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Prolonged Endocrine Responses to Medroxyprogesterone in Postmenopausal Women With Respiratory Insufficiency

From the Departments of Pulmonary Diseases, Obstetrics and Gynecology, and Clinical Chemistry, Turku University Hospital; and the Departments of Biostatistics and Physiology, Turku University, Turku, Finland.

Address reprint requests to: Tarja Saaresranta, MD Department of Pulmonary Diseases Turku University Hospital Kiinamyllynkatu 4–8 Turku FIN-20520 Finland E-mail: tarja.saaresranta{at}tyks.fi

Objective: To evaluate the endocrinologic changes associated with, and possibly responsible for, prolonged ventilatory improvement after short-term medroxyprogesterone acetate (MPA) in chronic respiratory failure.

Methods: Fourteen postmenopausal women with permanent or previous episodic hypercapnic or hypoxemic respiratory failure were enrolled in a placebo-controlled, 12-week, single-mask trial including 14-day treatment periods with placebo and MPA (60 mg daily) and a 6-week follow-up. We evaluated the duration of MPA-induced alterations on serum concentrations of progesterone, estradiol, testosterone, FSH, LH, sex hormone–binding globulin (SHBG), and prolactin. Hormones were measured four times: at baseline, after 14 days with MPA, and during the washout on days 21 and 42.

Results: With MPA, FSH decreased 42.7% (P < .001, 95% confidence interval [CI] -54.2, -31.6), LH 62.1% (P < .01; 95% CI -81.0, -32.6), and SHBG 58.1% (P < .001; 95% CI -63.0, -43.9). Luteinizing hormone remained decreased (-28.7%; P < .01; 95% CI -42.0, -14.2) at the 3-week washout, whereas FSH and SHBG were back to pretreatment levels. Prolactin had a borderline initial increase of 23.5% (P= .097; 95% CI -3.5, 50.5) with MPA and a significant increase at the 3-week (31.9%; P < .05; 95% CI 1.0, 62.9) and 6-week (26.4%; P < .05; 95% CI 4.4, 48.3) washouts.

Conclusion: Medroxyprogesterone acetate 60 mg daily for 2 weeks has both immediate (FSH, LH, and SHBG), prolonged (LH), and rebound endocrinologic (prolactin) effects up to 6 weeks after treatment. The MPA-induced widespread endocrine aftereffects could explain the earlier reported prolonged ventilatory improvement.

This article has been cited by other articles:

				T. Saaresranta, K. Irjala, and O. Polo Effect of medroxyprogesterone on arterial blood gases, leptin and neuropeptide Y in postmenopausal females Eur. Respir. J., December 1, 2002; 20(6): 1413 - 1418. [Abstract] [Full Text] [PDF]

				T. Saaresranta and O. Polo Hormones and Breathing Chest, December 1, 2002; 122(6): 2165 - 2182. [Abstract] [Full Text] [PDF]

				T. Saaresranta, P. Polo-Kantola, E. Rauhala, and O. Polo Medroxyprogesterone in postmenopausal females with partial upper airway obstruction during sleep Eur. Respir. J., December 1, 2001; 18(6): 989 - 995. [Abstract] [Full Text] [PDF]