Hormonal therapy and cholelithiasis

Area of Science:

• Gastroenterology
• Endocrinology
• Surgical Oncology

Background:

• Cholelithiasis (gallstones) incidence is rising in younger women.
• While biochemical changes and mechanical obstruction are known causes, the impact of female hormones on gallbladder function is less understood.
• Estrogen-progesterone elevation during pregnancy is linked to hypercholesterolemia, a known risk factor.

Purpose of the Study:

• To alert abdominal surgeons to a new factor contributing to cholelithiasis in young women.
• To investigate the association between hormonal medication and the incidence of cholelithiasis.
• To highlight the role of hormonal therapy in the development of gallbladder disease.

Main Methods:

• A retrospective survey of 1346 cholecystic operations performed between 1969 and 1973.
• Comparison of age at operation between young women (<40 years) on hormonal medication versus a control group not on hormonal therapy.

Main Results:

• A higher incidence of cholelithiasis was observed in women, as expected.
• Women under 40 using hormonal medication underwent surgery at a younger age compared to those not on hormonal therapy.
• Hormonal therapy appears to predispose women to gallbladder disease.

Conclusions:

• Female hormones can cause gallbladder sluggishness, leading to functional obstruction and predisposing to cholelithiasis.
• The incidence of gallbladder disease in young women using hormonal therapy is expected to increase.
• Cholelithiasis should be suspected in young females using birth control medication; early diagnosis and surgical intervention are advised.