TUDCA for Women: Pregnancy, Hormones and Menopause

There are no TUDCA benefits shown specifically for women: women took part in most TUDCA trials, often as the majority, but no trial looked at results for women separately. TUDCA's medicine labels say not to take it during pregnancy, and the Italian label adds breastfeeding. What is different for women is the gallbladder itself, because estrogen, pregnancy and hormone therapy all affect gallstone risk.

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Search for TUDCA benefits for women and you will find promises of hormonal balance, liver detox and support for female physiology. None of these come from studies of women taking TUDCA. Yet women do have real reasons to think about bile and the gallbladder, from pregnancy to menopause, and women are more likely than men to develop gallstones [1].

This guide sets out what the TUDCA trials show about women, what the labels say about pregnancy and breastfeeding, and what estrogen, pregnancy and hormone therapy do to the gallbladder. It finishes with life after gallbladder removal.

Does TUDCA Have Benefits for Women?

We found no TUDCA benefit shown specifically for women. Women took part in most of the trials and were often the majority, but none reported results for women separately, and we found no study of TUDCA in menopause. The benefits studied in people, such as liver enzymes in liver disease and indigestion in the month after gallbladder removal, are covered in our guide to TUDCA benefits.

How many women took part in TUDCA trials?

Women took part in most trials, and were the majority in the gallbladder and liver trials:

• after gallbladder removal, 138 of 203 people, about two-thirds [2]
• in a trial in primary biliary cholangitis, a liver disease, 167 of 199 [3]
• in a four-week insulin study in adults with obesity, 12 of 20 [4]
• in a year-long trial in ALS, 10 of 29 [5]

That tells us women took TUDCA in these trials. It doesn't tell us whether it works differently in women, because no trial looked.

Can You Take TUDCA During Pregnancy?

No. Both medicine labels list pregnancy among the situations where TUDCA should not be used [6, 7], and no study has tested it in pregnant women. Women who could conceive are asked to use reliable contraception, a non-hormonal method on the Turkish label [6, 7]. Our guide to who should not take TUDCA covers the full list.

What happens to the gallbladder in pregnancy?

Sludge and gallstones often form during pregnancy and often go away afterward. In a US study of 3,254 women, 10.2% had sludge or stones on at least one scan by four to six weeks after delivery, but many cleared, and 4.2% had new sludge or stones on the scan after delivery [8]. In an Italian study of 272 women, new sludge appeared in 31%, was generally without symptoms, and had gone in 61% of women followed after delivery [9].

What is intrahepatic cholestasis of pregnancy?

Intrahepatic cholestasis of pregnancy is a liver condition of pregnancy marked by itching and raised bile acid levels in the blood [10]. The itching typically affects the palms and soles, usually in the second half of pregnancy, and the condition affects up to 2% of pregnancies [11]. It poses little risk to the mother but needs monitoring because of risks to the baby, so itching in pregnancy is something to tell your doctor or midwife about [10].

US maternal-fetal medicine specialists recommend ursodiol, a long-established prescription medicine also called UDCA, as the first treatment for the mother's itching [10]. In the largest trial it eased itching slightly, but outcomes for babies were similar to placebo [12]. It is prescribed and monitored by your care team, and it is not a reason to take TUDCA, which the labels rule out in pregnancy.

Can You Take TUDCA While Breastfeeding?

The Italian label rules TUDCA out while breastfeeding; the Turkish one asks the doctor to weigh the benefit for the mother against any risk for the baby [6, 7]. We found no study that measured TUDCA in breast milk. One trial of TUDCA in breastfeeding mothers has been registered but, as of October 2026, had not started recruiting, so it offers no safety data [13].

Many pages say only that TUDCA should be avoided because research is limited. The labels go further, so if you are breastfeeding, the safest course is to wait.

Why Do Women Get More Gallstones?

Women are more likely to develop gallstones than men, and NIDDK says women with extra estrogen in their body from pregnancy, hormone replacement therapy or birth control pills may be more likely to form them [1]. One review describes women at all ages as twice as likely as men to form cholesterol gallstones, a difference that starts at puberty [14].

Estrogen changes bile. According to The Menopause Society, estrogens increase the amount of cholesterol the liver puts into bile, make that cholesterol more likely to form crystals, and slow gallbladder emptying [15]. In a study of 29 women, an oral estrogen raised cholesterol secretion into bile and made bile more prone to forming stones [16]. Obesity, older age and fast weight loss also raise gallstone risk [1].

Does Menopause Affect the Gallbladder?

In the years around menopause, hormone levels go up and down unpredictably [17]. The gallbladder question that has been studied most around menopause is hormone therapy, which adds estrogen back. Our guide to menopause bloating covers digestive changes around menopause more broadly.

Does hormone therapy raise gallbladder risk?

Oral hormone therapy, which your doctor may prescribe for menopause symptoms such as hot flashes [18], did in the large WHI trials of women aged 50 to 79. Gallbladder events occurred at 78 per 10,000 women a year on estrogen alone vs 47 on placebo, and 55 vs 35 on estrogen plus a progestin [19]. A 2026 Cochrane review, drawing on the same trials, found that oral therapy probably increases gallbladder disease needing surgery with estrogen alone, and may increase it with estrogen plus a progestin, and noted these older oral treatments may not represent the hormone therapy used today [20].

Patches and gels may carry less risk. In a UK study of about a million women, gallbladder disease was more common with oral therapy than with patches or gels, compared with women who never used it [21]. That was an observational study, and The Menopause Society notes that no randomized trial has confirmed the difference [15]. US labels for both estrogen pills and patches carry the same gallbladder warning [18, 22].

Should you stop hormone therapy if you have gallstones?

That depends on why you take it and what your stones are doing, so it is a decision for the doctor who prescribes your hormones. Don't stop on your own. TUDCA's labels advise avoiding estrogens and hormonal contraceptives alongside it [6, 7], so mention TUDCA too if you are thinking of taking it.

What If You've Had Your Gallbladder Removed?

Many women reach the question of TUDCA after gallbladder removal, which the labels don't list as a reason not to take it [6]. In the one trial after gallbladder removal, about two-thirds of participants were women, and indigestion eased faster on TUDCA in the first month, after which the untreated group caught up [2]. Our guide to TUDCA after gallbladder removal covers the research in detail.

After removal, bile flows directly from the liver into the small intestine instead of being stored for meals [23]. Dr.Primal's TUDCA is made for life after gallbladder removal and taken with meals, to support healthy bile flow and fat digestion when richer meals feel heavy.

In Summary: TUDCA for Women

No TUDCA benefit has been shown specifically for women, and the labels rule it out in pregnancy and, on the Italian label, while breastfeeding. Women's gallbladders are affected by estrogen, pregnancy and oral hormone therapy, which can make gallstones and gallbladder problems more likely, and the labels advise against combining TUDCA with estrogens.

If you are working out what is behind your symptoms after meals, our digestion quiz is a quick way to put your symptoms and habits in order.

This article is for general education and is not a substitute for advice from your doctor. TUDCA is sold as a dietary supplement. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.