Effects of long-term proton pump inhibitor use on sexual hormones and sexual and reproductive health in female patients

Endocrine. 2024 Feb;83(2):494-501. doi: 10.1007/s12020-023-03572-8. Epub 2023 Nov 1.

Abstract

Purpose: Proton pump inhibitors (PPIs) are widely used to treat a range of gastrointestinal diseases around the world. Long-term use of PPIs has been associated to a variety of undesirable effects. Although short-term therapy has been shown to have little or no effect on endocrine hormone in women, however, its long-term safety has received little attention. We aimed at evaluating long-term use of PPIs and its effects on female reproductive hormones as well as related clinical consequences.

Methods: A cross-sectional study was conducted in two outpatient gastroenterology clinics in the province of Khyber Pakhtunkhwa. This study included female patients who had been using PPIs on a regular basis for 3 months or more.

Results: In total of 101 participants, patients with sexual complaints have significantly altered levels of prolactin (p = 0.05), estrogen (p < 0.001) and progesterone (p = 0.001) than patient without sexual complaints. The frequency of amenorrhea (p < 0.001), cyclic disturbances (p < 0.001), breast augmentation (p = 0.001) and painful breast (p = 0.004) were statistically significant in patients with raised serum prolactin values. Serum values of Sex hormone binding globulin SHBG (p < 0.001), estradiol (p = 0.002) and total testosterone (p < 0.001) were significantly altered between normal prolactin and hyperprolactinemic patients.

Conclusion: These findings suggest that long-term PPI use may cause endocrine hormone disturbances leading to sexual difficulties in women.

Keywords: Endocrine hormones; Estradiol; Long-term; Prolactin; Proton pump inhibitors; Sexual disorders.

MeSH terms

  • Cross-Sectional Studies
  • Estradiol
  • Female
  • Humans
  • Prolactin*
  • Proton Pump Inhibitors*
  • Reproductive Health

Substances

  • Prolactin
  • Proton Pump Inhibitors
  • Estradiol