Tie pill-gallbladder ills to raised cholesterol.

Recent reports indicate that oral contraceptive users have twice the risk and postmenopausal women on estrogen therapy 2.5 times the risk of developing gallbladder disease as those who do not use these drugs. Supersaturation of gallbladder bile with cholesterol and changes in bile acid have been suggested as the reason. In a study, the mean level of cholesterol saturation was found to be 92% in a group of women not taking the pill and 125% when they were taking oral contraceptives. This difference was considered highly significant (p .001). Of 11 women studied before and then during pill use, 10 showed raised cholesterol levels in bile during this therapy (p .01). Also the relative proportions of bile acids changed. Cholic acid was increased during pill use and the proportions of chenodeoxycholic acid and lithocholic acid were decreased. It was noted that chenodeoxycholic acid therapy has been used experimentally to promote disappearance of gallstones by decreasing cholesterol saturation of bile. It has been claimed that chemical gallbladder disease predates the X-ray evidence of gallstones by months or years. It has been suggested that the real incidence of gallbladder disease associated with pill use and other estrogen therapy is higher than formerly thought.