Low testosterone levels are associated with endothelial dysfunction in oophorectomized early postmenopausal women

Abstract

Background: The actual consequences of low testosterone levels in women remain uncertain. Objective: To assess endogenous testosterone influence on body composition, vascular and metabolic function in recent postmenopausal women. Design: We studied 81 postmenopausal women under transdermal estradiol (E 2 ) replacement therapy, 36 with bilateral oophorectomy (group O), and 45 controls (group C) through venous occlusion plethysmography, bioimpedance, DEXA, biochemical, hormonal, and inflammatory profile. Results: Total testosterone level (TT) in group O was 11.0 (4.0-17.75) vs 23.0 (10.0-42.5) ng/dl in group C (PZ0.001). Forearm blood flow, in ml/min/100 ml tissue, was lower in group O compared to group C at baseline (1.57 (1.05-2.47) vs 2.19 (1.59-2.66) PZ0.036), following reactive hyperemia response (endothelium-dependent flow mediated dilatation, 3.44 (2.38-4.35) vs 4.3 (3.09-5.52), PZ0.031) and following nitroglycerin (endothelium-independent dilation, 1.39 (0.99-1.7) vs 1.76 (1.15-2.0), PZ0.025), with a positive correlation between TT and all parameters except for the reactive hyperemia response (rZ0.233-0.312, PZ0.036-0.004). The sVCAM1 levels were negatively correlated with TT (rZ-0.320, PZ0.005). E 2 and other hormone levels, biochemical parameters and body composition did not differ between groups. Multiple linear regressions showed that the levels of TT, compared with other confounding variables, may explain the variation observed on endothelial parameters, with low explanatory power. Conclusion: The absence of ovarian testosterone production in recent postmenopausal oophorectomized women was associated with deleterious effects on endothelial function.

Sex differences in vascular aging in response to testosterone

“…These data are consistent with previous observations in postmenopausal women showing FAI was an independent predictor of changes in endothelial function, where a higher baseline FAI was associated with a greater reduction in FMD after 29 months of follow-up [65]. However, in contrast, other studies have shown that low endogenous testosterone was associated with reduced endothelial function measured via FMD in healthy postmenopausal women [66] and by plethysmography in oophorectomized early postmenopausal women taking hormone therapy [67].…”

Sexual Health in Menopause

“…Finally, it should be noted that hormone levels and vascular health represent two integrated systems, simultaneously acting in the maintenance of female genital tissues’ integrity. Consistently, recent evidence suggests that endogenous testosterone is able to influence body composition and vascular and metabolic function in recent postmenopausal women, and the absence of ovarian testosterone production in recent postmenopausal oophorectomized women seems correlated with deleterious effects on endothelial function [39].…”

Genomic and non-genomic effects of androgens in the cardiovascular system: clinical implications

“…In humans, low testosterone levels are associated with endothelial dysfunction [ 108 ], which can be reverted by testosterone therapy. The vascular function of male patients as examined by the vasomotor function of the brachial artery and intima-media thickness of the carotid artery demonstrated that low levels of testosterone are associated with endothelial dysfunction, independent of body mass index, presence of diabetes, hyperlipidaemia or hypertension and age [ 109 ].…”