The relationship between endocrine organs and stroke is most apparent for the sex hormones. Stroke is the third leading cause of death in adulthood and coincides with a time of hormonal transition, particularly for women. Although estrogen has numerous beneficial effects on the vasculature, these are offset by a procoagulant effect. The risk of venous thrombosis and stroke is increased with pregnancy, the puerperium, and estrogen administration. Clinical trials of menopausal estrogen therapy have not been shown to reduce vascular events in primary or secondary prevention trials, and national guidelines advise against their use for this purpose. Testosterone has beneficial effects on lipid profiles, insulin resistance, and obesity that could be beneficial, but no clinical trials data of andropausal testosterone therapy are available. Stroke also occurs as a complication of excessive hormone use, such as ovarian stimulation with infertility and anabolic steroid abuse.
Relationship Disclosure: Dr Sila has received personal compensation for activities with Bristol-Myers Squibb Company and sanofi-aventis.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Sila has nothing to disclose.