Gallbladder Surgery Risk Increased for Women On Oral Oestrogen

A French study has identified an increased risk for menopausal women on oral oestrogen-only Hormone Replacement Therapy and the possibility of gallbladder surgery.


Recently reported in the Canadian Medical Association Journal  this was a large-scale study of more than 70 000 menopausal women in France and it seems the increased risk does not apply to women using skin patches, gels or creams.

Risk Factors

It is a cliche that women who are fair, fat and over forty are more prone to gallstone disease, but certainly it has become common in developed countries. The greatest risk factors are:

  • women over 50
  • obesity
  • diabetes
  • high cholesterol
  • poor diet
  • had two or more children.

It is more common in France to have skin application of hormones whereas the USA and UK doctors prefer to more often prescribe HRT orally in pill form.


It was clear from this 16 year study the women on oral HRT had an increased risk of gallbladder surgery for complications of gallstones. They particularly noted that the risk was higher when the oestrogen was not balanced by progestogens (synthetic progesterone) but no comparison was made with bioidentical natural progesterone.

This is a pity as the key role of progesterone is to balance excess oestrogen, and this is something the synthetic  progestogens cannot do.  Dr. Antoine Racine, Institut national de la santé et de la recherche médicale (INSERM) and Université Paris Sud, also stated that “Complicated gallstone disease should be added to the list of potential adverse events to be considered when balancing the benefits and risks associated with menopausal hormone therapy,”

It seems clear that the findings of this study support current recommendations for minimizing doses and duration of hormone therapy for menopausal symptoms. However, if hormone therapy is considered necessary, transdermal formulations (such as creams, patches or gels) may have fewer adverse effects than oral formulations.

Helpful information:

If you are at risk from gallstones it makes sense to minimise the effects of oestrogen and to ensure hormone balance with opposing the excess oestrogen with bioidentical natural progesterone.

Tackling oestrogen dominance would be the first place to start by eliminating as much as possible from medications, xenoestrogens and environmental sources.