Abstract
That ovarian secretions may influence the formation of gallstones is suggested by several observations. In the first place, the excess prevalence of gallstones among women appears shortly after the menarche.1 2 3 Secondly, estrogen-replacement therapy in postmenopausal women and oral-contraceptive treatment in premenopausal women increase the risk of gallbladder disease,4 5 6 7 as does estrogen administration in men.8 Thirdly, oophorectomy in the rat is accompanied by a decrease in the ratio of cholesterol to its solubilizing lipids — bile acids and phospholipids — in bile.9 Fourthly, administration of exogenous estrogens and progestins to animals and human beings raises the ratio of biliary cholesterol to . . .