Effects of oral contraceptives on body fluid regulation

Abstract

To test the hypothesis that estrogen reduces the operating point for osmoregulation of arginine vasopressin (AVP), thirst, and body water balance, we studied nine women (25 ± 1 yr) during 150 min of dehydrating exercise followed by 180 min of ad libitum rehydration. Subjects were tested six different times, during the early-follicular (twice) and midluteal (twice) menstrual phases and after 4 wk of combined [estradiol-norethindrone (progestin), OC E + P] and 4 wk of norethindrone (progestin only, OC P) oral contraceptive administration, in a randomized crossover design. Basal plasma osmolality (Posm) was lower in the luteal phase (281 ± 1 mosmol/kgH2O, combined means, P < 0.05), OC E + P (281 ± 1 mosmol/kgH2O, P < 0.05), and OC P (282 ± 1 mosmol/kgH2O, P < 0.05) than in the follicular phase (286 ± 1 mosmol/kgH2O, combined means). High plasma estradiol concentration lowered the Posm threshold for AVP release during the luteal phase and during OC E + P [ x-intercepts, 282 ± 2, 278 ± 2, 276 ± 2, and 280 ± 2 mosmol/kgH2O, for follicular, luteal (combined means), OC E + P, and OC P, respectively; P < 0.05, luteal phase and OC E + P vs. follicular phase] during exercise dehydration, and 17β-estradiol administration lowered the Posm threshold for thirst stimulation [ x-intercepts, 280 ± 2, 279 ± 2, 276 ± 2, and 280 ± 2 mosmol/kgH2O for follicular, luteal, OC E + P, and OC P, respectively; P < 0.05, OC E + P vs. follicular phase], without affecting body fluid balance. When plasma 17β-estradiol concentration was high, Posm was low throughout rest, exercise, and rehydration, but plasma arginine vasopressin concentration, thirst, and body fluid retention were unchanged, indicating a lowering of the osmotic operating point for body fluid regulation.