An elevated thrombotic risk due to abnormal fibrinolysis might be associated with insulin resistance in postmenopause. The aim of this study was to investigate the association of insulin resistance with a biochemical marker of fibrinolysis as well as the effect of transdermal estrogen treatment (ET) on this association.Thirty postmenopausal hysterectomized women received transdermal estradiol during 3 months. 17Beta-estradiol, FSH, LH, plasminogen activator inhibitor type 1 (PAI-1), insulin and glucose were measured in blood samples before and after ET. Insulin resistance was calculated by the use of the homeostasis model assessment for insulin resistance (HOMA-IR).ET induced a significant decrement in both PAI-1 levels and HOMA-IR values. The study also showed that HOMA-IR was a significant predictor for PAI-1 concentrations.Short-term ET improved HOMA-IR values in parallel with a decrease in PAI-1 levels.2007 S. Karger AG, Basel