Progesterone does not alter osmotic regulation of AVP

Abstract

To test the hypothesis that progesterone, independent of estrogen, decreases the plasma osmotic threshold for arginine vasopressin (AVP) release and thirst onset, we compared AVP and thirst responses to hypertonic saline infusion (HSI) during administration of oral contraceptives (OCs) containing progesterone (OCP) with responses to infusion of OCs containing progesterone and estrogen (OCEP). Eight women (29 ± 2 yr) were infused with 3% NaCl (120 min, 0.1 ml·kg body wt-1·min-1) and consumed fluid (90 min, 15 ml/kg body wt) in the early follicular and midluteal phases of a 28-day menstrual cycle and also after 4 wk of OCP and after 4 wk of OCEP in a randomized crossover design. Baseline plasma osmolality (Posm) was lower in the luteal phase (280 ± 1 mosmol/kgH2O) and during OCEP (283 ± 1 mosmol/kgH2O) than in the follicular phase (286 ± 1 mosmol/kgH2O, P < 0.05) but was unaffected by OCP (284 ± 1 mosmol/kgH2O). Posm remained lower in the follicular phase than in the luteal phase and with OCEP throughout the first 50 min of HSI. The mean abscissal plasma AVP concentration-Posm intercept was unaffected by OCP (267 ± 1 mosmol/kgH2O) but was greater in the follicular phase (273 ± 2 mosmol/kgH20) than in the luteal phase (266 ± 4 mosmol/kgH2O) and with OCEP (268 ± 2 mosmol/kgH2O, P < 0.05). There were no differences in osmotic thresholds for thirst onset across experimental days. Despite the lower osmotic threshold for AVP release during the luteal phase and with OCEP, fluid balance, renal free water clearance, and Na+ regulation during HSI were unaffected by menstrual phase or OC treatment, indicating a lower osmotic operating point for body water balance. OCP did not affect osmotic AVP regulation, suggesting that progesterone does not affect osmotic fluid regulation through a mechanism independent of estrogen.