What type of study is this?

This is a Systematic Review study.

September 5, 2025

L-Citrulline Supplementation in Postmenopausal Women: Evidence from Clinical Trials

Puntos clave

L-Citrulline supplementation significantly reduces systolic and diastolic blood pressure in postmenopausal women.
Improvements in flow-mediated dilation (FMD) were noted, enhancing endothelial function and nitric oxide availability.
Supplementation led to increased muscle oxygenation and strength, especially when combined with resistance training.
L-Citrulline also improved heart rate variability, indicating a favorable modulation of autonomic regulation.

Resumen

Introduction: Postmenopausal women are at heightened risk for cardiovascular and muscular health decline due to endothelial dysfunction, arterial stiffness, and reduced nitric oxide (NO) bioavailability. L-Citrulline, a precursor to L-arginine and NO, has emerged as a promising supplement to counter these age-related vascular and musculoskeletal impairments. Material and Methods: A systematic review of randomized controlled trials was conducted in accordance with PRISMA guidelines using PubMed, ScienceDirect, and Cochrane Library databases. Eligible studies assessed oral L-Citrulline supplementation in postmenopausal women, with outcomes categorized into: vascular function (blood pressure, flow-mediated dilation FMD, pulse wave velocity PWV); muscle function and oxygenation (tissue saturation index TSI, oxy-/deoxyhemoglobin O₂Hb/HHb, strength, lean mass, exercise performance); and autonomic regulation (heart rate variability HRV). Methodological quality was evaluated using the Cochrane Risk of Bias Tool 2.0. Results: L-Citrulline supplementation, administered in doses ranging from 6 to 10 g/day over 4–8 weeks, significantly improved cardiovascular outcomes, including reductions in brachial and aortic systolic/diastolic blood pressure, pulse pressure, and augmentation index. Flow-mediated dilation (FMD) improved by up to 2.7%, and nitric oxide availability increased, indicating enhanced endothelial function. Additionally, L-Citrulline improved muscle oxygenation during exercise, increased leg lean mass and strength when combined with low-intensity resistance training, and favorably modulated autonomic function through improved heart rate variability. Conclusion: L-Citrulline supplementation demonstrates substantial potential for improving vascular health, enhancing muscle oxygenation and strength, and restoring autonomic balance in postmenopausal women. These findings support its use as a non-pharmacological strategy to mitigate age-related declines in cardiovascular and muscular function.

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