Hormone replacement therapy increases ACTH/dehydroepiandrosterone sulfate in menopause.
OBJECTIVE
To demonstrate that hypoestrogenism in menopause is in part responsible for the decrease in circulating dehydroepiandrosterone sulfate (DHEA-S) and ACTH levels. To test this hypothesis, 25 postmenopausal women aged 47-60 years, were given orally conjugated equine estrogen (CEE) to study the effect on circulating DHEA-S, cortisol and ACTH.


METHODS
A prospective, non-blinded study was performed. Hormonal levels were analyzed before and after three cycles of CEE 0.625 mg/day for 21 days followed each by chlormadinone acetate for 5 days.


RESULTS
Low baseline levels of DHEA-S increased significantly after HRT (1.71+/-0.75 to 3.3+/-1.5 micromol/l, (P<0.001). ACTH levels augmented moderately from 3.26+/-1.4 to 4.7+/-1.8 pmol/l (P<0.05) and cortisol from 350.4+/-118 to 450.8+/-144 nmol/l (P<0.01). A positive correlation was obtained between 17 beta-estradiol and ACTH (r=0.48), estradiol and cortisol (r=0.52) as well as estradiol and DHEA-S (r=0.60). In addition, the correlation was highly significant (P<0.001) between ACTH and DHEA-S at the term of HRT.


CONCLUSIONS
HRT increased DHEA-S, ACTH and cortisol concentrations, which may suggest that this therapy may exert a stimulatory effect on the pituitary gland when baseline hypoestrogenism is present, but further studies are required to clarify the mechanism underlying this process.
Fonseca
E
E
Endocrine Research Unit, Hospital de Especialidades, Centro Médico Nacional, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Basurto
L
L
Velázquez
S
S
Zárate
A
A
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D002715:Chlormadinone Acetate / Q000008:administration & dosage*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D004334:Drug Administration Schedule; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D020249:Hormone Replacement Therapy; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D045167:Progesterone Congeners / Q000008:administration & dosage*; D011446:Prospective Studies
D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D002715:Chlormadinone Acetate; D019314:Dehydroepiandrosterone Sulfate; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone