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Gallbladder disease risk 'less with HRT patches than pills' Using hormone replacement therapy (HRT) patches rather than pills could reduce the risk of gallbladder disease associated with the treatment, new research claims. Previous studies have linked gallbladder disease with HRT, a treatment regularly prescribed to women suffering from the effects of the menopause. Approximately one million UK women were taking HRT in 2005 and the majority were taking it orally. Researchers from Oxford University reviewed data from the Million Women Study involving over 1.3 million UK women aged 50 to 69 years. Writing on the website of the British Medical Journal, bmj.com, they report that after following the women for an average of six years, 19,889 women were admitted to hospital with gallbladder disease and 17,190 (86 per cent) had to have their gallbladder removed (cholecystectomy). Compared to women who had never taken HRT, all women using HRT had an increased risk of developing gallbladder disease. They also found that women taking the HRT in a patch or gel form were substantially less likely to be admitted to hospital for gallbladder disease and less likely to have their gallbladder removed than the women taking HRT in the form of tablets. The increased risk of gallbladder disease gradually decreased after use of HRT stopped. However, ten years after stopping, the risk remained greater than in women who had never used HRT. The authors suggest that the reason for the difference in risk of developing gallbladder disease between oral and transdermal (ie skin patches) HRT might be due to the different way oestrogen is absorbed. When taken orally, much of the oestrogen is broken down by the liver before entering the circulation. In contrast, when given in patch form oestrogen is given in lower doses and absorbed directly through the skin and into the circulation. This, the researchers argue, may explain the lower risk of gallbladder disease associated with the patch form of HRT. "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," they conclude.  11 July 2008, 00:02 |
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