Postmenopausal hormone therapy (PMHT) is associated with an increased risk of acute pancreatitis, reveals a new prospective population-based study.

The association between use of exogenous sex hormones (PMHT and oral contraceptives) and increased risk of acute pancreatitis has been noted in case reports published since the 1970s, but had not been investigated prospectively in a large group of women. To address this lack of data, Viktor Oskarsson and colleagues obtained self-reported information from 31,494 postmenopausal women in the Swedish Mammography Cohort about their baseline use of PMHT; 13 years later, in 2010, they analysed the Swedish National Patient Register to identify the women who had been admitted to hospital with acute pancreatitis.

At baseline, 14,721 women had never used PMHT, 3,660 were past users and 13,113 were current users of this therapy. During the studied period, 237 cases of incident acute pancreatitis were recorded among the cohort. Women who had ever used PMHT had an approximately 1.5 times increased risk of acute pancreatitis compared with those who had never used this therapy. The risk seemed to be higher among women who had used PMHT for hot flushes and among those who had used the therapy for >10 years.

Oskarsson points out that the study findings need to be confirmed by other large and well-controlled studies. He also hopes that future research will examine the role of various preparations, doses and routes of administration of PMHT in relation to acute pancreatitis, which were aspects not addressed in this study.

“Whilst PMHT is effective in the treatment of postmenopausal symptoms, its benefits go hand-in-hand with potential risks,” comments Oskarsson. “As such, the decision to use PMHT should be made by each woman having been given sufficient information by her physician to make a fully informed choice.” On the basis of the study findings, Oskarsson concludes that an increased risk of acute pancreatitis may have to be added to the list of potential adverse effects to be considered when balancing the benefits and risks associated with PMHT.