Lim Alexandria H, Varghese Chris, Sebaratnam Gabrielle, Schamberg Gabriel, Calder Stefan, Gharibans Armen, Andrews Christopher N, Daker Charlotte, Foong Daphne, Ho Vincent, Wise Michelle R, O'Grady Gregory
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Alimetry, Auckland, New Zealand.
Clin Transl Gastroenterol. 2025 Sep 1;16(9):e00880. doi: 10.14309/ctg.0000000000000880.
Chronic gastroduodenal disorders are more prevalent among young women, many of whom are hormonal contraception users. We aimed to evaluate the effects of hormonal contraception on symptom severity and gastric myoelectrical activity in people with chronic gastroduodenal disorders.
This analysis was conducted on a large international cohort of patients who met Rome IV criteria for chronic nausea and vomiting syndrome or functional dyspepsia and had undergone body surface gastric mapping using Gastric Alimetry. Symptoms were continuously reported on 0-10 Likert scales using a validated symptom logging app.
One hundred twenty-seven people were included: 43 women using hormonal contraception, 30 not using hormonal contraception, 30 postmenopausal women, and 24 men. Hormonal contraception users had higher nausea than nonusers (3.80 [interquartile range 2.00-5.42] vs 2.25 [0.20-4.43]; P < 0.05), particularly when using combined oral contraceptives with hormone-free intervals compared with continuous use (5.20 [4.30-6.00] vs 2.40 [1.70-3.80], P = 0.02). Premenopausal women were more symptomatic than postmenopausal women and men ( P < 0.001). Principal Gastric Frequency was higher in hormonal contraception users (median 3.1 cpm vs 3.00 cpm, P < 0.001) and highest with progestogen-only formulations ( P < 0.02).
Women with gastroduodenal disorders on hormonal contraception experience increased nausea in comparison with nonusers, with substantial variation dependent on contraceptive type. Hormonal contraception users also demonstrated modified gastric electrophysiology. These results imply that nonhormonal contraceptive alternatives should be trialled as a means to reduce symptoms in gastroduodenal disorders.
慢性胃十二指肠疾病在年轻女性中更为普遍，其中许多人使用激素避孕法。我们旨在评估激素避孕法对慢性胃十二指肠疾病患者症状严重程度和胃肌电活动的影响。
本分析针对一大组符合罗马IV标准的慢性恶心和呕吐综合征或功能性消化不良患者的国际队列进行，这些患者使用胃动力测量仪进行了体表胃电图检查。使用经过验证的症状记录应用程序，通过0至10的李克特量表持续报告症状。
共纳入127人，其中43名使用激素避孕法的女性、30名未使用激素避孕法的女性、30名绝经后女性和24名男性。使用激素避孕法的人比未使用者恶心程度更高（3.80[四分位间距2.00 - 5.42]对2.25[0.20 - 4.43]；P < 0.05），特别是与连续使用相比，使用有激素无间隔期的复方口服避孕药时（5.20[4.30 - 6.00]对2.40[1.70 - 3.80]，P = 0.02）。绝经前女性比绝经后女性和男性症状更明显（P < 0.001）。使用激素避孕法者的主胃频率更高（中位数3.1次/分钟对3.00次/分钟，P < 0.001），仅含孕激素制剂使用者的主胃频率最高（P < 0.02）。
与未使用者相比，患有胃十二指肠疾病且使用激素避孕法的女性恶心程度增加，且因避孕类型不同有显著差异。使用激素避孕法者的胃电生理学也有改变。这些结果表明，应尝试使用非激素避孕替代品来减轻胃十二指肠疾病的症状。
