Alpha-2 adrenergic activity in perimenopausal women

Non-Hormonal Replacement Therapy Regimens: Do they have an Effect on Cardiovascular Risk?

INTRODUCTION

Menopause is associated with adverse effects on quality of life of perimenopausal and post-menopausal women. It also has an impact on the development of cardiovascular disease (CVD). Hormonal treatments are the most effective medications for menopausal symptoms relief. Given the fact that hormonal treatments are contraindicated for many women, non-hormonal treatment, such as Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), gabapentin, pregabalin, clonidine and phytoestrogens, constitute alternative treatments. Nevertheless, little is known about their effects on CVD risk.

METHODS

PubMed, EMBASE and Cochrane Library were searched for the effects of non-hormonal treatment on CVD risk, blood pressure, heart rate, lipids and glucose concentrations, weight gain, cardiovascular events, stroke, mortality and morbidity.

RESULTS

Phytoestrogens, pregabalin and gabapentin seem to have no adverse effects on the cardiovascular system. Phytoestrogens, in particular, seem to reduce CVD risk through many pathways. On the other hand, SSRIs and SNRIs, although effective in reducing menopausal vasomotor symptoms, should be cautiously administered to women with known CVD (e.g. with cardiac arrhythmias, atherosclerotic disease or stroke). As clonidine has been associated with cardiovascular adverse effects, it should be administered only in cases where blood pressure regulation is mandatory.

CONCLUSION

Further research is needed to produce definite conclusions regarding the cardiovascular safety of non-hormonal medications for menopausal symptoms relief.

Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis-Part I

Ovarian hormones have a significant effect on the central nervous system of female migraineurs. Reproductive milestones such as menarche, pregnancy, and menopause are associated with changes in the clinical course of migraine headache. Migraine attacks are commonly triggered during declines in serum estrogen levels that occur before and during the time of menstruation. Therefore, substantial clinical evidence suggests that changes in ovarian hormones affect migraine headache. This represents the first of two manuscripts defining the role of ovarian hormones in the pathogenesis of migraine headache. The purpose of the first article will be to review the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine headache. The second manuscript will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.

Saliva level of free 3-methoxy-4-hydroxyphenylglycol (MHPG) as a biological index of anxiety disorders

To access the saliva level of free 3-methoxy-4-hydroxyphenylglycol (MHPG) as a biological index of anxiety disorders, gender- or age-dependent changes in saliva MHPG level in patients with anxiety disorders were investigated. Saliva MHPG levels in 196 normal volunteers (59 male, 137 female) and 42 outpatients with anxiety disorders (20 male, 22 female) at the initial consultation to the hospital were measured by gas chromatography-mass spectrometry. Saliva MHPG levels in patients were higher than those in normal subjects. The increase in saliva MHPG levels in male patients was greater than that in female patients. Age-associated increase in the saliva MHPG level was greater in patients than in normal subjects. Especially, a significant interaction of age vs. patient effect was found in female subjects (P=0.0005), but not in male subjects (P=0. 174). These data indicate that the measurement of saliva MHPG would be valuable for detecting pathological anxiety in male patients regardless of age and in older female patients, but not in younger female patients.

Postjunctional alpha2-adrenoceptors in the rat tail artery: effect of sex and castration

To investigate sex-related differences in vasoconstrictor responses to postjunctional alpha2-adrenoceptor activation, isolated ring segments of tail arteries from Fischer-344 rats were studied. Addition of the alpha2-adrenoceptor agonist, UK-14304 [5-bromo-6-(2-imidazoline-2yl)-aminol-quinoxaline], enhanced vasoconstriction to the selective alpha1-adrenoceptor agonist, methoxamine, in arteries from both males and females. The response to UK-14304 was significantly greater in arteries from males as compared to female arteries. Addition of alpha2-adrenoceptor antagonist, idazoxan or rauwolscine, shifted norepinephrine concentration response curves to the right. Antagonist effects also tended to be greater in arteries from males as compared to females. After gonadectomy, male-female differences persisted; thus, removal of sex hormones in either males or females did not alter responses to either agonists or antagonists of alpha2-adrenoceptors. These findings suggest that sex differences in alpha2-adrenoceptor function are not maintained by either male or female gonadal steroid hormones but may be developmentally regulated.