The Association of Estrogen Replacement Therapy and the Raynaud Phenomenon in Postmenopausal Women

1 August 1998 | Volume 129 Issue 3 | Pages 208-211

Background: Hormonal factors may play an important role in the pathophysiology of the Raynaud phenomenon. Experimental studies have shown an increased vasoconstrictor response to estrogen, a response that can be prevented by the addition of progesterone.

Objective: To measure the association between estrogen replacement therapy (alone and with progesterone) and the Raynaud phenomenon.

Design: Cross-sectional study.

Setting: Framingham Offspring Study.

Participants: 497 postmenopausal women.

Measurements: Prevalence of the Raynaud phenomenon according to hormone use. Covariates measured included age, body mass index, smoking, alcohol consumption, and ß-blocker use.

Results: Forty-nine women were classified as having the Raynaud phenomenon (9.9%). The prevalence of this phenomenon was 8.4% among women who did not receive estrogen, 19.1% among women receiving estrogen alone, and 9.8% among women receiving estrogen plus progesterone. The adjusted odds ratio for the Raynaud phenomenon was 2.5 (95% CI, 1.2 to 5.3) for unopposed estrogen and 0.9 (CI, 0.3 to 2.6) for estrogen plus progesterone, with nonusers as the reference group.

Conclusions: Unopposed estrogen therapy was associated with the Raynaud phenomenon in postmenopausal women. This association was not present in women who were receiving combined hormone therapy.

Author and Article Information

From the Boston University Arthritis Center and Boston University Medical Center, Boston, Massachusetts; and the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Acknowledgments: The authors thank J. Coffman, MD, and J. Korn, MD, for their insight and advice; Bryan Besso for interviewing participants; and the staff and participants of the Framingham Offspring Study.
Grant Support: In part by National Institutes of Health grants AR20613 and AG09300, National Institutes of Health National Heart, Lung, and Blood Institute contract N01-HC-38038, and a Canadian Arthritis Society Research Fellowship (Dr. Fraenkel).
Requests for Reprints: Liana Fraenkel, MD, Boston University Arthritis Center, A203, 715 Albany Street, Boston, MA 02118.
Current Author Addresses: Drs. Fraenkel, Zhang, and Felson, Ms. Chaisson, and Mr. Evans: Boston University Arthritis Center, A203, 715 Albany Street, Boston, MA 02118.