STUDIES ON THE MECHANISM OF THE PLASMA 17-HYDROXYCORTICOSTEROID ELEVATION INDUCED IN MAN BY ESTROGENS*

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Abstract
Daily oral ethinyl estradiol 0.1 and 0.5 mg, diethylstilbestrol 15 mg and conjugated equine estrogens 10 mg elevate plasma 17-hydroxycorticosteroids (17-OHCS) above normal without producing hyperadrenocorticism. These estrogens produce (1) increases in corticosteroid-binding protein (transcortin) and in transcortin-binding capacity, (2) delay in clearance from blood of exogenous hydrocortisone and tetrahydrocortisone and (3) decrease of conjugated urinary 17-OHCS but not of free 17-OHCS. Increased protein binding of hydrocortisone can explain all of the changes in steroid metabolism induced by estrogens except for delay in clearance of tetrahydrocortisone, a steroid not bound to corticosteroid binding protein.