Hormone Use and GERD / Acid Reflux

As many as half of all women experience some heartburn during pregnancy. It's not just caused by the growing fetus, but the valve at the top of the stomach, called the lower esophageal sphincter, becomes weaker in pregnancy. Just why this happens is not known, but the theory is that the pregnant woman's higher levels of estrogen and progesterone may contribute to the weakened sphincter, allowing the stomach's contents to reflux back into the esophagus.

A study recently published in the Archives of Internal Medicine (2008;168(16):1798-1804) examined that theory. They made use of data collected in the Nurses' Health Study, which began in 1976 and followed the lives of over 121,000 women until the present day. Every two years the participants fill out follow-up surveys that ask about their medical history, personal habits and medication use. Every four years they also supply information about their diets.

In 2002 the questionnaire the nurses received asked whether they had experienced heartburn or acid reflux, how often they had these symptoms, and for how many years they had been experiencing them. Using that information, the researchers designated those women experiencing heartburn / acid reflux symptoms once a week or more as having symptoms of GERD (Gastroesophageal Reflux Disease).

The researchers excluded from consideration women who were premenopausal and those women who were taking medications for GERD / acid reflux. Those women who were in menopause also answered questions about whether they had used hormone replacement therapy or whether they used over-the-counter "herbal, natural, or soy-based preparations" to treat post-menopausal symptoms.

After comparing the experiences of those postmenopausal women with GERD to those without symptoms of GERD, the researchers noted that compared to those women who had never used hormone replacement therapy or herbal preparations, those women who were currently using hormone replacement therapy or preparations were almost 75% more likely to experience symptoms of GERD. Indeed, the higher the dosage and the longer the use of the medications or preparations, the higher the risk of GERD symptoms. This held true even when the researchers limited the comparison to those who had "very frequent" GERD symptoms of "several times a week or daily."

What this means for you

Yet another reason to avoid hormone replacement therapy, whether prescribed or over-the-counter, unless there are clear benefits for you. If you're on hormone replacement therapy, be sure you know why you're on it. It might just be giving you heartburn.

First posted: November 5, 2008