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. 2023 Dec:128:110142.
doi: 10.1016/j.contraception.2023.110142. Epub 2023 Aug 24.

Changes in hair cortisol concentration in intrauterine device initiators: A prospective cohort study

Nora Doty  1 , Ethan Beckley  2 , Bharti Garg  3 , Sumiko Maristany  4 , David W Erikson  5 , Jeffrey T Jensen  6
Affiliations

Changes in hair cortisol concentration in intrauterine device initiators: A prospective cohort study

Nora Doty et al. Contraception. 2023 Dec.

Abstract

Objectives: Prior studies found increased hair cortisol concentration (a surrogate marker for hypothalamic-pituitary-adrenal axis activation) in users of the levonorgestrel intrauterine device (LNG 52 mg IUD). We evaluated change in hair cortisol and psychometric tests in women initiating a copper (CuT380 IUD) or LNG 52 mg IUD.

Study design: We prospectively enrolled healthy women initiating an LNG 52 mg IUD or CuT380 IUD. Participants provided hair and blood samples and completed psychometric inventories (Patient Health Questionnaire-9, Positive and Negative Affect Schedule, and Psychological General Well-Being Index) after IUD insertion and at 6 and 12 months. We used liquid chromatography with tandem mass spectrometry to measure hair cortisol concentrations. We compared hair cortisol concentrations and psychometric test changes from baseline to 6 and 12 months using independent two-sample t tests.

Results: We enrolled 39 of our targeted 86 participants (LNG 52 mg IUD 26, CuT380 IUD 13). Thirty-eight subjects (LNG 52 mg IUD 25, CuT380 IUD 13) completed 6 months of follow-up. We found no difference between cohorts in the mean change in hair cortisol concentrations at 6 months (LNG 52 mg IUD n = 21 [-0.01 pg/mg (95% CI -1.26, 1.23); CuT380 IUD n = 13 [-1.31 pg/mg (-3.36, 0.73)]). While psychometric inventory results remained within normal ranges, LNG 52 mg IUD users reported a trend toward more favorable changes over time.

Conclusions: We did not find clinically important differences in hair cortisol concentrations following initiation of a CuT380 IUD or LNG 52 mg IUD; psychometric inventories demonstrated no adverse effect of hormonal IUDs on mood.

Implications: Our findings of similar hair cortisol concentrations following the initiation of either the LNG 52 mg IUD or CuT380 IUD suggest that hormonal IUDs do not increase cortisol concentrations or alter stress reactivity, and favorable effects on psychometric inventories provide further reassurance that the LNG 52 mg IUD has no adverse impact on mood.

Trial registration number: ClinicalTrials.gov NCT03499379.

Keywords: Cortisol; IUD; Intrauterine device; Mood; Stress.

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Conflict of interest statement

Declarations of interest: Dr. Jensen has received payments for consulting from Bayer Healthcare, Hope Medicine, Foundation Consumer Healthcare, Mayne Pharma, Myovant, ViiV Healthcare, and TherapeuticsMD. OHSU has received research support from Abbvie, Bayer Healthcare, Daré, Estetra SPRL, Hope Medicine, Organon, Medicines360, Merck, Myovent, and Sebela. These companies and organizations may have a commercial or financial interest in the results of this research and technology. These potential conflicts of interest have been reviewed and managed by OHSU. None of the other authors have anything to declare.

Figures

Figure 1:
Figure 1:
Flow chart showing participation of women in study evaluating the effect of initiating use of the LNG 52 mg IUD or CuT380A IUD on hair cortisol concentration and mood (United States, 2018)
See this image and copyright information in PMC

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