For many decades, evidence of a link between gall bladder problems and oral contraceptives has been mounting. What is the nature of this evidence? Can oral contraceptives really increase the risk of gallbladder disease?
Oral contraceptives are used to prevent pregnancy, and are approximately 99% effective. There are two main classes of oral contraceptives: a combined pill which contains both progestin and estrogen, and a progestin-only pill which is sometimes referred to as the mini-pill. Most oral birth control medications have several potential side effects, some of which are minor, and some of which are more serious. Serious complications include an increased risk of liver or breast cancer, stroke, heart attack, or blood clot.
The use of oral birth control medication can also increase the risk of developing gallbladder disease. The gallbladder is a small organ located beneath the liver. It secretes a substance called bile, which helps break down fats in the stomach. In gallbladder disease, gallstones, formed of deposits of cholesterol and other substances, cause symptoms such as pain and inflammation of the gallbladder.
Gall Bladder Problems and Oral Contraceptives: The Evidence
Some studies have shown that there is a link between gall bladder problems and oral contraceptives. The following list outlines various different studies that have been carried out on women taking oral contraceptives. The studies have examined gallbladder health in women using oral birth control, and control groups of women not using oral contraceptives.
- A 1976 study was one of the first to find physical evidence to support the existence of a true link. This study found that women taking oral contraceptives had significant changes in the composition of their bile; the researchers theorized that these changes might account for the increased risk of gallbladder disease. (Bennion, et. al. 1976).
- A 1993 review of current literature on gallbladder disease and oral contraceptives concluded that oral contraceptive use was associated with a slightly elevated risk of gallbladder disease. The researchers also suggested that newer low-dose oral contraceptives were safer in this regard than older contraceptives. (Thijs and Knipschild, 1993).
- A 1994 study of 482 women with benign gallbladder disease concluded that there was so significant association between oral contraceptive use and benign gallbladder disease. In addition, no link was found between BMI or age and gallbladder disease. (Vessey and Painter, 1994).
In general, it seems that the risk is higher with so-called combined oral contraceptives than with progestin-only contraceptives. Another important point is the suggestion that the risk of gallbladder disease is more likely to increase in women who either already have gallstones, or who are susceptible to gallbladder disease for other reasons.
C Thijs and P Knipschild. Oral contraceptives and the risk of gallbladder disease: a meta-analysis. Am J Public Health. 1993 August; 83(8): 1113–1120.
National Institute of Health MedlinePlus: Estrogen and Progestin (Oral Contraceptives).
LJ Bennion, RL Ginsberg, MB Gernick, and PH Bennett. (1976) Effects of oral contraceptives on the gallbladder bile of normal women. New England Journal of Medicine. 294: 189-192.
Martin Vessey, Md, FRS, Rosemary Painter, Ma, DPhil. Oral contraceptive use and benign gallbladder disease; revisited. Volume 50, Issue 2, Pages 167-173 (August 1994).