EFFECT OF NORPLANT(R) IMPLANTS ON THE PITUITARY-ADRENAL AXIS FUNCTIONAND RESERVE CAPACITY

The present work investigated the effects of Norplant(R) implants on t he pituitary-adrenal function among 15 users of Norplant(R) implants p rior to and 6 months after insertion of the implants. Serum cortisol l evels and their diurnal variations, ACTH and 24-h urinary 17-ketostero ids, ketogenic steroids, 17-hydroxy steroids, and creatinine, were mea sured. Also, a dynamic test (the 5-h Synacthen(R) depot = ACTH stimula tion test) was done before and 6 months after implants insertion. The 9 a.m. cortisol levels were blunted (within the normal ranges) while t he 6 p.m. values were unaltered. The 24-h urinary ketogenic, hydroxy, and ketosteroids were also unchanged after Norplant(R) implants use. T he ACTH stimulation test showed a decreased adrenal response which was also within normal ranges. These data should raise the question relat ed to suprarenal response to acute or prolonged stresses, such as surg ical operations or shock in women using Norplant(R) implants. (C) 1997 Elsevier Science Inc.