Gender and gallstone disease.
Gallstone disease is a common disorder all over the world. In the Western societies about 80 % of the gallstones are composed primarily of cholesterol. Several risk factors for gallstone formation have been identified. One of the most important risk factors is female gender. Rates of gallstones are two to three times higher among women than men. But this is primarily a phenomenon of the childbearing age. Pregnancy is also a major risk factor for gallstone formation. The risk is related to the number of pregnancies. Sex hormones are most likely to be responsible for the increased risk. Estrogen increases biliary cholesterol secretion causing cholesterol supersaturation of bile. Thus, hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease. However, the effect of estrogen is dose-dependent and new oral contraceptives with a low estrogen dose do not seem to increase the rate of gallstone formation. The present article focuses on the mentioned risk factors associated with female sex hormones.
Novacek
Gottfried
G
Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria. gottfried.novacek@meduniwien.ac.at
D000328:Adult; D000367:Age Factors; D001646:Bile / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003276:Contraceptives, Oral / Q000009:adverse effects; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004967:Estrogens / Q000502:physiology; D005260:Female; D042882:Gallstones / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D012727:Sex Characteristics
D003276:Contraceptives, Oral; D004967:Estrogens; D002784:Cholesterol