A comparative study of autonomic function tests in normotensive premenopausal and postmenopausal women

Abstract

|| ABSTRACT Background: Premenopause is a term that encompasses the entire reproductive period up to final menstrual period, whereas menopause is the permanent cessation of menstruation. Menopause is ‘‘burning out of ovaries.’’ After menopause, the primordial follicles become atretic; hence, the ovaries fail completely to produce estrogen. The presence of estrogen receptors in the heart, vascular smooth muscles, and autonomic brainstem centers establishes a probable participation in the regulation of cardiovascular system. Aims and Objective: To compare the autonomic function tests in premenopausal and postmenopausal women. Materials and Methods: The autonomic function tests in 60 premenopausal women (25–45 years) and 60 postmenopausal women (45–60 years) were compared. The following parameters were studied: (i) body mass index (BMI); (ii) waist–hip ratio (WHR); (iii) Parasympathetic function tests—(a) heart rate response to postural change (30:15 ratio), (b) heart rate variation during deep breathing, and (c) Valsalva maneuver test; and iv) sympathetic function tests—(a) orthostatic tolerance test, (b) sustained isometric handgrip test, and (c) cold pressor test. Result: (1) BMI and WHR significantly increased in the postmenopausal women when compared with the premenopausal women. (2) The 30:15 ratio significantly decreased in the postmenopausal women when compared with the premenopausal women whereas heart rate variation during deep breathing and Valsalva maneuver test did not show any significant change. (3) All the sympathetic function test results significantly increased in the postmenopausal women when compared with premenopausal women. Conclusion: This finding showed an increased tendency of obesity and autonomic imbalance with sympathetic overactivity in the postmenopausal women when compared with the premenopausal women.