Basal and metoclopramide-stimulated prolactin (PRL) serum levels in users and non-users of a copper intrauterine device (TCu-380 IUD)

Sexual function and metabolic/hormonal changes in women using long-term hormonal and non-hormonal contraceptives: a pilot study

BACKGROUND

Female sexual dysfunction is a common condition that negatively impacts the emotional health and quality of life of the affected individuals. Long-acting reversible contraceptives (LARCs) are becoming increasingly popular due to their effectiveness and convenience. LARCs can be hormonal (etonogestrel releasing implant-ENG and Levonorgestrel intrauterine system-LNG) or non-hormonal (copper intrauterine device-CuIUD and copper-silver intrauterine device-SIUD). There are very few studies that assess the influence on LARCS on sexual function are lacking. This study aimed to assess changes in sexual function as well as metabolic and hormonal parameters in women after implantation with LARCs.

METHODS

In this prospective cohort study, we assessed 80 women who visited the Military Police Hospital in Brazil for LARCs placement. The study participants were divided into 4 groups according to the type of LARC received: ENG n = 17; LNG n = 22, CuIUD n = 18 and SIUD n = 23. The four groups were evaluated twice (prior to LARC placement and approximately 3 months later) for sexual function, using the Female Sexual Function Index (FSFI) and Female Sexual Quotient (QS-F) questionnaires. Metabolic and hormonal parameters were also assessed using blood tests.

RESULTS

ENG worsened sexual function according to FSFI and QS-F, across all domains. A decrease in sex hormone-binding globulin (SHBG) between stages was observed for all groups. We observed an improvement in sexual function for non-hormonal LARCs, specially SIUD. However this improvement was not statistically significant.

CONCLUSION

The use of non-hormonal LARCS improved sexual function. Etonogestrel implants, had a negative influence on sexual function, probably by blocking ovarian function, and thus reducing the production of androgens and estrogens.

Age-related changes in the metoclopramide-induced prolactin release in nulliparous women

OBJECTIVE

To assess the metoclopramide-stimulated PRL response in nulliparous women as a function of chronological age (CA).

DESIGN

Open and prospective study.

SETTING

Outpatient endocrine clinic of a third level medical institution.

PATIENTS

Fifty-one clinically healthy volunteer nulliparous women 15.8 to 48.2 years of age, with regular menses at least 1 year before the study (except 3 postmenopausal women) and no regular drug ingestion during the last 6 months, studied on days 18 to 22 of their menstrual cycle.

INTERVENTIONS

After a 30-minute rest, three basal blood samples were obtained; oral metoclopramide (10 mg) was administered followed by subsequent blood samples at 60, 90, and 120 minutes.

MAIN OUTCOME MEASURES

Duplicate serum PRL determinations were performed by RIA in all samples with P and E2 only in the pool of the basal samples. Hypothesis was formulated before data collection.

RESULTS

All menstruating women had serum P levels > or = 4.0 ng/mL (> or = 12.72 nmol/L). A linear correlation was observed between CA and the serum PRL response, and also between CA and serum E2. Multiple regression analysis showed that CA and body mass index had the most marked effect on PRL response. Women < or = 25.0 years old had a serum PRL response and mean basal serum E2 levels lower than women > 25.1 years old.

CONCLUSIONS

The metoclopramide-induced PRL response in nulliparous women augmented linearly as CA increased, suggesting a gradual decrease in the dopaminergic tone in older women, perhaps partially compensated by a high estrogen level to prevent an unrestrained rise in serum PRL levels.