstrual or oral contraceptive pill cycle in premenopausal women but is lower in women than in men. Although unaffected by within-cycle changes in estradiol, brachial flow-mediated dilation is negatively correlated with duration of oral contraceptive pill use for second-generation pills. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/behind-the-bench-episode-2/ .
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Affiliation(s)
- Ninette Shenouda
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stacey E. Priest
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa I. Rizzuto
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Limberg JK, Peltonen GL, Johansson RE, Harrell JW, Kellawan JM, Eldridge MW, Sebranek JJ, Walker BJ, Schrage WG. Greater Beta-Adrenergic Receptor Mediated Vasodilation in Women Using Oral Contraceptives. Front Physiol 2016; 7:215. [PMID: 27375493 PMCID: PMC4896959 DOI: 10.3389/fphys.2016.00215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/23/2016] [Indexed: 11/25/2022] Open
Abstract
Background: β-adrenergic receptors play an important role in mitigating the pressor effects of sympathetic nervous system activity in young women. Based on recent data showing oral contraceptive use in women abolishes the relationship between muscle sympathetic nervous system activity and blood pressure, we hypothesized forearm blood flow responses to a β-adrenergic receptor agonist would be greater in young women currently using oral contraceptives (OC+, n = 13) when compared to those not using oral contraceptives (OC–, n = 10). Methods: Women (18–35 years) were studied during the early follicular phase of the menstrual cycle (days 1–5) or placebo phase of oral contraceptive use. Forearm blood flow (FBF, Doppler ultrasound) and mean arterial blood pressure (MAP, brachial arterial catheter) were measured at baseline and during graded brachial artery infusion of the β-adrenergic receptor agonist, Isoproterenol (ISO), as well as Acetylcholine (ACH, endothelium-dependent vasodilation) and Nitroprusside (NTP, endothelium-independent vasodilation). Forearm vascular conductance was calculated (FVC = FBF/MAP, ml/min/100 mmHg) and the rise in FVC from baseline during infusion quantified vasodilation (ΔFVC = FVCinfusion − FVCbaseline). Results: ISO increased FVC in both groups (p < 0.01) and ISO-mediated ΔFVC was greater in OC+ compared to OC– (Main effect of group, p = 0.02). Expressing data as FVC and FBF resulted in similar conclusions. FVC responses to both ACH and NTP were also greater in OC+ compared to OC–. Conclusions: These data are the first to demonstrate greater β-adrenergic receptor-mediated vasodilation in the forearm of women currently using oral contraceptives (placebo phase) when compared to those not using oral contraceptives (early follicular phase), and suggest oral contraceptive use influences neurovascular control.
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Affiliation(s)
| | | | | | - John W Harrell
- Department of Kinesiology, University of Wisconsin Madison, WI, USA
| | | | - Marlowe W Eldridge
- Department of Kinesiology, University of WisconsinMadison, WI, USA; Department of Pediatrics, University of WisconsinMadison, WI, USA
| | - Joshua J Sebranek
- Department of Anesthesiology, University of Wisconsin Madison, WI, USA
| | - Benjamin J Walker
- Department of Anesthesiology, University of Wisconsin Madison, WI, USA
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12
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Harvey RE, Hart EC, Charkoudian N, Curry TB, Carter JR, Fu Q, Minson CT, Joyner MJ, Barnes JN. Oral Contraceptive Use, Muscle Sympathetic Nerve Activity, and Systemic Hemodynamics in Young Women. Hypertension 2015; 66:590-7. [PMID: 26101348 PMCID: PMC4537364 DOI: 10.1161/hypertensionaha.115.05179] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/28/2015] [Indexed: 01/21/2023]
Abstract
Endogenous female sex hormones influence muscle sympathetic nerve activity (MSNA), a regulator of arterial blood pressure and important factor in hypertension development. Although ≈80% of American women report using hormonal contraceptives sometime during their life, the influence of combined oral contraceptives (OCs) on MSNA and systemic hemodynamics remains equivocal. The goal of this study was to determine whether women taking OCs have altered MSNA and hemodynamics (cardiac output and total peripheral resistance) at rest during the placebo phase of OC use compared with women with natural menstrual cycles during the early follicular phase. We retrospectively analyzed data from studies in which healthy, premenopausal women (aged 18-35 years) participated. We collected MSNA values at rest and hemodynamic measurements in women taking OCs (n=53; 25±4 years) and women with natural menstrual cycles (n=74; 25±4 years). Blood pressure was higher in women taking OCs versus those with natural menstrual cycles (mean arterial pressure, 89±1 versus 85±1 mm Hg, respectively; P=0.01), although MSNA was similar in both groups (MSNA burst incidence, 16±1 versus 18±1 bursts/100 heartbeats, respectively; P=0.19). In a subset of women in which detailed hemodynamic data were available, those taking OCs (n=33) had similar cardiac output (4.9±0.2 versus 4.7±0.2 L/min, respectively; P=0.47) and total peripheral resistance (19.2±0.8 versus 20.0±0.9 U, respectively; P=0.51) as women with natural menstrual cycles (n=22). In conclusion, women taking OCs have higher resting blood pressure and similar MSNA and hemodynamics during the placebo phase of OC use when compared with naturally menstruating women in the early follicular phase.
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Affiliation(s)
- Ronee E Harvey
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.).
| | - Emma C Hart
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Nisha Charkoudian
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Timothy B Curry
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Jason R Carter
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Qi Fu
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Christopher T Minson
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Michael J Joyner
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
| | - Jill N Barnes
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center (Q.F.); and Department of Human Physiology, University of Oregon, Eugene (C.T.M.)
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Ofojekwu MJN, Nnanna OU, Okolie CE, Odewumi LA, Isiguzoro IOU, Lugos MD. Hemoglobin and Serum Iron Concentrations in Menstruating Nulliparous Women in Jos, Nigeria. Lab Med 2013. [DOI: 10.1309/lmm7a0f0qbxeyssi] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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