Menopause is a time of many major changes. As your body moves through this transition, there are effects that go way beyond your monthly period stopping. After menopause, women are more prone to a variety of health conditions. These include heart disease, osteoporosis and gastroesophageal reflux disease (GERD).
“Post-menopausal women are about two or three times more likely to have GERD than pre-menopausal women,” says Sarah Russell, M.D., an internal medicine and gastroenterology specialist at Henry Ford Health.
What Is GERD?
Gastroesophageal reflux disease occurs when acid from your stomach makes its way back into your throat. This symptom is also called acid reflux. “The acid can also cause heartburn—a sensation that feels like a burning pain in the chest,” says Dr. Russell.
Hormonal Changes And GERD
Overall, GERD is more common in men than women. But with age, more women suddenly begin to experience acid reflux and heartburn. As your menstrual cycle winds down, so does the production of certain hormones.
As your body produces less estrogen, the ratio of hormones in your body shifts. Because you now have less estrogen circulating, the balance tips. Suddenly you have more testosterone than estrogen.
“That shift may be one reason why more women start to experience GERD for the first time after menopause,” says Dr. Russell. “GERD is much more prevalent in men, and after menopause, women’s hormones are a bit more like men’s.”
Less estrogen can affect how long food stays in the stomach (the longer it stays, the more likely you are to experience reflux). It can also cause the esophageal sphincter (the muscle that opens and closes the esophagus) to relax, allowing acid to pass into the throat more easily.
Cortisol is another hormone that’s affected by menopause—and that also plays a role in GERD symptoms. “Cortisol production increases after menopause,” says Dr. Russell. “More cortisol makes you feel hungrier, so you eat more. And cortisol also makes you store more weight around your belly.”
Surprisingly, using hormone replacement therapy (HRT) doesn’t seem to alleviate the effects of menopause on GERD symptoms. “You would expect that replacing estrogen would make all those things go away,” says Dr. Russell. “But current research suggests that HRT can actually increase the risk of reflux.”
Lifestyle Changes For Menopause And Acid Reflux
Luckily, making a few healthy lifestyle changes can often significantly improve GERD symptoms—or even prevent reflux in the first place. These habits are important for good health at any age, but Dr. Russell says they’re even more critical after menopause.
Habits that will help keep your digestive system healthy and prevent reflux and heartburn include:
Managing GERD
- Avoiding foods that trigger reflux: The biggest culprits tend to be spicy foods, acidic foods (like tomatoes), fatty foods, carbonated drinks, caffeine and alcohol.
- Eating smaller, more frequent meals: Smaller meals digest more quickly. It’s also important to avoid eating less than three hours before bed.
- Exercising regularly: Physical activity helps reduce cortisol levels. It also keeps your digestive system moving and helps you manage your weight.
- Getting enough sleep: Restorative sleep helps keep cortisol levels in check.
- Limiting use of anti-inflammatory medications: Medications like ibuprofen can irritate the lining of your stomach.
- Maintaining a healthy weight: Being overweight or obese means more pressure on your digestive organs, increasing your risk of reflux.
- Not smoking: Smoking increases your risk of acid reflux and puts you at risk for developing esophageal cancer.
Reviewed by Sarah Russell, M.D., an internal medicine and gastroenterology specialist who sees patients at Henry Ford Hospital in Detroit and Henry Ford Medical Center - Columbus.
