Progesterone is an important hormone in the female body, produced by the ovaries and the adrenal glands -- and in pregnant women, by the placenta. This hormone plays several significant roles, including preparing the body for and maintaining a pregnancy. In addition, together with other hormones, it helps regulate the monthly menstrual cycle and can influence mood and sexual desire. Progesterone is frequently used in hormone replacement therapy and in treating infertility. Unfortunately, progesterone can also bring on or worsen acid reflux.
Progesterone and Acid Reflux
Acid reflux, or heartburn, occurs when the stomach contents are regurgitated back up the esophagus. This can lead to burning and discomfort in the chest or throat area. It can also cause difficulty swallowing, coughing or nausea. Progesterone is one of many things that can cause or aggravate acid reflux. The hormone causes relaxation of the lower esophageal sphincter (LES), a ring of muscle in the esophagus that contracts to keep stomach contents from flowing in the wrong direction. If this muscle ring relaxes too much, the contents of the stomach can rise back up the esophagus and cause acid reflux. This is one reason pregnant women get heartburn -- their progesterone levels are elevated.
Several lifestyle modifications may help decrease acid reflux symptoms, even when progesterone is present or elevated. Overweight individuals -- with a BMI of 25 or greater -- are at increased risk for developing acid reflux. Weight loss can help decrease the frequency of symptoms or even resolve them in some cases. Smoking cessation and sleeping with the upper body slightly elevated also help decrease the likelihood of acid reflux.
Modifying the diet can also help minimize the likelihood of developing acid reflux. Individuals may have different triggers that aggravate heartburn symptoms, but some of the common culprits include caffeine, chocolate, alcohol, mint, raw onion and garlic. These foods may, like progesterone, contribute to reflux by relaxing the lower esophageal sphincter, or they may aggravate reflux through different mechanisms. The American College of Gastroenterology also recommends limiting intake of fatty foods, as these also seem to trigger symptoms.
Warnings and Precautions
Those experiencing new or worsening acid reflux should contact their medical providers. Chronic acid reflux can lead to long-term damage, including erosion of the lining of the esophagus and esophageal ulcers, but treatment can mitigate some of these risks. Progesterone therapy, in addition to any influence it may have on acid reflux, can have side other side effects, including effects on mood. Finally, whether or not you are on hormone replacement therapy, chest pain should be taken seriously. It should not automatically be attributed to heartburn, because cardiac chest pain and heartburn are often confused for one another.
Is This an Emergency?
- Alimentry Pharmacology & Therapeutics: The Management of Heartburn in Pregnancy
- Obesity: Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial
- American Journal of Gastroenterology: Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease