As women approach menopause, many experience an increase in acid reflux and heartburn. During perimenopause and post-menopausal years, fluctuating reproductive hormones can significantly affect your body, leading to symptoms like burning in the chest and throat. Scientists don’t fully understand how this process works, but these changes can worsen acid reflux.
According to Sarah Russell, M.D., an internal medicine and gastroenterology specialist at Henry Ford Health, post-menopausal women are more likely to suffer from GERD compared to their pre-menopausal years.
lifestyle changes are essential to manage the disturbing symptoms. Eating smaller meals and avoiding certain foods that trigger acid reflux can help. Reducing stress, maintaining a healthy weight, and quitting smoking are also crucial.
Simultaneously, focusing on better sleeping habits can reduce heartburn and improve overall quality of life. Medications and over-the-counter products can provide relief, while probiotic supplements may address digestive issues linked to menopause.
Menopause and Acid Reflux (How Interconnected?)
During perimenopause, fluctuating hormone levels can lead to increased acid reflux. Women in this phase are about three times more likely to experience acid reflux than those not yet in menopause. The drop in estrogen and rise in testosterone, along with increased cortisol, contribute to this issue.
Additionally, relaxing the oesophagal sphincter and longer stomach digestion times elevate reflux risks. Interestingly, hormone replacement therapy (HRT) may not help and might even worsen reflux symptoms. Nearly half of perimenopausal and menopausal women report acid reflux, with more severe symptoms post-menopause.
What is Acid Reflux?
Acid reflux is a pathological condition where the sphincter—a muscle ring at the oesophagus and stomach junction—doesn’t close properly. This allows acid to rise back up, causing a burning sensation and other symptoms.
If this condition becomes chronic or long-term, it is known as GERD or GORD, (gastroesophageal reflux disease). Although society may normalize heartburn and acid reflux, it is crucial to manage this condition effectively.
Symptoms of Acid Reflux
The most prominent symptom is that You might feel a burning sensation in your chest, a symptom of acid reflux. This happens when stomach acid leaks through the valve between your stomach and the oesophagus, known as the oesophageal sphincter. Some other symptoms include
- The sour taste in your mouth, a recurring cough, or even hiccups.
- a hoarse voice or a weak voice, along with bad breath.
- Feeling bloated or sick after meals is quite noticeable, especially after you’ve eaten because your body produces more acid.
- Activities like lying down or bending over can make it worse by allowing the acid to travel back up your oesophagus.
How Menopause and Acid Reflux are Interconnected
During perimenopause, a woman’s reproductive hormones such as estrogen and progesterone fluctuate, with levels rising and falling before eventually dropping for good once she passes into menopause. This transition can lead to increased acid reflux.
Perimenopausal and menopausal women are around three times more likely to experience acid reflux than those who have not yet started the transition to menopause. Studies have shown that menopause is a greater risk factor for GERD than smoking, drinking, or certain illnesses like asthma, emphysema, or diabetes.
Interestingly, the relationship between changing hormone levels and acid reflux isn’t fully understood. Scientists believe that as a woman’s menstrual cycle ends and estrogen levels reduce, the balance shifts, leading to more testosterone. This shift might explain why GERD becomes more prevalent in menopausal women.
Additionally, food tends to stay longer in the stomach, increasing the likelihood of reflux. The oesophagal sphincter – the muscle that controls the opening and closing of the oesophagus – can also relax, allowing acid to pass into the throat more easily.
Another factor is cortisol production, which increases after menopause, making women feel hungrier and causing them to eat more. This leads to more weight being stored around the belly, contributing further to reflux. Surprisingly, hormone replacement therapy (HRT) doesn’t seem to alleviate these effects and may even increase the risk of reflux.
One study found that nearly 42% of perimenopausal women and 47% of menopausal women reported symptoms of acid reflux. The NHS notes that increases in both estrogen and progesterone are associated with worse acid reflux symptoms. However, symptoms tend to be more severe after menopause, when hormone levels are reduced.
Which Foods Can Worsen Acid Reflux?
During menopause, many women notice changes in their digestion and may experience acid reflux more frequently. Understanding which foods can worsen acid reflux is crucial for managing these symptoms effectively.
Certain foods take longer to digest, causing stomach discomfort and increasing the chances of acid leaking into the oesophagus.
For instance, fatty and fried foods stay in the stomach longer, giving acid more time to move back into the oesophagus and causing heartburn. Spicy and acidic foods, such as citrus fruits, juices, vinegar, and sauces like ketchup, can add to the acid in your stomach. This is similar to the effect of tomatoes, onions, and even peppermint.
Furthermore, alcohol relaxes the oesophageal sphincter, making it easier for acid to escape and irritate the throat. Drinks like coffee and fizzy drinks, along with chocolate, can also be significant triggers for acid reflux.
