P1612 - Risk of De Novo Gastroparesis in Pre- and Peri-Menopause, Non-Obese Females on Progestogen-Only Contraceptives Versus Combined OCP: A Multi-Center Analysis

Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Luis Nieto, MD⁴, Pedro Palacios-Argueta, MD⁵, Paul Kroner, MD, MSc⁶, Frank J. Lukens, MD^7
1Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; ²Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT; ³Universidad de Guayaquil, School of Medicine, Atlanta, GA; ⁴Emory School of Medicine, Atlanta, GA; ⁵Mayo Clinic Florida, Jacksonville, FL; ⁶Riverside Regional Medical Center, Newport News, VA; ⁷Mayo Clinic, Jacksonville, FL

Introduction: There is evidence suggesting that oral contraceptive pills (OCP) may stabilize gastroparesis symptoms associated with hormonal fluctuations. Progesterone has been shown to slow gastrointestinal motility in a dose-dependent manner, theoretically worsening gastroparesis symptoms. However, this association has not been studied. The aim of this study is to assess the risk of de novo gastroparesis in pre- and peri-menopause, non-obese females on progestogen-only contraceptives versus combined OCP.

Methods: A retrospective cohort study was performed using large population-based data from the TriNetX platform. All female patients aged 18 – 51 years between January 1, 2010, and May 31, 2024, were identified. Patients with obesity (BMI ≥ 30), diabetes mellitus, and medications associated with gastroparesis were excluded. Two cohorts were defined based on the treatment received, progestogen-only contraceptives versus combined OCP. The cohort of patients who received progestogen-only contraceptives was matched with patients who received combined OCP according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. The primary outcome was de novo gastroparesis, and secondary outcomes were gastroesophageal reflux disease (GERD), functional dyspepsia, nausea and vomiting, abdominal pain, cholecystitis, cholelithiasis, and Barrett’s esophagus. Odds ratio (OR) with 95% confidence intervals were calculated; p-value < 0.05 was considered statistically significant.

Results: The progestogen-only contraceptive cohort included 87,990, while the OCP group included 114,109. After propensity matching 1:1, 75,255 patients were included from each cohort. In the progestogen-only group, the mean age was 24.8 years. In the OCP group, the mean age was 24.7 years. The progestogen-only group had significantly lower risk of GERD (OR 0.81; 0.76 – 0.87), functional dyspepsia (OR 0.73; 0.58 – 0.91), and nausea and vomiting (OR 0.91; 0.86 – 0.95). No significant differences were observed in de novo gastroparesis, abdominal pain, cholecystitis, cholelithiasis, and Barret’s esophagus.

Discussion: Pre- and peri-menopause, non-obese females on progestogen-only contraceptives do not have increased risk of de novo gastroparesis when compared to those on combined OCP. Moreover, the rates of GERD, functional dyspepsia, and nausea and vomiting are lower in the progestogen-only cohort. Further studies are required to elucidate the mechanism of these findings.


Disclosures:


Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Luis Nieto, MD⁴, Pedro Palacios-Argueta, MD⁵, Paul Kroner, MD, MSc⁶, Frank J. Lukens, MD⁷. P1612 - Risk of De Novo Gastroparesis in Pre- and Peri-Menopause, Non-Obese Females on Progestogen-Only Contraceptives Versus Combined OCP: A Multi-Center Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.