Background: Coronary heart disease (CHD) in premenopausal women is rare. This may be related to the protective effect of endogenous estrogens on the female cardiovascular system. The aim of the study was to analyse the levels of sex hormones in premenopausal women with CHD confirmed by coronary angiography.
Methods: Thirty women aged 34–53 years and with a mean age of 46.3 ± 5.2 years were enrolled in the study. All were regularly menstruating, in the premenopausal period (i.e. with FSH < 15 IU/L and FSH > LH), with stable CHD and with significant atherosclerotic plaques in coronary angiography (narrowings > 50% of the lumen diameter). Of these, 80% had myocardial infarction in their histories. Estradiol plasma levels and gonadotrophic hormone (luteinising hormone LH and follicle-stimulating hormone FSH) plasma levels were measured in the women under investigation.
Results: A diminished estradiol level was diagnosed in 14 patients (46.7%) of the 30 premenopausal women examined (patients with hypoestrogenemia). In 12 women (40%) hypoestrogenemia was accompanied by diminished levels of gonadotrophins (hypoestrogenaemia of hypothalamic origin).
Conclusion: The plasma estradiol level was diminished in 46.7% of premenopausal women with CHD. Insufficient level of endogenous estradiol could have contributed to the early development of atherosclerotic plaques in the epicardial coronary arteries of the women examined.