Circulating cortisol levels after exogenous cortisol administration are higher in women using hormonal contraceptives: data from two preliminary studies

Abstract

Exogenous cortisol administration has been used to test the influence of glucocorticoids on a variety of outcomes, including memory and affect. Careful control of factors known to influence cortisol and other endogenous hormone levels is central to the success of this research. While use of hormonal birth control (HBC) is known to exert many physiological effects, including decreasing the salivary cortisol response to stress, it is unknown how HBC influences circulating cortisol levels after exogenous cortisol administration. To determine those effects, we examined the role of HBC on participants’ cortisol levels after receiving synthetic cortisol (hydrocortisone) in two separate studies. In Study 1, 24 healthy women taking HBC and 26 healthy men were administered a 0.1 mg/kg body weight intravenous dose of hydrocortisone, and plasma cortisol levels were measured over 3 hours. In Study 2, 61 participants (34 women; 16 were on HBC) received a 15 mg hydrocortisone pill, and salivary cortisol levels were measured over 6 hours. Taken together, results from these studies suggest that HBC use is associated with a greater cortisol increase following cortisol administration. These data have important methodological implications: (1) when given a controlled dose of hydrocortisone, cortisol levels may increase more dramatically in women taking HBC vs. women not on HBC or men; and (2) in studies manipulating cortisol levels, women on hormonal contraceptives should be investigated as a separate group.

Reduction in the occurrence of distressing involuntary memories following propranolol or hydrocortisone in healthy women

“…Finally, although both studies tested healthy young women, participants differed in the use of contraceptive medication. Only 40% of participants in Rombold et al's (2016) study were using oral contraceptives (compared to 100% in the current study), and such participants might show a distinct response to the trauma film (Roche, King, Cohoon, & Lovallo, 2013) and to hydrocortisone (Gaffey, Wirth, Hoks, Jahn, & Abercrombie, 2014) relative to non-users.…”

Long‐term use of continuous subcutaneous hydrocortisone infusion therapy in patients with congenital adrenal hyperplasia

“…24,25 Women on OCP therapy show greater increase in cortisol levels following exogenous cortisol administration when compared to women not on OCP suggesting a role of OCP in cortisol metabolism. 26 As expected, we did note increases in total cortisol levels post-OCP initiation (approximately 45%). Unfortunately, free cortisol and salivary cortisol were not measured as part of this study.…”

“…The effects of increased cortisol at the tissue level are not seen as protein‐bound cortisol contributes to the rise in plasma cortisol . Women on OCP therapy show greater increase in cortisol levels following exogenous cortisol administration when compared to women not on OCP suggesting a role of OCP in cortisol metabolism . As expected, we did note increases in total cortisol levels post‐OCP initiation (approximately 45%).…”

Sex differences in salivary cortisol reactivity to the Trier Social Stress Test (TSST): A meta-analysis

“…Consistent sex differences exist in cortisol output in response to acute stress (see Zimmer et al, 2003), with most studies reporting higher cortisol output in men following the TSST (reviewed in Kudielka and Kirschbaum, 2005; for non-significant difference see, for example, Kelly et al, 2008). Following exogenous cortisol administration, women tend to show higher levels of glucocorticoids compared to men (Gaffey et al, 2014). Further, men tend to exhibit a significantly higher anticipatory cortisol response to stress relative to women (Engert et al, 2013;Kirschbaum et al, 1992).…”