Menopausal characteristics and hormone replacement therapy in relation to long-term risk of cholecystectomy in women.
Level 3 - non-randomized controlled study
Non-randomized prospective cohort study
PubMed 39664317 · doi:10.3389/fmed.2024.1446271
What was done
Multivariable Cox regression models were used to analyze 184,677 women from the UK Biobank to assess the associations of menopausal characteristics (age and type of menopause) and hormone replacement therapy (HRT) with the long-term risk of incident cholecystectomy over a median follow-up of 12.7 years.
What was found
During follow-up, 4,991 incident cases of cholecystectomy occurred. Natural menopause, regardless of age, showed no association with cholecystectomy risk, whereas young surgical menopause and ever-use of HRT were each associated with increased risk. Women who experienced surgical menopause and initiated HRT before menopause had the highest risk compared to naturally menopausal never-users of HRT (hazard ratio = 2.28; 95% confidence interval: 1.70-3.04).
Why it matters
This study clarifies that exogenous hormone use and early surgical menopause—rather than natural menopausal timing—are key drivers of severe gallbladder disease requiring surgery in women.
Limits
The observational design cannot establish causality or eliminate confounding by indication. Detailed HRT formulations, dosages, and administration routes were not reported in the abstract. The UK Biobank population primarily comprises individuals of European ancestry and is subject to healthy volunteer selection bias.
Cited by
- supports Female sex hormones and hormonal fluctuations increase the risk of gallbladder disease requiring surgical removal (cholecystectomy).