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Prescribing HRT increases womens' risk of gallbladder disease

By Lilian Anekwe

Prescribing HRT to postmenopausal women increases their risk of gallbladder disease, according to the findings of a major UK study.

Previous studies have shown there is an increased risk of gallbladder disease in women using HRT, but the evidence is still unclear on the magnitude of the risk, and whether using HRT in the form of a patch or a pill is associated with the greatest risk.

An analysis of hospital admission data for more than a million women in England and Scotland found that compared to women who had never been prescribed HRT, women who were current users were 1.6 times more likely to be admitted to hospital for gallbladder disease.

Of the two forms of HRT, the researchers found that women prescribed transdermal therapy were at ‘substantially lower' risk of gallbladder disease than those presribed oral therapy (relative risks 1.17 vs. 1.74, respectively).

The results also suggest that the risk of gallbladder disease decreases after women stop therapy, and researchers also found a dose effect – with increased relative risks of gallbladder disease in women prescribed higher doses of HRT compared with lower doses.

The study, by researchers in the epidemiology unit at the University of Oxford, is published online today in the BMJ. The researchers concluded:

‘In the UK over five years an estimated 1.1% of middle-aged women who have never used hormone replacement therapy are admitted to hospital for a cholecystectomy.

‘Use of transdermal oestrogen increases the risk to 1.3% and use of oral oestrogens increases this risk to 2.0%.

‘For women who choose to use hormone replacement therapy, one cholecystectomy could be avoided for every 140 users of transdermal therapy rather than oral therapy over a five year period.'

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