The effect of transient sex hormone fluctuations on vascular endothelial function

Am J Physiol Heart Circ Physiol. 2025 Jul 1;329(1):H217-H232. doi: 10.1152/ajpheart.00174.2025. Epub 2025 Jun 3.

Abstract

This review article summarizes the current literature investigating the effects of transient sex hormone fluctuations on large artery endothelial function, primarily concerning the menstrual cycle and the diurnal rhythm of testosterone secretion. Women and men experience acute fluctuations in circulating levels of sex hormones, and there is substantial variability in circulating levels of sex hormones in both sexes. These acute fluctuations in sex hormones generally coincide with alterations in endothelial cell function and in vivo endothelium-dependent vasodilation, and we see that the timing of these acute fluctuations matches the timing of cardiovascular events in both women and men. It is important to improve our understanding of how acute fluctuations in sex hormones affect endothelial function in women and men, as clinical cardiovascular complications coincide with these changes. This would allow for the identification of novel therapeutic targets and aid in the prevention and treatment of cardiovascular disease.

Keywords: endothelial function; endothelium; estrogen; progesterone; testosterone.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiovascular Diseases / physiopathology
  • Circadian Rhythm
  • Endothelium, Vascular* / metabolism
  • Endothelium, Vascular* / physiology
  • Endothelium, Vascular* / physiopathology
  • Female
  • Gonadal Steroid Hormones* / blood
  • Gonadal Steroid Hormones* / metabolism
  • Humans
  • Male
  • Menstrual Cycle*
  • Sex Factors
  • Testosterone / blood
  • Testosterone / metabolism
  • Vasodilation*

Substances

  • Gonadal Steroid Hormones
  • Testosterone