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The PCOS Solution

Your gallbladder and the oral contraceptive pill

Wednesday, December 16, 2015

If you’re considering use of the oral contraceptive pill, a contraceptive implant, a mirena coil or post menopause hormone therapy, you should know that this may increase your risk for gall bladder disease. The research is conflicting, as research often is; but there’s enough in the scientific literature to give you pause before you talk this over with your doctor. (*I’ve listed some papers at the end of this article if you’d like to research further yourself.)

Synthetic hormones are proposed to affect gall bladder function several ways.

- First, they increase the cholesterol saturation in bile, so that formation of cholesterol stones becomes more likely. 

- Secondly, synthetic hormones may increase the formation of inflammatory molecules (arachiodonic acid and prostaglandin) which can cause the gallbladder wall to become inflamed. 

- Lastly, the motility (ability of the gallbladder to squeeze out bile) is affected by synthetic hormones.

It’s important to note that other factors can promote gall bladder disease, including too much of your own hormones, insulin resistance, and a family tendency to gall bladder problems.

Here’s what’s supposed to happen: Your liver is constantly producing bile, but obviously doesn’t need it all right away. So some is stored and concentrated in your gallbladder, in readiness for your next meal. After your repast the fats in the food make it through your stomach and into your small intestine, where a digestive hormone, cholecystokinin, detects them and signals the gall bladder that fats are present. In response your gallbladder squeezes out some bile, the fats are dismantled into molecules and all the good nutrients in that food (including fat soluble vitamins) can now be absorbed. 

So what can you do if you have to use synthetic hormones? After all, there are some situations where medical intervention like the pill is the only way you’ll be able to function – for instance if you have severe endometriosis or excruciatingly painful periods. It’s always a risk-benefit balance decision. However what you can do to help is optimise your gallbladder function and hose down inflammation. Work with your practitioner on the causative factors for your problem while you’re taking the oral contraceptive pill to ease the symptoms.

Diet and lifestyle factors often underpin the symptoms of endometriosis and painful periods. Issues like insulin resistance, a pro-inflammatory diet. Issues that can be addressed while you’re managing your pain through using the oral contraceptive pill.

*The papers are
Etminan et al ‘Oral contraceptives and the risk of gallbladder disease: a comparative safety study 2011 Canadian Medical Association Journal

Cirillo et al ‘Effect of estrogen therapy on gallbladder disease’ 2005 American Medical Association

Thijs et al ‘Oral contraceptives and the risk of gallbladder disease: A meta-analysis’ 1993 American Journal of Public Health

If you enjoyed this article, you might also enjoy 'A brief guide to your gallbladder' 

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