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Menopause after a history of intrahepatic cholestasis of pregnancy

Turunen, Kaisa MD1; Helander, Kristiina MA1; Mattila, Kari J. MD, PhD1,2; Sumanen, Markku MD, PhD1

doi: 10.1097/GME.0000000000000101
Brief Report

Objective: Intrahepatic cholestasis of pregnancy is a hormone-provoked disorder that fades quickly after parturition. The aim of this study was to establish whether a history of intrahepatic cholestasis of pregnancy reduces the use of hormone therapy for menopausal symptoms and, irrespective of hormone therapy, whether intrahepatic cholestasis is associated with other health aspects after menopause.

Methods: In 2010, questionnaires were sent to a cohort of women who delivered in Tampere University Hospital, Finland, from 1969 to 1988. The study population comprised postmenopausal women with a history of intrahepatic cholestasis of pregnancy (n = 189) and their controls (n = 416). The main outcome measures were the use of hormone therapy and other means of alleviating menopausal symptoms, and the diseases the women reported.

Results: There were no differences in the use of hormone therapy between the two groups. Of the diseases reported, breast cancer, hepatobiliary diseases, and hypothyroidism were more frequent among women with a history of intrahepatic cholestasis of pregnancy, whereas cardiac arrhythmia was less frequent. With respect to other diseases, there were no differences.

Conclusions: A history of intrahepatic cholestasis of pregnancy does not reduce the use of hormone therapy. However, when physicians prescribe hormone therapy for these women, a history of intrahepatic cholestasis of pregnancy calls for attention in view of its association with gallstones.

From the 1Department of General Practice, School of Medicine, University of Tampere, Finland; and 2Center for General Practice, Pirkanmaa Hospital District, Tampere, Finland.

Received June 3, 2013; revised and accepted August 22, 2013.

Funding/support: The Center for General Practice at the Tampere University Hospital District funded the postal survey.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Kaisa Turunen, MD, Department of General Practice, School of Medicine, FI-33014 University of Tampere, Finland. E-mail: kaisa.turunen@uta.fi

© 2013 by The North American Menopause Society.