Reversible suppression of hypothalamo–pituitary–adrenal axis in Addison’s disease due to ethinyl oestradiol-induced increase in total cortisol

An OCP containing 30 μg EE induced relative and reversible hypercortisolaemia in a patient with Addison's disease with evidence of suppression of ACTH secretion on dynamic pituitary function tests.We suggest that, in some patients with adrenal failure, EE administration may lead to unrecognised relative hypercortisolaemia and IR.There is literature evidence that, in patients with Addison's disease, EE may decrease cortisol clearance.These alterations are reversible upon EE withdrawal and may have implications for the choice of a contraceptive agent in women with Addison's disease.