Hormone-containing therapies may increase the risk of IBS and functional dyspepsia

A large-scale, retrospective study of 712,741 women found that hormone-containing contraceptives and hormone replacement therapy (HRT) may be linked to irritable bowel syndrome (IBS) and functional dyspepsia.

The study analysed medical records from general practices in the United Kingdom, focusing on women aged 15 and older who were prescribed oral contraceptives or intrauterine devices (IUDs), as well as women aged 55 and older who were prescribed HRT [1]. Patients with inflammatory bowel disease, coeliac disease, peptic ulcer, gastric cancer, or colorectal cancer were excluded.

The primary endpoints were the prevalence rates of IBS and functional dyspepsia and their associations with hormone therapies. The mean age at first registration was 40 years. Among women aged 15 and older, 33% used oral contraceptives and 4.5% used IUDs. Among women aged 55 years and older, 33% used HRT. The overall prevalence of IBS was 16.7% (95% CI 16.6–16.8) and functional dyspepsia had a prevalence of 19.0% (95% CI 18.9–19.1).

Oral contraceptive use was strongly associated with IBS (OR 2.44; 95% CI 2.48–2.41; P<0.001), and a similar association was found for IUD use (OR 2.10; 95% CI 2.15–2.05; P<0.001). These associations were minimally affected by proton pump inhibitor use or Helicobacter pylori’s presence. For women aged 55 and older, HRT use was associated with an increased risk of IBS (OR 1.63; 95% CI 1.65–1.61; P<0.001). The association between oral contraceptives and IUD use with functional dyspepsia in women aged 15 and older was relatively weak. However, for women aged 55 and older, HRT use was significantly associated with functional dyspepsia (OR 2.09; 95% CI 2.12–2.06; P<0.001), though this association was reduced after controlling for proton pump inhibitor use and Helicobacter pylori’s presence.

The study demonstrates that oral contraceptives, IUDs, and HRT are associated with IBS, while HRT is also associated with functional dyspepsia. These findings suggest that hormone-containing therapies are important risk factors for certain gut-brain disorders.

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   1. Jones M, et al. Oral contraceptives, hormonal replacement therapy and risk of disorders of gut-brain interaction (irritable bowel syndrome and functional dyspepsia): a primary care study of over 700,000 women. Mo1133, DDW 2024, 18–21 May, Washington DC, USA.

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Posted on 11 July 202411 July 2024