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Autonomic control of body temperature and blood pressure: influences of female sex hormones

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Abstract

Female reproductive hormones exert important non-reproductive influences on autonomic regulation of body temperature and blood pressure. Estradiol and progesterone influence thermoregulation both centrally and peripherally, where estradiol tends to promote heat dissipation, and progesterone tends to promote heat conservation and higher body temperatures. Changes in thermoregulation over the course of the menstrual cycle and with hot flashes at menopause are mediated by hormonal influences on neural control of skin blood flow and sweating. The influence of estradiol is to promote vasodilation, which, in the skin, results in greater heat dissipation. In the context of blood pressure regulation, both central and peripheral hormonal influences are important as well. Peripherally, the vasodilator influence of estradiol contributes to the lower blood pressures and smaller risk of hypertension seen in young women compared to young men. This is in part due to a mechanism by which estradiol augments beta-adrenergic receptor mediated vasodilation, offsetting alpha-adrenergic vasoconstriction, and resulting in a weak relationship between muscle sympathetic nerve activity and total peripheral resistance, and between muscle sympathetic nerve activity and blood pressure. After menopause, with the loss of reproductive hormones, sympathetic nerve activity, peripheral resistance and blood pressure become more strongly related, and sympathetic nerve activity (which increases with age) becomes a more important contributor to the prevailing level of blood pressure. Continuing to increase our understanding of sex hormone influences on body temperature and blood pressure regulation will provide important insight for optimization of individualized health care for future generations of women.

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Acknowledgements

The authors wish to thank the many colleagues and trainees who have supported our work in this area over many years, as well as the patience and enthusiasm of the research volunteers, who always make our work days fun. The authors’ work represented in this review was primarily supported by NIH HL 83947.

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Correspondence to Nisha Charkoudian.

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Dr. Charkoudian is an employee of the U.S. Department of Defense. The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official United States Department of the Army position, or decision, unless so designated by other official documentation. Approved for public release; distribution unlimited.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Charkoudian, N., Hart, E.C.J., Barnes, J.N. et al. Autonomic control of body temperature and blood pressure: influences of female sex hormones. Clin Auton Res 27, 149–155 (2017). https://doi.org/10.1007/s10286-017-0420-z

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