Abstract

PIP: There is still much to learn regarding the effects of female sex hormones on the metabolism of bile acids and cholesterol and about biliary physiology. It has been observed that, in every population studied, cholesterol cholelithiasis occurs more commonly in women than in men. This difference begins during puberty and continues through the childbearing years. Administration of oral contraceptives to premenopausal women doubles the incidence of cholesterol cholelithiasis. Administration of estrogens to postmenopausal women and to men causes similar effects. Obesity is associated as well with excess hepatic cholesterol secretion. Various possible mechanisms for the effect of female sex hormones on biliary lipids, gallbladder storage capacity, and contractility are discussed.