Spontaneous changes in weight, leg volume, renin, aldosterone and sex hormones in patients with cyclical oedema

Abstract

In four women with cyclical oedema related to the menstrual cycle, weight, leg volume, urinary excretion of sodium, aldosterone and oestrogens, plasma concentrations of progesterone, angiotensin II and plasma renin activity were measured at intervals during 4 weeks while they were taking a fixed sodium diet. In another patient, regular biphasic changes in weight and basal body temperature, disappearing after ovariectomy, were demonstrated. Changes in weight (varying between 3.5 and 5.5 kg) with corresponding changes in sodium balance were observed. In three patients, the maximum weight occurred in the second half, and in the other patient in the first half of the menstrual cycle. Plasms renin activity was in the normal range in all patients. It tended to rise when weight fell and vice versa. Aldosterone excretion behaved similarly and seems to be related to plasma progesterone in three patients. Orthostatic increase in leg volume did not significantly correlate with change in early morning weight. Thus, renin, aldosterone and orthostatic pooling of plasma fluid did not seem to be of primary importance in the pathogenesis of oedema in these patients. Oestrogen excretion in the luteal phase of the cycle was abnormally low in two patients; both had premenstrual oedema. In none of the patients could sodium retention be explained by excessive oestrogen and/or diminished progesterone production.