Baltimore, MD—For years, postmenopausal women have complained about digestive symptoms with the use of hormone therapy (HT). Now, a new systematic review and meta-analysis has identified a significant link between the use of HT and GERD.

Background information in the Menopause report noted that GERD—which has a global prevalence of nearly 14%—includes symptoms such as heartburn, dysphagia, and chest pain. The authors from the Bloomberg School of Public Health at John Hopkins University and colleagues pointed out that antidepressants and anti-inflammatory drugs also are suspected of causing GERD, although there has been conflicting evidence.

The researchers looked at the association between ever or current menopausal HT use and GERD using a systematic review and meta-analysis. Five full-length studies were included that covered more than one million participants and were published between 2008 and August 31, 2022.

The pooled analysis of the found a significant direct association between estrogen use and GERD (aOR [adjusted odds ratio] 1.41; 95% CI, 1.16-1.66; I2 = 97.6%) and progestogen use and GERD (two studies: aOR 1.39; 95% CI, 1.15-1.64; I2 = .0%). The use of combined HT was also associated with GERD (1.16; 95% CI, 1.00-1.33; I2 = 87.9%). “Overall, HT use was associated with 29% higher odds for GERD (aOR 1.29; 95% CI, 1.17-1.42; I2 = 94.8%),” the authors wrote. “The large number of pooled participants, differences in study design, geography, patient characteristics, and outcome assessment resulted in significant high heterogeneity.”

The authors pointed out out that all five studies reported a significant association between estrogen use and GERD, as well as between GERD and HT containing a combination of estrogen plus a progestogen. They noted that women who received combined estrogen-progestogen therapies had a lower risk of GERD symptoms compared with HT containing estrogen alone or progestogen alone.

The researchers cautioned, however, that their results should be interpreted with caution, given the small number of included studies and high heterogeneity. Still, they advised, “This warrants careful evaluation of GERD risk factors when prescribing HT to reduce the risk of potential GERD complications.”

Additional research is suggested because of the small number of included studies. HT has proven effective in treating many menopause symptoms. GERD risk factors should be considered when evaluating women with menopause symptoms.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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