ABSTRACT
Adrenal function and its reserve capacity were studied in eighteen healthy non-lactating women who received depot-medroxyprogesterone acetate (DMPA: 9 subjects) and norethisterone enanthate (NET-EN: 9 subjects) as long-acting injectable contraceptives. Methodological assessments included: (i) morning fasting concentration of serum cortisol; (ii) diurnal variation of adrenal corticol activity as evidenced by cortisol concentration in serum samples taken at 0700 and 1600 hours; (iii) urinary free cortisol excretion; and (iv) cortisol response to insulin-induced hypoglycaemia. None of these assessments was significantly altered by contraceptive administration. This finding indicates that the subject's ability to release cortisol in response to a stressful situation, as well as to normal day-to-day activity, was not impaired by these contraceptive steroids.
PIP: Adrenal cortical function and its reserve capacity were studied in 9 women who received depot medroxyprogesterone acetate (DMPA) and in 9 women who received norethisterone enanthate (NET-EN) as long acting injectable contraceptives. Adrenal function was assessed by means of morning fasting concentration of serum cortisol, diurnal variation of adrenal corticol activity, and measurement of free urinary cortisol, and cortisol release in response to insulin-induced hypoglycemia. These assessments were made both prior to and at intervals after the initiation of contraceptive treatment. Data were combined and presented in 4 blocks: before treatment; 30 days after 1st injection; during treatment (data from 3rd, 4th, and 5th assessments); and after treatment (6th assessment made 6 months after the last injection). Neither the fasting concentration nor the circadian rhythm of cortisol were significantly altered by the use of either form of gestagens, not even when subjects were exposed to a relatively high level of these steroids during the first 30 days of their injection. It seems likely that the slight but insignificant decrease in the mean levels of cortisol following the introduction of gestagen injectable contraceptives is related primarily to reduction of the plasma binding protein. The mean level of free cortisolin 24-hour urine collections remained unchanged in both groups of subjects, confirming that adrenal function remained essentially unchanged in injectable contraceptive users.
