The relationship between female sex and cholelithiasis is not well clarified. There is some evidence that relates the pathogenesis of the gallstones to hormonal alterations. Perimenopausal women with dyspeptic symptoms revealed substantial delay in gallbladder emptying. Some elements related to the perimenopause may be responsible for the reduction of gallbladder emptying. This probably contributes to the pathogenesis of gallstones which are much more frequent during this period.