Respiratory Insufficiency in Postmenopausal Women: Conclusion

In: Respiratory

5 Sep 2014

Respiratory Insufficiency in Postmenopausal Women: ConclusionAlthough no change in BP was found after 2 weeks of MPA, there was a significant decrease of the systolic BP at the 3-week washout. This finding was not expected and there is a high likelihood of a random observation; however, cardiovascular effects have been monitored during MPA therapy with controversial results, but to our knowledge the washout period has not been followed up. Regensteiner et al found that neither estrogen nor MPA (60 mg/d for 1 week) alone had an effect on BP, whereas combination of the two hormones lowered the systolic and diastolic BP in normotensive postmenopausal women. asthma inhaler

Prelevic and Beljic reported that combining cyclic MPA (5 mg/d for 10 days) with estrogen increased the BP in healthy postmenopausal women. High doses of MPA (up to 400 to 800 mg/d) used in postmenopausal women for metastatic breast cancer increased BP. No change in BP was found in healthy women undergoing the menopause transition who were treated with oral estrogens and cyclic MPA (MPA 10 mg/d for 14 days). In subjects with high-altitude polycythemia, diastolic BP decreased with MPA in subjects with normal lung function but not in those with lung disease. Our result could be interpreted in line with the observation that hypercapnic BP response is greater during the luteal phase of the menstrual cycle. During hormone therapy, the MPA-induced BP increase is counteracted by low CO2, resulting in no change, whereas during the washout period, the BP decreases because MPA is withdrawn but the CO2 remains low.
MPA is known to improve arterial blood gases. Our results provide evidence that a therapeutically sufficient response could be achieved with intermittent MPA therapy in postmenopausal women with respiratory insufficiency. Mimicking the physiologic pattern of female hormone rhythmicity might result in better dynamic interactions with other hormones than what perhaps would be achieved with continuous administration. To whom, how, and how much remain to be answered.

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