Hormone therapy linked to higher risks of GERD

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Women who have used hormone therapy for menopausal symptoms may be more likely to develop gastroesophageal reflux disease, or GERD, a new analysis suggests.

The study, published online June 27, 2023, by the journal Menopause, analyzed data from five earlier studies involving more than one million women, none of whom had been diagnosed with GERD before the study's start. Researchers found that participants who were current or past users of hormone therapy for relieving menopausal symptoms were 29% more likely over all to develop GERD, which is characterized by heartburn, difficulty swallowing, and chest pain. Women who used estrogen alone had a 41% higher odds of GERD, while progesterone-only hormone therapy was linked to a 39% higher risk. Hormone therapy combining estrogen and progesterone was associated with only a 16% higher risk for GERD.

The study was observational, meaning it couldn't prove that hormone therapy causes GERD, only that an association exists. Female hormones are believed to relax the muscles that control the lower esophageal sphincter (the valve between the bottom of the esophagus and top of the stomach), allowing stomach acid to flow back into the esophagus. Women considering hormone therapy should review their other risk factors for GERD and make necessary lifestyle changes to prevent it, including quitting smoking, maintaining a healthy weight, and not lying down after eating heavy meals, the study authors said.