Influence of Estrogens and Progesterone on the Venous System of the Lower Limbs in Women

Abstract

Treatments with estrogens and progestogens are suspected of causing vascular complications either directly or by metabolic consequences. Although many studies have demonstrated an increased incidence of arterial and deep venous thrombosis, since 1970 the dose of estrogens and progesterones have been lowered with a proportional lowering of side effects. After classification of estrogens and progestogens, we studied their peripheral vascular effects. In our study, we demonstrated that the effects of estroprogestogen treatment on the superficial venous system depend on the dose of estrogen and progestogen.

Vascular Actions of Estrogens: Functional Implications

“…As the venous wall is a key component of Virchow's triad required for the initiation of the thrombus ), more work is needed to understand how various estrogenic products affect both the endothelium and smooth muscle of veins to develop products with arterial protection but limited venous risks. Varicose veins represent a venous disorder that is associated with increases in circulating estrogen (Vin et al, 1992;Ciardullo et al, 2000). However, causality of this condition is complicated by various genetic components and physical factors such as obesity.…”

Chronic venous disease progression and modification of predisposing factors

“…The existence of positive family history and other factors such as orthostatism prolonged for Ͼ4 hours daily, 8 obesity, defined as a body mass index (BMI) Ͼ30 kg/m 2,6 ET, 14 and multiparity, 13 were considered as predisposing to CVD progression (Table I). We also documented preoperative ESU.…”

“…4 Several risk factors have been associated with the development of CVD, including older age, 5 female gender, 5,6 family history, 5,7 standing occupation, [8][9][10][11][12] obesity, 6,10-12 and multiparity. 7,10,12,13 However, other potential factors that may be involved in CVD progression have not been well studied, such as estrogen treatment (ET), 10,11,14 and warrant further investigation. On the other hand, although many studies have shown that elastic compression stockings are the keystone of CVD treatment in the context of symptom relief, 15 ulcer healing, 16 and antithrombotic prophylaxis, 17 limited evidence is present on supportive role of elastic stocking use (ESU) in the inhibition of CVD progression that is limited mainly to patients with post-thrombotic etiology.…”

Iliac vein stenting in postmenopausal leg swelling

“…Hormonal changes that occur with aging and menopause appear to have a role, but the precise mechanisms remain ill-defined. [1][2][3] Since prior history or features of chronic venous disease (CVD) is usually absent, a venous cause is seldom investigated. Although other menopausal symptoms may be present, 1,4 the leg swelling is a dominant feature in many patients seeking specific treatment.…”