HRT therapy may increase risk of acute pancreatitis

Women who use postmenopausal hormone replacement therapy (HRT) may be at increased risk of acute pancreatitis, found a new study in CMAJ (Canadian Medical Association Journal).

Acute pancreatitis, a sudden inflammation of the pancreas, has symptoms that range from mild discomfort to severe, debilitating pain and may, in some cases, even lead to death.

Although several case reports have indicated that there may be an association between use of HRT and risk of acute pancreatitis, the evidence from large studies is sparse. To understand whether there is an association, the researchers looked at data on 31 494 Swedish postmenopausal aged 48-83 years at the start of the 13-year study from 1997 to 2010. At the start of the study, 13 113 (42%) of the women were current users of HRT, 3660 (12%) were previous users, and the remainder had never used the therapy. Of the current users of HRT, 6795 (52%) used systemic therapy for hot flashes, 4148 (32%) used local therapy for vaginal dryness, and 2170 (16%) used both therapies.

After taking account of factors likely to influence the results, the researchers found that women who currently or previously had used HRT had an approximately 1.5 greater risk of acute pancreatitis than those who had never used the therapy. The risk seemed to be higher among women who used and those who had used HRT for more than 10 years.

"There are no contemporary data that might explain our finding that the risk was sustained among past users of [HRT] or that the risk seemed to increase with duration of use," writes Dr. Viktor Oskarsson, Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, with coauthors. "These findings, though speculative, may suggest that exogenous estrogen induces some persistent change in the pancreas for which the duration of exposure may be important."

The authors suggest that if additional studies confirm these findings, physicians should consider the risk of when prescribing HRT.

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.131064

add to favorites email to friend print save as pdf

Related Stories

Hormone replacement therapy—clarity at last

May 24, 2013

The British Menopause Society and Women's Health Concern have today released updated guidelines on Hormone Replacement Therapy (HRT) to provide clarity around the role of HRT, the benefits and the risks. The new guidelines ...

Recommended for you

UN chief: Ebola cases in Mali a 'deep concern'

9 hours ago

The United Nations chief warned Friday that Ebola may be easing in part of West Africa but is still hitting hard in other areas and outpacing the international response.

Ebola death toll rises to 5,459: WHO

16 hours ago

The World Health Organization said Friday that 5,459 people had so far died of Ebola out of a total 15,351 cases of infection in eight countries since late December 2013.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.