PITUITARY-ADRENAL FUNCTION IN TEN PATIENTS RECEIVING MEDROXYPROGESTERONE ACETATE FOR TRUE PRECOCIOUS PUBERTY

Abstract

ABSTRACT The effect of medroxyprogesterone acetate (MPA) on pituitary-adrenal function was investigated in 10 patients with true precocious puberty. Although the patients receiving MPA responded to exogenously administered ACTH by a rise in the plasma 17-hydroxycorticosteroids, the mean values of both the pre- and post-ACTH levels were statistically lower than those obtained in the controls. In 7 of the 8 patients the increase of the urinary 17-ketogenic steroids following the oral administration of metyrapone was less than 2-fold. The data suggest that MPA in the dosages tested has a suppressive effect on pituitary ACTH synthesis and/or release. Despite this inhibition, however, no clinical evidence of hypoadrenocorticism was observed in these patients even during periods of stress. When the drug was discontinued, pituitary-adrenal function rapidly returned toward normal, suggesting that the suppressive effect of MPA was a relatively mild one.