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

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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.

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Acknowledgements

The authors would like to express their gratitude to Dr. Adil Naseer Khan (Head Gastroenterology. Department, Ayub Teaching Hospital, Abbottabad and Dr. Muhammad Naeem Gastroenterologist, Health Department, Mardan) for getting administrative approval and allowing us to perform this study in their outpatient clinics. The authors would also like to thank Ms. Saima Staff Nurse and Ms. Maryam Arif for their cooperation in conducting interviews with female patients.

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Authors and Affiliations

  1. Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan

    Muhammad Ashfaq, Qasim Khan, Syed Mobasher Ali Abid, Muhammad Junaid Hassan Sharif & Yasser M. S. A. Alkahraman

  2. Department of Community Medicine, Ayub Medical College, Abbottabad, Pakistan

    Muhammad Zeeshan Haroon

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Contributions

M.A.: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing—original draft. Q.K.: Formal analysis; Software; Validation. M.Z.H.: Conceptualization, Supervision; Validation, Writing—review & editing, Project administration. S.M.A.A.: Investigation, Formal analysis. M.J.H.S.: Data curation, Methodology, Validation. Y.MSA.A: Conceptualization, Supervision; Validation, Writing—review & editing.

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Correspondence to Yasser M. S. A. Alkahraman.

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Ashfaq, M., Khan, Q., Haroon, M.Z. et al. Effects of long-term proton pump inhibitor use on sexual hormones and sexual and reproductive health in female patients. Endocrine 83, 494–501 (2024). https://doi.org/10.1007/s12020-023-03572-8

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