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Heavy legs and hormone replacement therapy Volume 12, issue 7, Août - Septembre 2000

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  • Page(s) : 433-9
  • Published in: 2000

Between 25% and 50% of European adults and up to 80% in high risk sub-groups, complain of heavy legs, with or without chronic venous insufficiency. The number of women to whom hormonal substitution is or could be prescribed increases along with age and better knowledge of potential benefits. Because of the high prevalence of chronic venous insufficiency of the legs and its increasing incidence with age, there is a need for a better understanding of the vascular effects of sexual hormones. The effects of estrogens and progesterones on veins and circulation have been studied since prescription of these hormones as oral contraception and the description of related thromboembolic events. The identification of different receptors and their location in venous walls have helped to understand some of the hormonal effects. The distribution, the density and the receptor types vary with age, gender, hormonal status and vascular bed. Progesterone mainly reduces the tone of venous walls, whereas estrogens have variable effects. The life expectancy is not affected by a deterioration of chronic venous insufficiency. In contrast, the quality of life, morbidity and the cost of treatment are dramatically affected. In addition, the increased risk of thromboembolic events has to be considered, as shown in recent studies. These findings underline the need for further studies on the relations between hormones and venous function and for caution when prescribing hormonal substitution.