Newer oral contraceptives don't increase gallbladder risk

Concerns that oral contraceptives (OCs) containing the fourth-generation progestin drospirenone (Yasmin, Yaz) might pose a higher risk of gallbladder disease than older formulations with levonorgestrel are unjustified, a new Canadian study suggests.

Researchers found that the overall risk of gallbladder removal among more than 2.7 million US women who used OCs between 1997 and 2009 wasn’t significantly higher in women taking pills with newer versions of progestin-including drospirenone-than women prescribed pills containing levonorgestrel. About 1% of both levonorgestrel users and drospirenone users had gallbladder surgery over an average follow-up period of about 1 year.

“Strictly on the side effect of gallbladder disease with these drugs, it appears from our study that the risks are pretty much the same amongst different agents,” says lead researcher Mahyar Etminan, PharmD, MSc. No previous studies have looked at whether gallbladder disease varies with different OC formulations, he notes.

When the researchers considered factors such as obesity and smoking habits, they found a small statistical increase in the risk of gallbladder surgery in women taking drospirenone and 2 other newer progestins (desogestrel and norethindrone), compared with women taking levonorgestrel. However, the differences are unlikely to be “clinically significant,” the researchers say.

Compared with other women, women taking OCs have a higher risk of gallstones and other gallbladder disorders, such as inflammation. Media reports of gallbladder problems associated with newer OCs containing drospirenone have prompted concern that these pills pose a greater gallbladder risk than other OC formulations.

The study was published online April 18 in the Canadian Medical Association Journal.