Assessment of pituitary and ovarian function in women receiving modern hormonal contraception

Abstract

Hormonal contraceptives induce changes in the hypothalo-pituitary-ovarian loop and this eventually results in their therapeutic effects. The study aimed to investigate the level of changes induced in the pituitary gland and the ovary by hormonal contraceptive agents. The sample size was 200. One hundred and fifty (150) women desirous of contraception who met the World Health Organization medical eligibility criteria were enlisted and equally divided into 3 groups, those on: (A) combine oral contraceptive pill containing levonorgestrel 0.15mg and ethinyloestradiol 0.03mg, (B) injectables of progesterone-only containing depo medroxyprogesterone acetate 150mg, (C) long-acting and contraceptive made up of progesterone alone containing 68mg of etonogestrel (Implanon) while the remaining 50 served as control (D). All data collected were analyzed using SPSS 23. Hormonal contraceptive administration resulted in reduced secretion of the gonadotropins (follicle-stimulating hormone and luteinizing hormone) from the pituitary gland in all the hormonal contraceptives employed in the study ( = 0.000). There was also reduced serum levels of estrogens ( = 0.001) and progesterone ( = 0.000) when compared with the controls. There were increased serum levels of prolactin with the hormonal contraceptives ( = 0.000) when compared. With the administration of hormonal contraceptives, there were no luteinizing hormone peak and no rise in serum progesterone concentration in the luteal phase in the women on hormonal contraceptives. This reflects that ovarian follicular development was stalled and ovulation was inhibited. There was also an elevation in serum prolactin level.