Here is the list of food items responsible for triggering acid reflux:
- foods having a lot of spices
- fatty and fried foods
- peppermint
- fruits and juices of the Orange family
- vinegar and sauces like ketchup, hot sauce
- tomatoes
- onions
- fizzy drinks and beverages
- chocolate
- coffee
- Alcohol drinks
It’s important to be mindful of these dietary choices to manage symptoms effectively.
Etiological Factors for Acid Reflux
Smoking:
Smoking tobacco significantly contributes to acid reflux and heartburn by relaxing the oesophageal sphincter. This muscle’s relaxation allows acid to enter the oesophagus. Additionally, smoking reduces the production of saliva, which helps neutralise stomach acid. The NHS advises stopping smoking to improve symptoms.
Obesity:
Menopause can trigger acid reflux due to hormonal changes, particularly in estrogen. Carrying extra fat around the waist can contribute to acid reflux. This is because obesity increases pressure on the stomach, which can cause the oesophageal sphincter to leak. Elevated levels of hormones like estrogen during menopause can exacerbate this issue.
To manage symptoms, consider these tips for losing weight:
- Maintain a healthy weight by incorporating regular exercise and a balanced diet.
- Focus on developing a routine that reduces extra fat accumulation.
- Be mindful of foods that trigger reflux, especially during menopause.
As someone who has navigated menopause, I found that managing my weight significantly reduced my acid reflux symptoms. Keeping active and mindful regarding diet helped me avoid the discomfort associated with increased pressure on the stomach.
Stress and Its Effects:
Stress during menopause does not affect the stomach acid secretion directly, however, it can cause pain and discomfort from acid reflux. Increased sensitivity to foods can worsen symptoms, so it’s crucial to reduce stress to managing these issues.
Chronic Pathologies:
Many women experience chronic pathologies like illnesses that include acid reflux. Menopause can cause these symptoms to worsen due to bacterial infections and changes in the stomach lining.
Hiatus hernias and stomach ulcers are common problems that make acid reflux even worse. Personal experience has shown that managing diet and stress can help reduce these symptoms.
Medications:
When dealing with menopause and acid reflux, certain medications can cause or worsen symptoms. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may lead to heartburn and irritation of the lining of the oesophagus.
using NSAIDs during menopause increases acid reflux symptoms and significant irritation and discomfort.
Lifestyle Modification For Menopause And Acid Reflux
Time to Review Eating Habits:
As someone who has experienced both menopause and acid reflux, I know that changing the way you eat can make a big difference. The biggest culprits for triggering acid reflux are spicy and acidic foods like tomatoes, as well as fatty foods, carbonated drinks, caffeine, and alcohol. One strategy that has worked is having smaller, more frequent meals. These meals digest more quickly, which can help in reducing heartburn and other reflux symptoms.
eating at least three hours before bed prevents the worst symptoms that often occur after meals. By changing the way you eat, you can improve things significantly. If specific foods or drinks trigger your symptoms, it’s best to avoid or limit them. Having smaller meals more often helps in reducing the amount of stomach acid you produce. Also, leaving a gap of 3–4 hours between eating and going to bed reduces stomach acid, making it less likely to travel up towards your throat when you’re lying down.
Sleeping Habits:
establishing a good sleeping routine can significantly reduce the effects of reflux at night. Studies have shown that certain positions can help. For instance, elevating the head of your bed by 10–20 cm using wood or bricks can be beneficial. This method helps by raising your chest and head above your stomach, preventing acid from rising into your throat while you sleep. Avoid propping yourself up with pillows as this can make symptoms worse by increasing pressure on your stomach. I recommend sleeping on your left side rather than your right. This doesn’t stop acid from moving up your oesophagus, but it does clear more quickly, causing less damage and heartburn pain. Ensuring you get enough restorative sleep is also important, as it keeps cortisol levels in check.
Healthy Weight Loss:
Maintaining a healthy weight is crucial during menopause and perimenopause, as obesity can increase the risk factors for acid reflux and other symptoms. losing weight gradually through a nutritious, balanced diet like the Mediterranean diet made a significant difference.
This diet includes a wide variety of plants, whole grains, and healthy fats, which not only helps in weight loss but is also sustainable. It’s important to avoid a calorie-restricted diet, as it’s not effective long-term, exercise regularly, but sometimes intense exercise could lead to bouts of acid reflux.
To manage this, warm up slowly and sometimes take antacid medication before my workouts. Being overweight puts more pressure on the digestive organs, thereby increasing the risk of reflux. Through these changes, you can manage to alleviate your symptoms and improve your overall health.
Stress Management:
Managing stress is crucial during menopause to help reduce the impact of acid reflux. Engaging in regular exercise can boost your mood and give your mind a break from anxious thoughts. incorporating exercise into your daily routine not only helps you to process these thoughts but also significantly reduces stress levels.
