Introduction: Menopause is linked to decreased vascular function and increased cardiovascular risk (1). Although exercise is cardioprotective, improving vascular health, post-menopausal women have shown a blunted response due to lower estrogen levels (2). Research has solely focused on endothelial cells, neglecting the role of smooth muscle cells (SMCs) in vascular function. While literature on the direct effects of estrogen on SMCs are conflicting, what is clear is the existence of estrogen receptors on SMCs (3). Additionally, estrogen appears to inhibit SMC proliferation (4,5).

Objective: This study investigated if exercise training and/or estradiol treatment improved wound healing in microvascular SMCs from early and late post-menopausal women. 

Methods: The study was approved by the ethics committee of Copenhagen (H-20037633) and conducted according to the Declaration of Helsinki. All participants were informed about the procedures and potential risks, both orally and in writing, with written informed consent obtained before enrollment. 

Early (1-5 years) and late (≥10 years) post-menopausal women not on hormone replacement therapy participated. Microvascular SMCs were isolated from muscle biopsies  of both early (n=7) and late (n=7) post-menopausal women, before and after an 8-week exercise regimen (aerobic interval training 3 times/week). Wound healing was assessed by scratching cultured SMCs and measuring wound closure at set time points (t=0, 4, and 24 post-wound infliction). An additional group were pre-incubated with 3.67 µM estradiol for 2 days prior to the wound healing assay.

Results: Basal wound healing was similar across groups. Estradiol pre-incubation had no independent effect. Exercise training improved wound healing profiles in both early and late post-menopausal groups. This improvement was significant in the late post-menopausal group with estradiol pre-treatment (P = 0.034). 

Conclusion: Preliminary data suggests exercise training improves the wound healing profile of SMCs, potentially indicating improved cellular health. This effect might be amplified when combined with estrogen therapy in late post-menopause.