Gallstones

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Risk of gallstones and cholecystitis is increased with all oestrogen preparations.
Oral preparations increase biliary cholesterol and saturation, promote its precipitation in the bile and also reduce gall bladder mobility, all contributing to gallstone formation.
Risk is higher with oral preparations compared to transdermal preparations, however even with the transdermal route, the increased risk is not completely abolished.
Women with gallstones should be informed of the above information before deciding to commence HRT and if HRT is started, clinicians should be careful to monitor for signs of worsening gallstone disease.

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