The relationship of the renin-angiotensin-aldosterone system to plasma gonadotropin, prolactin, and ovarian steroid patterns during the menstrual cycle

Abstract

Fasting supine renin activity, renin substrate concentration and aldosterone concentration in plasma were measured every other day during a complete menstrual cycle in 14 healthy young women; the patterns of LH, FSH, estradiol-17β, progesterone, 17α-hydroxyprogesterone, 4-androstendione, and prolactin in plasma were also determined radioimmunologically. During the luteal phase, the activity of the renin-angiotensin-aldosterone system is increased, probably due to the natriuretic effect of progesterone; very low progesterone values are accompanied by an early decrease of renin activity and aldosterone concentration. In some subjects, there were also peaks of renin and aldosterone in the late follicular phase or at the time of the LH surge. The mechanism of these changes is not yet clearly understood; however, it seems reasonable to assume that fluctuations of renin substrate concentration, which were demonstrated for the first time during the menstrual cycle, are related to this observation. Alternatively there may be a transient natriuresis induced by the estradiol secretion from the riping follicle. There is no temporal relationship between the periovulatory variations in 17α-hydroxyprogesterone concentration and in the renin-angiotensin-aldosterone system. Unexpectedly, plasma renin substrate concentration and renin activity were higher in the follicular phase of women with luteal failure. Neither prolactin, which was slightly higher during the luteal phase and during menstruation, nor gonadotropins seem to be directly related to the behavior of plasma renin activity or aldosterone concentration during the menstrual cycle in man.