Gallstones & Hormones: Why Women Are More Prone to Gallbladder Issues

When you think of “women’s health,” gallstones probably aren’t the first thing that comes to mind. They definitely weren't on mine - until, well it had to be!

We’re used to hearing about periods, pregnancy, perimenopause, and hot flashes - but the gallbladder? Not so much. And yet, women are up to three times more likely than men to suffer from gallstones and gallbladder problems.

So what’s going on? Spoiler: hormones have a lot to do with it.

Meet your gallbladder (the overlooked organ)

The gallbladder is a small, pear-shaped organ tucked neatly under your liver. Its job is to store bile, a digestive fluid that helps break down fats. But sometimes, bile hardens into stones - ranging in size from a grain of sand to a golf ball. When these stones block ducts, they can cause severe pain, nausea, and even require surgery to remove the gallbladder altogether.

Why women are at higher risk

So why do gallstones seem to “pick on” women? The answer lies in the powerful interplay of hormones:

• Estrogen – This hormone increases cholesterol in bile. Higher cholesterol means a higher chance of stones forming. That’s why women on birth control pills or hormone replacement therapy (HRT) can have a slightly increased risk.

  
  

• Progesterone – Often called the “relaxing hormone,” progesterone can slow down the emptying of the gallbladder, allowing bile to sit longer and form stones.

  
  

• Pregnancy – During pregnancy, both estrogen and progesterone levels soar, making gallstones more common in expectant mums. In fact, some women discover gallbladder issues for the first time during or after pregnancy.

  
  

• Perimenopause and menopause – Hormonal changes in midlife can also alter how the gallbladder functions, which is why gallstones often appear around this time.

Beyond hormones: lifestyle factors

Of course, hormones don’t tell the whole story. Diet and lifestyle play a role too. Diets high in fat and low in fibre, rapid weight loss, and sedentary habits can all contribute to gallstone formation. Add genetics into the mix (they often run in families), and the odds stack even higher.

The “female gallbladder story”

It’s no coincidence that doctors sometimes refer to the “4 Fs” when it comes to gallstones: Female, Forty, Fertile, and Fair. It’s a dated phrase, but it reflects the reality that women, particularly around middle age, face higher risks. The key difference today is that women are more aware of their health, asking questions, and pushing for answers.

What can women do?

The good news is that not every gallstone causes trouble - many people live with them and never even know they exist. But if you’re at risk, small lifestyle tweaks can help:

• Eat a balanced, fibre-rich diet

• Stay active and maintain a healthy weight (without crash dieting)

• Keep an eye on digestive discomfort, especially upper right abdominal pain, nausea after fatty meals, or bloating

And, importantly, talk to your doctor if you have a family history of gallbladder issues or are considering hormone therapies.

Gallbladder health doesn’t always get the spotlight, but it deserves a place in the women’s health conversation. Our hormones may put us at higher risk, but understanding the link gives us power - to watch out for symptoms, make proactive lifestyle choices, and take control of our health at every life stage.