The influence of high and low levels of estrogen on diurnal urine regulation in young women

Abstract

Background: Sex hormones have a pronounced effect on arginine vasopressin (AVP), and therefore on the diurnal water homeostasis. Low and high levels of plasma-estradiol as seen in the follicular phase of the menstrual cycle may therefore alter the diurnal regulation of urine production. Furthermore the structural resemblance of oxytocin to vasopressin has led to speculations about the possible antidiuretic properties of oxytocin under normal physiological conditions. To elucidate the influence of high and low p-estradiol on the regulation of the diurnal urine production, 15 normal menstruating women (21-33 y) underwent two circadian in-patient investigations, both situated in follicular phase.

Methods: Admitting the participants solely in the follicular phase resulted in high and low plasma-estradiol whereas plasma-progesterone was similar. Urine and blood samples were taken at predetermined time points to determine plasma AVP, plasma oxytocin, plasma aldosterone, plasma natriuretic peptide (ANP), urinary solute excretions, and urinary excretions of prostaglandin E2 (PGE-2) and aquaporin-2 (AQP-2). Blood pressure was measured every hour.

Results: Plasma AVP, plasma aldosterone and plasma ANP were unaffected by the different levels of estradiol. All had marked circadian variations whereas oxytocin did not display any circadian rhythm. High estradiol resulted in lower p-osmolality and p-sodium reflecting the downward resetting of the osmoreceptors. Oxytocin did not correlate with either diuresis or urine osmolality. The diurnal urine production was similar in the two groups as were urine osmolality, excretion of PGE-2 and AQP-2. AQP-2 does not have a circadian rhythm and is not significantly correlated to either AVP or oxytocin under normal physiological conditions.

Conclusion: High and low level of estradiol has no influence on the circadian rhythm of AVP or the subsequent urine production. High p-estradiol resets the osmoreceptors for AVP release. Furthermore it appears that oxytocin under normal physiological conditions do not contribute to the overall antidiuretic effect.

Figure 1

Diurnal rhythm of urine osmolality, diuresis, excretion rates of PGE-2, AQP-2 and sodium in women with low (white) or high (black) p-estradiol. Bars are mean ± SD.

Figure 2

Diurnal variation of clearance of sodium and osmoles, and solute free water reabsorption in natural cycling women with low (white) and high (black) p-estradiol. Values are mean ± SD.

Figure 3

P-sodium, p-osmolality and packed cell volume in low (white) and high (black) estrogen states. Values are mean ± SD.

Figure 4

Circadian rhythm of the hormones ANP, AVP, oxytocin, aldosterone and prolactin in women with low and high p-estradiol. The obtained difference in p-estradiol between low and high states is shown in the graph as well. Values are mean ± SD.