Postmenopausal women who have a history of submucous fibroids and abnormally heavy menstrual bleeding may find that when they start hormone replacement therapy, the heavy bleeding recurs. Some studies have found, however, that standard HRT doses do not increase the risk for recurring fibroids in most postmenopausal women. Estrogen stimulates the liver to remove cholesterol from blood and divert it into the biliary tract and gallbladder. If too much cholesterol is dumped by the liver into the gallbladder, it may precipitate out of the bile solution and form gallstones. As a result, postmenopausal women taking high doses of estrogen face an increased risk for gallstones.
Low doses pose no problem.
Gallstones are very common in all older American women but are rarely problematic. It should be noted, however, that the risk for this condition is still extremely low. Only women with a previous history of thromboembolism or other risk factors for it should avoid HRT for this reason. Liver Disease Complications. Estrogens do not damage the liver, but they metabolize more slowly in women with diseased livers, this can result in an increased effect of estrogen.