Title: Effect of Norplant implants on the pituitary-adrenal axis function and reserve capacity.

POPLINE Document Number: 120522

Author(s):

Toppozada MK
Ramadan M
El-Sawi M
Mehanna MT
Khamis Y
Marzouk S

Source citation:

CONTRACEPTION, 1997 Jan;55(1):7-10.

Abstract:

To ensure that Norplant contraceptive implants are not associated with a risk of pituitary-adrenal suppression, a series of laboratory tests were conducted in 15 women both before and 6 months after Norplant insertion. Comparisons of hormonal profiles before and after Norplant insertion revealed a significant drop in morning serum cortisol levels (404.33 +or- 84.07 nmol/l vs. 353.67 +or- 56.65 nmol/l, p < 0.05), but no significant change in evening readings. The observed changes in morning cortisol values were still within the normal range. Serum ACTH values and 24-hour urinary 17-hydroxy steroids, 17-ketogenic steroids, and 17-ketosteroids were not different after insertion compared to baseline. Before Norplant insertion, injection of synthetic ACTH resulted in a 259.59 +or- 169.53% increase in the mean level of serum cortisol 5 hours later; 6 months after Norplant insertion, the percent rise above baseline was 165.85 +or- 91.64%. The significantly lower adrenal response among Norplant users (although still within normal limits) is presumably due to a local inhibition of the adrenal itself and not of the hypothalamic-pituitary axis. Although these findings suggest a minimal suppressive effect of prolonged microdose release of levonorgestrel from Norplant implants, the suprarenal response to acute or prolonged stresses (e.g., surgical operations or shock) in Norplant users requires investigation.

Keywords:

Research Report
Clinical Research
Contraceptive Implants
Levonorgestrel
Endocrine Effects
Pituitary Hormones
Adrenal Cortex Hormones
Side Effects
Contraceptive Agents, Side Effects
Women
Research Methodology
Contraceptive Methods
Contraception
Family Planning
Contraceptive Agents, Progestin
Contraceptive Agents, Female
Contraceptive Agents
Endocrine System
Physiology
Biology
Hormones
Treatment
Demographic Factors
Population