Systemic and renal hemodynamic changes in the luteal phase of the menstrual cycle mimic early pregnancy

Abstract

Blood pressure decreases during early pregnancy in association with a decrease in peripheral vascular resistance and increases in renal plasma flow and glomerular filtration rate. These early changes suggest a potential association with corpora lutea function. To determine whether peripheral vasodilation occurs following ovulation, we studied 16 healthy women in the midfollicular and midluteal phases of the menstrual cycle. A significant decrease in mean arterial pressure in the midluteal phase of the cycle (midfollicular of 81.7 ± 2.0 vs. midluteal of 75.4 ± 2.3 mmHg, P< 0.005) was found in association with a decrease in systemic vascular resistance and an increase in cardiac output. Renal plasma flow and glomerular filtration rate increased. Plasma renin activity and aldosterone concentration increased significantly in the luteal phase accompanied by a decrease in atrial natriuretic peptide concentration. Serum sodium, chloride, and bicarbonate concentrations and osmolarity also declined significantly in the midluteal phase of the menstrual cycle. Urinary adenosine 3′,5′-cyclic monophosphate (cAMP) excretion increased in the luteal compared with the follicular phase, whereas no changes in urinary cGMP or NO2/NO3excretion were found. Thus peripheral vasodilation occurs in the luteal phase of the normal menstrual cycle in association with an increase in renal plasma flow and filtration. Activation of the renin-angiotensin-aldosterone axis is found in the luteal phase of the menstrual cycle. These changes are accompanied by an increase in urinary cAMP excretion indicating potential vasodilating mediators responsible for the observed hemodynamic changes.

Activation of the renin-angiotensin-aldosterone system in mares around ovulation

“…As a result, there are increased circulating concentrations of these hormones in women (Chapman et al 1997;Chidambaram et al 2002;Szmuilowicz et al 2006). In addition, it has been doi: 10.17221/32/2016-CJAS demonstrated that plasma REN, ANG, and ALD concentrations differ between the different phases of the estrous or the menstrual cycle (Szmuilowicz et al 2006).…”

“…In normotensive women, elevated concentrations of REN and ALD have been described in the luteal phase of the menstrual cycle compared with the follicular phase (Sealey et al 1994;Chapman et al 1997;Chidambaram et al 2002). However, a proportional increase in ANG concentration was not found.…”

“…However, a proportional increase in ANG concentration was not found. Because of this finding, Chapman et al (1997) and Chidambaram et al (2002) considered that the rise in ALD concentrations during the luteal phase could result from other pathways rather than from the activation of the RAAS. A sustained secretion of progesterone by the corpus luteum might be the main source of REN and ALD during the luteal phase (Chapman et al 1997;Chidambaram et al 2002).…”

“…It is currently unknown whether mares also present an activation of this system during the estrous cycle. As described before, the RAAS during the estrous cycle has been thoroughly evaluated in primates and non-primate animals and women (Harewood et al 1996;Chapman et al 1997;Chidambaram et al 2002;Szmuilowicz et al 2006;Sneeringer et al 2011), but not in mares.…”

Sex Hormones and Vascular Function

“…Observational studies have demonstrated that BP is lower when E 2 levels peak during the luteal phase than when they are at their nadir during the follicular phase of the menstrual cycle (Dunne et al, 1991;Karpanou et al, 1993;Chapman et al, 1997). Menopause is associated with a significant increase in BP in cross-sectional studies (Staessen et al, 1998).…”