Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion
Background: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known t...
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MDPI AG
2024-01-01
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| Series: | Endocrines |
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| Online Access: | https://www.mdpi.com/2673-396X/5/1/3 |
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| author | Alessandro D. Genazzani Alessandra Sponzilli Marcello Mantovani Emma Fusilli Francesco Ricciardiello Elisa Semprini Tommaso Simoncini Christian Battipaglia |
| author_facet | Alessandro D. Genazzani Alessandra Sponzilli Marcello Mantovani Emma Fusilli Francesco Ricciardiello Elisa Semprini Tommaso Simoncini Christian Battipaglia |
| author_sort | Alessandro D. Genazzani |
| collection | DOAJ |
| description | Background: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known to act on the spontaneous hypothalamic–pituitary functions reducing both GnRH and gonadotropin release and blocking ovulation. Aim: To evaluate spontaneous and GnRH-induced LH release during both phases of the menstrual cycle or under the use of the contraceptive pill. Methods: A group of 12 women, subdivided into two groups, volunteered for the study. Group A (n = 6, controls) received no treatments, while Group B (n = 6) received a 21 + 7 combination of ethinyl-estradiol (EE) 30 µg + drospirenone (DRSP) 3 mg. Both groups were evaluated twice: Group A during follicular and luteal phases, Group B during pill assumption and during the suspension interval, performing a pulsatility test, GnRH stimulation test, and hormonal parameters evaluation. Spontaneous and GnRH-induced secretory pulses were evaluated, as well as the instantaneous secretory rate (ISR). Results: COC treatment lowered LH and FSH (follicle stimulating hormone) levels significantly if compared to the follicular phase of spontaneous cycles. During the suspension interval, hormone levels rapidly rose and became comparable to those of the follicular phase of the control group. The LH pulse frequency under COC administration during the suspension interval was similar to that observed during the follicular phase (2.6 ± 0.3 pulses/180 min and 2.3 ± 0.2 pulses/180 min, respectively). The GnRH-induced LH peaks were greater in amplitude and duration than those observed after ISR computation in both groups. The GnRH-induced LH release during the luteal phase of the control subjects was higher than in the follicular phase (51.2 ± 12.3 mIU/mL and 14.9 ± 1.8 mIU/mL, respectively). Conversely, subjects under COC showed a GnRH-induced LH response similar during COC and during the suspension interval. Conclusions: Our data support that the EE + DRSP preparation acts on both spontaneous pulsatile release and GnRH-induced LH release during the withdrawal period of the treatment, and that after 5–7 days from the treatment suspension, steroidal secretion from the ovary is resumed, such as that of androgens. This suggests that in hyperandrogenic patients, a suspension interval as short as 4 days might be clinically better. |
| first_indexed | 2024-04-24T18:21:17Z |
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| institution | Directory Open Access Journal |
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| last_indexed | 2024-04-24T18:21:17Z |
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| spelling | doaj.art-6e0c6265563a4340b269260cfd45bbed2024-03-27T13:35:16ZengMDPI AGEndocrines2673-396X2024-01-0151364510.3390/endocrines5010003Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH SecretionAlessandro D. Genazzani0Alessandra Sponzilli1Marcello Mantovani2Emma Fusilli3Francesco Ricciardiello4Elisa Semprini5Tommaso Simoncini6Christian Battipaglia7Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyDepartment of Obstetrics and Gynecology, University of Pisa, 56126 Pisa, ItalyGynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Via l Pozzo 71, 41100 Modena, ItalyBackground: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known to act on the spontaneous hypothalamic–pituitary functions reducing both GnRH and gonadotropin release and blocking ovulation. Aim: To evaluate spontaneous and GnRH-induced LH release during both phases of the menstrual cycle or under the use of the contraceptive pill. Methods: A group of 12 women, subdivided into two groups, volunteered for the study. Group A (n = 6, controls) received no treatments, while Group B (n = 6) received a 21 + 7 combination of ethinyl-estradiol (EE) 30 µg + drospirenone (DRSP) 3 mg. Both groups were evaluated twice: Group A during follicular and luteal phases, Group B during pill assumption and during the suspension interval, performing a pulsatility test, GnRH stimulation test, and hormonal parameters evaluation. Spontaneous and GnRH-induced secretory pulses were evaluated, as well as the instantaneous secretory rate (ISR). Results: COC treatment lowered LH and FSH (follicle stimulating hormone) levels significantly if compared to the follicular phase of spontaneous cycles. During the suspension interval, hormone levels rapidly rose and became comparable to those of the follicular phase of the control group. The LH pulse frequency under COC administration during the suspension interval was similar to that observed during the follicular phase (2.6 ± 0.3 pulses/180 min and 2.3 ± 0.2 pulses/180 min, respectively). The GnRH-induced LH peaks were greater in amplitude and duration than those observed after ISR computation in both groups. The GnRH-induced LH release during the luteal phase of the control subjects was higher than in the follicular phase (51.2 ± 12.3 mIU/mL and 14.9 ± 1.8 mIU/mL, respectively). Conversely, subjects under COC showed a GnRH-induced LH response similar during COC and during the suspension interval. Conclusions: Our data support that the EE + DRSP preparation acts on both spontaneous pulsatile release and GnRH-induced LH release during the withdrawal period of the treatment, and that after 5–7 days from the treatment suspension, steroidal secretion from the ovary is resumed, such as that of androgens. This suggests that in hyperandrogenic patients, a suspension interval as short as 4 days might be clinically better.https://www.mdpi.com/2673-396X/5/1/3hormonal contraceptiondrospirenonefollicular phaseluteal phaseGnRH testLH |
| spellingShingle | Alessandro D. Genazzani Alessandra Sponzilli Marcello Mantovani Emma Fusilli Francesco Ricciardiello Elisa Semprini Tommaso Simoncini Christian Battipaglia Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion Endocrines hormonal contraception drospirenone follicular phase luteal phase GnRH test LH |
| title | Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion |
| title_full | Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion |
| title_fullStr | Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion |
| title_full_unstemmed | Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion |
| title_short | Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion |
| title_sort | modulatory effects of ethinyl estradiol plus drospirenone contraceptive pill on spontaneous and gnrh induced lh secretion |
| topic | hormonal contraception drospirenone follicular phase luteal phase GnRH test LH |
| url | https://www.mdpi.com/2673-396X/5/1/3 |
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