Progestogens’ biliary problems

The need for cholecystectomy in women taking oral contraceptive pills containing ethinyl oestradiol and drospirenone has led to litigation in North America. This has prompted research into a possible link between drospirenone and gall bladder disease.

Researchers analysed a database containing health information on 78 million Americans, including 2,721,014 women who had taken a combined contraceptive pill for at least six months.

There were 27,087 cases of cholecystectomy among the women. Factors significantly associated with gall bladder disease included, smoking, obesity and pancreatitis.

After adjusting for these factors the effect of the contraceptive pills could be assessed. The different progestogens were compared with pills containing levonorgestrel. 

The risk of cholecystectomy was significantly increased in women taking pills containing desogestrel, drospirenone and norethindrone.

There were 567,447 women who used