Vascular Changes in Healthy Youngsters with and without Influence of Oral Contraception

Abstract

Introduction : Cardiovascular diseases are one of the leading causes of mortality worldwide. It is known to have a reduced incidence in premenopausal women compared to the opposite sex. This appears to be related to the female hormones and their fluctuation throughout the menstrual cycle. Objectives : To evaluate and correlate behavior patterns of cerebral dynamics and arterial reactivity throughout the menstrual cycle and to identify possible differences caused by the use of oral contraceptives (OC). Methods : The sample consisted of 21 healthy, eumenorrheic and non-smoking young womens, belonging to the 18-21 age group. There were two distinct groups: 11 in the group without oral contraceptive (SCO) and 10 in the oral contraceptive group (CCO). Both groups performed an evaluation in the menstrual phase (MP), from the 1st to the 4th day, and in the ovulatory phase (OP), from the 12th to the 16th day. The third evaluation was performed in the late luteal phase (LLP) from the 26th to the 30th day, in the SCO group and in the OC pause, from the 21st to the 28th day, in the CCO group. Four noninvasive procedures were performed: blood pressure measurement, axillary temperature, carotid and right brachial artery sonography. Results : There were no statistically significant differences in carotid parameters, however, there were variations in the velocity of the systolic peak (VPS) of the common carotid artery (CCA) and internal carotid artery (ICA) and the ICA resistance index (IR), throughout the cycle. The SCO group showed a significant increase in FMD from MF to OF (p = 0.023), decreasing in LL (p = 0.012). The CCO group demonstrated a relative stabilization of FMD values. In OP, there were statistically significant differences between the two groups in relation to the FMD value (p = 0.040). Conclusions : Cyclic fluctuations of estrogen appear to influence cerebral vascular impedance and arterial reactivity but in different proportions. In conclusion, this study supports the idea of standardizing the timing of vascular testing in a premenopausal woman.