Endogenous sex hormones in women with ischemic stroke

The aim of this case-control study was to test the hypothesis that women with ischemic stroke exhibit changes in their sex hormone concentrations. Cases were 149 consecutive female patients with acute ischemic stroke. Fifty-one of these were examined after 6 months. Controls were 80 healthy women at the same age. Stroke severity was assessed on the Scandinavian Stroke Scale and infarct size by computed tomographic scan. Mean serum 17 beta-estradiol was 76 +/- 5 pmol/l (SEM) in stroke patients and 52 +/- 5 pmol/l in controls (p < 0.0001); the respective values of serum testosterone were 1.58 +/- 0.11 and 0.90 +/- 0.07 nmol/l (p < 0.0001). In stroke patients, high levels of 17 beta-estradiol and testosterone were significantly associated with stroke severity and infarct size, as well as with 6-month mortality. In a subgroup of patients, serum 17 beta-estradiol was not significantly changed after 6 months, whereas serum testosterone significantly decreased and was similar to the level in the controls. We conclude that serum concentrations of 17 beta-estradiol and testosterone are associated with stroke severity and 6-month mortality. The present data do not address the question of causality.