Hormone Replacement May Raise Women's Gallbladder Risk

By Amanda Gardner
HealthDay Reporter
Friday, July 11, 2008; 3:00 AM

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THURSDAY, July 10 (HealthDay News) -- A postmenopausal woman who uses hormone replacement therapy (HRT) may boost her risk for gallbladder disease, researchers say, although the risk appears to vary depending on how she receives the hormones.

"For women who are using HRT, their risk of gallbladder disease is less if they use a patch or gel form of HRT rather than the tablet form of HRT," noted Dr. Bette Liu, a clinical epidemiologist at the University of Oxford in the United Kingdom.

"There is evidence that is developing that the patch may have less negative effects than the pill. We need to make sure that we're talking about the menopausal hormone therapy patch, not the birth control patch -- there may be less adverse effects than when taking estrogen by mouth," said Dr. Patricia J. Sulak, professor of obstetrics/gynecology at Texas A&M Health Science Center College of Medicine and an obstetrician/gynecologist with Scott & White.

According to Sulak, who was not involved in the study, hormone therapy can be taken non-orally in several ways, including gels (rubbing it on), the patch and even spraying it on.

Not only are patches and gels given at lower doses, but they bypass having to be metabolized through the liver, thus reducing any effect on the gallbladder, the authors explained. The gallbladder stores bile produced in the liver, and less estrogen collected in the bile could explain the reduced risk, the team noted.

The findings were published this week in the online edition of the British Medical Journal.

HRT is still taken by large numbers of women to relieve the symptoms of menopause -- despite evidence of various health risks, including heightened odds for breast cancer and stroke.

The risk of developing gallbladder disease also increases when a woman hits menopause, and experts have long known that HRT contributes to this risk. To date, however, no one has analyzed whether the risk varies depending on how HRT is administered. A recent study did find that the risk of blood clots was lower in women taking HRT via skin patches as opposed to pills.