To further aid in stress management, you can embrace techniques like meditation, yoga, and deep breathing exercises. These practices are effective in lowering the hormone cortisol, which helps to reduce stress and lower blood pressure.
Sharing thoughts with a sympathetic friend, family member, or colleague can also be incredibly beneficial. Sometimes, talking about your experiences can lighten the emotional load. You can also try talking therapy, including cognitive behavioural therapy (CBT), which has been a game-changer for emotional well-being.
Say NO to Smoking and Alcohol:
During menopause, managing acid reflux becomes vital, and saying no to smoking and alcohol can make a significant difference. Smoking increases pressure in the oesophagus, leading to more frequent episodes of reflux. Similarly, alcohol consumption impacts sleep quality and the oesophagus, causing abnormal acid secretion and disrupting the mucosa lining in the stomach.
These factors combined worsen reflux symptoms. By addressing both smoking and alcohol habits, you can better manage acid reflux and ensure a more comfortable experience during menopause.
Appropriate Medication:
During menopause and perimenopause, women often experience symptoms like acid reflux and heartburn, which can be managed by taking antacids that help neutralise stomach acid. Additionally, alginates form a barrier on top of the acid, providing short-term relief.
However, for persistent issues, it’s important to consult a doctor who may prescribe proton pump inhibitors such as omeprazole or lansoprazole to reduce the amount of acid the stomach produces.
Persistent symptoms like food getting stuck in the throat, feeling sick, or experiencing unexplained weight loss should be checked by a professional. Furthermore, taking probiotic supplements can help manage menopause symptoms by introducing friendly bacteria that boost gut health and provide various benefits to the body.
What happens if Acid Reflux is left untreated?
When menopause hits, many women find themselves dealing with reflux. This isn’t just any acid reflux—it’s often more painful and regular, deeply affecting the quality of life. Over time, this can lead to serious health issues. The increased risk of developing ulcers in the oesophagus is real.
Even more concerning is Barrett’s oesophagus, where damaged cells grow abnormally, raising the risk of cancer. If you notice these symptoms, it’s crucial to see a doctor.
However, it’s also important to remember that most people with acid reflux don’t develop these severe conditions. Regular check-ups can help manage and mitigate these risks, ensuring you maintain a good quality of life during and after menopause.
Does HRT Help with Acid Reflux?
When it comes to menopause and acid reflux, many women wonder if hormone replacement therapy (HRT) can provide relief. Hormone changes during perimenopause and menopause are often linked to an increased risk of acid reflux. However, research and large-scale studies show that HRT doesn’t improve these symptoms. Both perimenopausal and menopausal women are at a greater risk of developing GERD and acid reflux.
Interestingly, menopausal women on HRT are more likely to have GERD. Despite this, low levels of estrogen or other hormones don’t necessarily reduce acid reflux. Perimenopausal women with higher levels of reproductive hormones still experience symptoms. This complex relationship between hormone changes and acid reflux leaves much that scientists still don’t understand.
It’s clear that the relationship between hormone changes and acid reflux is complicated, and scientists still don’t understand everything. It’s essential to discuss all treatment options with your healthcare provider, especially when dealing with perimenopausal and menopausal symptoms.
Is Menopause Associated Heartburn Curable?
Many women experience heartburn and acid reflux as a symptom during menopause. For those who are perimenopausal, these issues can be especially troublesome. It’s important to make lifestyle changes and try different products that might help.
If these adjustments don’t improve your situation, you’ll likely need to consult a doctor. Regularly feeling these symptoms means you could be suffering from something that requires medical attention.
FAQs:
Can acid reflux be a symptom of menopause?
During menopause, many women experience fluctuating oestrogen levels which can alter how much acid the stomach produces, leading to heartburn. A study found that 42% of perimenopausal and 47% of menopausal women suffered from this symptom.
Can hormonal imbalance cause acid reflux?
According to research, elevated levels of estrogen and progesterone can significantly increase the chances of experiencing gastroesophageal reflux. This theory is supported by various observations showing that lower oesophagal sphincter pressures tend to decrease during pregnancy and with the use of sequential oral contraceptives.
Does menopause cause gastric problems?
During menopause, many women experience gastric problems like acid reflux and bloating. These issues can cause significant discomfort. it’s common to feel flatulence after meals because the food is not fully digested. This can also lead to constipation. Menopause often brings changes that affect digestion, leading to an increase in gas and other related symptoms.
How to treat menopause indigestion?
Managing menopause indigestion can be eased with natural remedies like Black cohosh, Dong Quai, and Evening Primrose oil. Licorice root (though not if you have high blood pressure), Red Clover, Siberian Ginseng, and Wild Yam are beneficial, as is Omega-3 if you’re not getting it from your diet (rich in DHAs). These can help soothe symptoms effectively.