Estrogen, Progesterone, and Vascular Reactivity: Potential Cellular Mechanisms*

FEMALE hormones are broadly recognized as affecting susceptibility to vascular disease, yet comparatively little is known about the cellular mechanisms by which they exert their effects. While clinical and epidemiological data support a protective effect of estrogen on cardiovascular function, a female predominance in other vascular disorders suggests that sex steroids influence the pathogenesis of vascular disease as well. Most of the literature on cellular effects of estrogen and progesterone has emerged from studies in the breast, uterus, and brain. Whether similar mechanisms occur in the vasculature and influence susceptibility to vascular disease is largely unknown. The purpose of this review is to provide a framework for identifying the mechanisms by which female sex steroids influence vascular function. A diverse literature encompassing clinical observations, whole animal, isolated vessel, and cell culture studies has been incorporated in the hopes of providing a common basis for considering the influences of the female sex steroids on the vascular system.