Endocrine enigmas: vascular health in females throughout the lifespan

It is well established that gonadal hormones, such as estrogen and progesterone, influence vascular function and structure. Premenopausal females experience fluctuations in these hormones during each menstrual cycle, transiently during pregnancy, and during the menopause transition; yet the impact of these hormonal fluctuations on vascular health remains something of an enigma. This review aims to unravel this enigma by 1) discussing how the exclusion of females in vascular research has influenced diagnoses of cardiovascular disease, and overall disease burden, 2) outlining the utility of subclinical markers of atherosclerosis for the early identification of cardiovascular disease, and 3) highlighting the changes in vascular function and structure that have been observed during the menstrual cycle, pregnancy, and menopause.