Changes in NO signaling cascade with aging and the loss of estrogens. 1, NO is synthesized in the endothelium by eNOS using l-arginine as a substrate, where it then diffuses into the VSM. 2, Within the VSM, NO binds to sGC, which consists of two subunits, α and β. sGC catalyzes the conversion GTP to cyclic GMP. Cyclic GMP has multiple effects, which include: activation of phosphodiesterases (PDE), activation of cyclic GMP dependant ion channels. 3, Activation of cyclic GMP dependant protein kinase G (PKG). VASP is then phosphorylated at serine 239 by PKG. VASP is an established biochemical endpoint in the NO/cyclic GMP pathway in VSM, and is an index of defects in NO signaling and/or endothelial dysfunction. Aging combined with ovariectomy depressed sGC α1 and β1 expression, resulting in decreased phosphorylation of VASP, and consequently decreased relaxation in response to NO. E2 replacement blocked these changes. NC, No change; P, phosphorylation; PDE5, phosphodiesterose-5.