Inhibition of adrenocortical responsiveness during progestin therapy

Leach, Robert B.; Margulis, R.R.

doi:10.1016/s0002-9378(16)34785-8

Cited by 20 publications

(5 citation statements)

References 6 publications

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“…Whether this increase in plasma corticosteroid levels influences the normal regulation of cortisol secretion has been a matter of controversy. Several investigators have reported a decreased response to metyrapone in subjects taking the combined pill, and suggested that this indicated interference with the ACTH release mechanism (Leach and Margulis, 1965;Ansari and Beck, 1969). Others have shown that oestrogens lessen the inhibition of 1 1p-hydroxylase activity whereby metyrapone acheves its effect, either by inducing increased 1 IS-hydroxylase in the adrenal cortex (Sprunt et al, 1968), or by accelerating hepatic conjugation of metryrapone itself (Meikle et al, 1970).…”

Section: Discussionmentioning

confidence: 99%

“…This may lead to interference with the normal homeostatic control of cortisol secretion which is regulated with reference to the free cortisol level (Kawai and Yates, 1966). It has been suggested that there is, in fact, a degree of suppression of corticotrophin (ACTH) secretion by the pituitary in patients receiving the combined pill (Leach and Margulis, 1965;Ansari and Beck, 1969), and that this is probably due to the progestogen component (Ansari and Beck, 1969). There are three principal physiological determinants of cortisol secretion.…”

mentioning

confidence: 99%

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Hypothalamo‐pituitary‐adrenal Function During Oral Contraceptive Therapy With Combined Preparations Oestrogen‐progestogen and Progestogen‐only Preparations

Daly

Elstein

1972

BJOG

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Summary Plasma corticosteroid levels and the urinary excretion of 17‐0x0 and 17‐oxogenic steroids have been determined in a group of healthy women taking combined oestrogen‐progestogen oral contraceptives. The results have been compared with those obtained in untreated patients and in a group taking preparations containing only progestogens (the mini pill). The marked changes produced by the combined preparations are not seen with the mini pill which does not appear to affect cortisol metabolism. Dynamic tests of hypothalamo‐pituitary‐adrenal function (the assessment of the nyctohemeral rhythm of plasma corticosteroids and urinary free cortisol, ACTH stimulation, insulin‐hypoglycaemia and dexamethasone suppression tests) showed no abnormality in patients taking either the combined pill or the mini pill.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Hypothalamo‐pituitary‐adrenal Function During Oral Contraceptive Therapy With Combined Preparations Oestrogen‐progestogen and Progestogen‐only Preparations

Daly

Elstein

1972

BJOG

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“…It must also be acknowledged that the dosage of estrogen utilized differed from that contained in the oral contraceptives studied here. In contrast, Mestman and colleagues [12,23], Leach and colleagues [13] and Wallach and colleagues [24] failed to demonstrate any differences in 24 h excretion of urinary 17-ketosteroids following ACTH infusion between women on oral contraceptive agents and normal control subjects. The investigators concluded that adrenocortical responses to ACTH in women on oral contraceptives were normal.…”

Section: I6)mentioning

confidence: 98%

“…There is also diminished adrenal responsiveness to metyrapone during estrogen use, possibly because of increased hepatic conjugation of metyrapone [11][12][13][14]. Different investigators have reported differences in adrenocortical responsiveness to ACTH in women taking estrogen [3,12,13]. Thus, the effects of oral contraceptives on adrenocortical function have not been delineated clearly.…”

Section: Introductionmentioning

confidence: 99%

Increased adrenocortical responsiveness to exogenous ACTH in oral contraceptive users

et al. 1986

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To evaluate the effects of changing steroid milieu on adrenocortical function, basal levels and responses of cortisol, 17-hydroxyprogesterone (17PO), androstenedione (A), dehydroepiandrosterone (DHEA), and testosterone to exogenous synthetic ACTH were investigated in six normal women during the early follicular (EF) and midluteal (ML) phases of the menstrual cycle and in five women on an oral contraceptive (OC) agent (35 micrograms ethinyl estradiol and 1 mg ethynodiol diacetate, Demulen). Baseline serum steroid and cortisol binding globulin (CBG) levels were measured on days 3-7 and 21-23 of the menstrual cycle in the normal subjects and on days 3-7 of OC treatment cycles. ACTH stimulation (10 micrograms m-2 i.v. bolus) was performed following dexamethasone suppression (0.5 mg p.o. q 6 h X 4). Basal levels of cortisol and CBG as well as cortisol responses to ACTH were increased in OC users relative to normal women tested during both the EF and ML phases of the cycle. In addition, 17PO levels were increased during the ML phase both before and following dexamethasone suppression compared to levels present in the EF phase and in OC users, no doubt because of increased ovarian steroidogenesis.

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“…The production of androgen by the adrenal gland and the ovaries is, in turn, regulated by the pituitary gland. However, there is research which suggests that progesterone has an inhibitory effect on the pituitary gland (Leach & Margulis, 1965). Since the pituitary gland secretes hormones that control the activity of the adrenal glands and gonadotropic substances that regulate activities of the ovaries, any suppression of the effects of the pituitary gland ultimately affects the production of androgen in women.…”

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confidence: 99%

The menstrual cycle and response to erotic literature.

Abramson¹,

Repczynski²,

Merrill³

1976

Journal of Consulting and Clinical Psychology

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This study focuses upon the relationship between the phase of the menstrual cycle and sexual arousability. One hundred thirty-three women participated in an experiment that induced sexual arousal by means of an erotic story. The independent factors were use of contraceptive pills (combined type) versus no contraceptive pills and the phase of the menstrual cycle. The greatest degree of sexual arousal and genital sensations to the erotic stimuli was experienced by women on contraceptive pills who were in the menstrual phase of the menstrual cycle. The least degree of sexual arousal and genital sensations to the erotic stimuli was also experienced by women on contraceptive pills, those in the premenstrual phase of the menstrual cycle.

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Inhibition of adrenocortical responsiveness during progestin therapy

Cited by 20 publications

References 6 publications

Hypothalamo‐pituitary‐adrenal Function During Oral Contraceptive Therapy With Combined Preparations Oestrogen‐progestogen and Progestogen‐only Preparations

Hypothalamo‐pituitary‐adrenal Function During Oral Contraceptive Therapy With Combined Preparations Oestrogen‐progestogen and Progestogen‐only Preparations

Increased adrenocortical responsiveness to exogenous ACTH in oral contraceptive users

The menstrual cycle and response to erotic literature.

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