POSTMENOPAUSAL HORMONE USE AND CHOLECYSTECTOMY IN A LARGE PROSPECTIVE-STUDY

Objective: To examine the association between postmenopausal hormone u se and cholecystectomy. Methods: A prospective cohort study was perfor med, with follow-up every 2 years. Participants were 54,845 postmenopa usal United States nurses, who reported both hormone use and cholecyst ectomy on mailed questionnaires. Results: Cholecystectomy was reported by 1750 women during 8 years of follow-up. After adjusting for confou nding factors, women currently using postmenopausal hormones were at a n increased risk of cholecystectomy (relative risk [RR] 2.1, 95% confi dence interval [CI] 1.9-2.4) compared to never-users. For current user s, the risk of cholecystectomy increased with increasing duration of h ormone use (RR 2.6, 95% CI 2.2-3.1 for 10 years or more) and higher do ses of estrogen (RR 2.4, 95% CI 2.0-2.9 for users of 1.25 mg or more). Although the risk for past hormone users decreased substantially in w omen who had discontinued use 1-2.9 years ago (RR 1.6, 95% CI 1.2-2.0) , a small risk persisted for women who had stopped taking hormones 5 o r more years previously (RR 1.3, 95% CI 1.1-1.6). However, after contr olling for time since last use, duration of past use had little or no effect on the risk of cholecystectomy (RR 1.4 and RR 1.7 for past user s of less than 2 years and 10 or more years' duration, respectively). Conclusion: Women using postmenopausal hormones are at an increased ri sk of cholecystectomy. Women and their physicians should consider the spectrum of risks and benefits when deciding whether to take hormones. (Obstet Gynecol 1994;83:5-12)