P0632 - Risk of Constipation and Slow Transit Constipation 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, Miguel Salazar, MD⁴, Luis Nieto, MD⁵, Pedro Palacios-Argueta, MD⁶, Paul Kroner, MD, MSc⁷, Frank J. Lukens, MD^8
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; ⁴University of California Riverside, Riverside, CA; ⁵Emory School of Medicine, Atlanta, GA; ⁶Mayo Clinic Florida, Jacksonville, FL; ⁷Riverside Regional Medical Center, Newport News, VA; ⁸Mayo Clinic, Jacksonville, FL

Introduction: Both progesterone and estrogen have been implicated in decreased colonic motility, potentially leading to slower transit times and consequently, constipation. However, this association has not been studied extensively. The aim of this study is to assess the risk of constipation and slow transit constipation 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 constipation 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 outcomes were constipation, slow transit constipation, overflow incontinence. The secondary outcomes were nausea and vomiting, abdominal pain, cholecystitis, cholelithiasis, and gastroesophageal reflux disease (GERD). Odds ratio (OR) with 95% confidence intervals were calculated; p-value < 0.05 was considered statistically significant.

Results: The progestogen-only contraceptive cohort included 74,467, while the OCP group included 96,382. After propensity matching 1:1, 64,638 patients were included from each cohort. The mean age was 25.1 years for both cohorts. The progestogen-only group had significantly lower risk of constipation (OR 0.83; 0.77 – 0.90), nausea/vomiting (OR 0.91; 0.86 – 0.96), and GERD (OR 0.80; 0.73 – 0.87). No significant differences were observed in slow transit constipation, overflow incontinence, abdominal pain, cholecystitis, and cholelithiasis.

Discussion: Although no significant differences were observed in slow transit constipation, pre- and peri-menopause, non-obese females on progestogen-only contraceptives have 17% lower risk for overall constipation when compared to those on combined OCP. Additionally, the rates of GERD and nausea and vomiting were lower in the progestogen-only cohort. Further studies are required to determine the clinical impact of contraceptive use.


Disclosures:


Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Miguel Salazar, MD⁴, Luis Nieto, MD⁵, Pedro Palacios-Argueta, MD⁶, Paul Kroner, MD, MSc⁷, Frank J. Lukens, MD⁸. P0632 - Risk of Constipation and Slow Transit Constipation 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.