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We thank Dr Tsuda1 for recognizing our work and bringing to light additional aspects of the complex effect of estrogen on sympathetic nerve activity and NO. Indeed, NO-synthase is well known to be upregulated by estrogen, and endothelial function (via flow-mediated dilation) is known to be improved during the high-estrogen phases of the menstrual cycle.2,3 We have recently shown that transdermal estrogen in young women improves …

Response to Roles of Sex Steroid Hormones and Nitric Oxide in the Regulation of Sympathetic Nerve Activity in Women