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Updated: Jul 18, 2025
Collecting Hair Samples for Hair Cortisol Analysis in African Americans
Published on: June 10, 2018
Changes in hair cortisol concentration in intrauterine device initiators: A prospective cohort study
Nora Doty1, Ethan Beckley2, Bharti Garg3
1Department of Obstetrics and Gynecology, Hackensack Meridian Health Jersey Shore University Medical Center, Neptune, NJ, United States.
Insights
The levonorgestrel intrauterine device (LNG 52 mg IUD) and copper IUD (CuT380 IUD) showed no significant difference in hair cortisol levels. Both IUD types did not adversely affect mood, with the LNG IUD showing a trend toward favorable psychological well-being.
Area of Science:
- Endocrinology
- Reproductive Health
- Psychoneuroendocrinology
Background:
- Previous research indicated elevated hair cortisol concentrations, a stress marker, in users of the levonorgestrel intrauterine device (LNG 52 mg IUD).
- The hypothalamic-pituitary-adrenal (HPA) axis activation is a key area of interest in hormonal contraceptive research.
Purpose of the Study:
- To compare changes in hair cortisol concentrations and psychological well-being between women using a copper IUD (CuT380 IUD) and a levonorgestrel intrauterine device (LNG 52 mg IUD).
- To investigate the potential impact of different IUD types on HPA axis activity and mood.
Main Methods:
- Prospective enrollment of healthy women initiating either an LNG 52 mg IUD or CuT380 IUD.
- Collection of hair and blood samples, alongside psychometric assessments (PHQ-9, PANAS, PWBI) at baseline, 6, and 12 months.
- Measurement of hair cortisol using liquid chromatography-tandem mass spectrometry and statistical comparison of changes between groups.
Main Results:
- No significant difference in the mean change of hair cortisol concentrations was observed between the LNG 52 mg IUD and CuT380 IUD groups at 6 months.
- Psychometric inventory results remained within normal ranges for both groups.
- A trend towards more favorable psychological changes over time was noted in the LNG 52 mg IUD users.
Conclusions:
- Initiation of either the LNG 52 mg IUD or CuT380 IUD did not result in clinically significant differences in hair cortisol concentrations.
- Hormonal IUDs, specifically the LNG 52 mg IUD, do not appear to increase cortisol concentrations or negatively impact stress reactivity.
- Psychometric data suggest no adverse mood effects associated with the LNG 52 mg IUD, providing reassurance for its use.
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.
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