In acid reflux, the stomach’s contents are regurgitated back up the esophagus. In addition to many other symptoms, this condition can cause burning and discomfort in the chest. Some evidence suggests that several hormones in the body may play a role in acid reflux. Estrogen is one example. This important hormone is responsible for the regulation and development of the female reproductive system, including the menstrual cycle. While the exact role of estrogen in acid reflux is not known, some evidence suggests that estrogen, together with other hormones, may have an aggravating effect.
Estrogen and Acid Reflux in Pregnancy
During pregnancy, the body experiences a surge in several important hormones, including estrogen. The hormone helps a mother’s uterus maintain the pregnancy and also stimulates development in the fetus. Some evidence suggests that this hormone surge may also contribute to acid reflux. It is theorized that this is because estrogen may cause a valve in the esophagus, called the lower esophageal sphincter (LES), to relax. This relaxation allows the contents of the stomach to reverse course and travel back up the esophagus. As a result, acid reflux occurs, and the individual can experience heartburn, difficulty swallowing, coughing and nausea.
Estrogen, Hormone Replacement Therapy and Acid Reflux
In hormone replacement therapy, estrogen, along with other hormones, is given during menopause or afterward. Such treatments can help minimize symptoms like hot flashes or vaginal dryness. It also helps prevent bone loss, which can occur due to the sharp drop in estrogen after menopause. Unfortunately, the supplemental estrogen received when undergoing hormone replacement therapy, along with another hormone called progesterone, may also lead to acid reflux. Some research suggests that this may be due to relaxation of the LES, though other mechanisms are possible. According to a 2008 study in the "Journal of the American Medical Association," the risk of GERD symptoms increased with the dose and the duration of estrogen use.
Estrogen, Obesity and Acid Reflux
Obesity is associated with an increased risk of acid reflux. Being overweight is believed to contribute to reflux in a number of different ways. The effect of extra body fat on estrogen levels might be one of them. Circulating estrogen levels tend to be higher in overweight and obese females, especially after menopause. If such elevation causes a loosening of the LES, women with a higher body mass index may be at greater risk for developing acid reflux for a number of reasons. Maintaining a healthy BMI can help avoid this.
Estrogen, Birth Control and Acid Reflux
Many women use contraceptives as means of birth control. Whether taken orally, administered via a patch, injected or implanted within the body, many of these contraceptives use estrogen to limit fertility. Some researchers theorize that the hormones in these contraceptives may lead to an increase in the risk of developing acid reflux. According to the authors of a 2007 study in the "Journal of Gastroenterology and Hepatology," a relationship has been found between the use of oral contraceptives and the development of acid reflux.
Side Effects of Estrogen and Acid Reflux
The use of estrogen, whether in hormone replacement therapy or birth control, can lead to many side effects, including nausea and vomiting, and some of these symptoms are similar to those associated with acid reflux. An increase in any of these symptoms may be serious and should not automatically be attributed to heartburn. In addition, long-term use of estrogen can place a person at an increased risk for blood clots, heart disease, stroke and some forms of cancer. Thus, it is very important for people to report any symptoms to their medical provider.
- Best Practice and Research Clinical Gastroenterology: Gastroesophogeal Reflux Disease in Pregnancy
- JAMA Internal Medicine: Postmenopausal Hormone Use and Symptoms of Gastroesophogeal Reflux
- Endocrine Related Cancer: Body Fatness as a Cause of Cancer
- Clinical Gastroenterology and Hepatology: Determinants of Gastroesophageal Reflux Disease in Adults With a History of Childhood Gastroesophageal Reflux Disease