Current, past menopausal hormone therapy use linked to GERD

Key takeaways:

• Hormone therapy use was associated with 29% higher odds for GERD among postmenopausal women.
• Estrogen and progestogen use were both significantly directly associated with GERD.

Past or current use of menopausal hormone therapy is significantly associated with GERD among postmenopausal women, according to results of a systematic review and meta-analysis.

“Previous research has associated female sex with symptomatic GERD, attributed to elevated levels of estrogen and progesterone seen during pregnancy and with oral contraceptive use,” Wafa A. Aldhaleei, MBBCh, MSc, MPH, graduate student in the department of epidemiology and biostatistics at the Bloomberg School of Public Health at Johns Hopkins University, and colleagues wrote. “However, the association between hormone therapy and GERD in postmenopausal women remains unclear.”

Aldhaleei and colleagues evaluated five randomized controlled trials and observational studies published from 2008 to 2022 — identified in PubMed, MEDLINE, Embase, Web of Science or Scopus — that investigated the association between menopausal hormone therapy (HT) and GERD. The studies included 1,031,134 participants.

In the pooled analysis published in Menopause, researchers observed a significant direct association between estrogen use and GERD (adjusted OR = 1.41; 95% CI, 1.16-1.66) and a significant direct association between progestogen use and GERD (aOR = 1.39; 95% CI, 1.15-1.64). Combined HT use was also associated with GERD among postmenopausal women (aOR = 1.16; 95% CI, 1-1.33).

Researchers noted that HT use was associated with 29% higher odds for GERD among postmenopausal women (aOR = 1.29; 95% CI, 1.17-1.42).

In addition, due to the large number of pooled study participants, study design differences, patient characteristics and outcome assessment, there was significant high heterogeneity in this systematic review and meta-analysis, according to the researchers.

“Gastroesophageal reflux disease risk factors should be included in the evaluation of women with menopause symptoms and considered in patient-centered discussions about the risks and benefits of HT for menopause symptom management,” the researchers wrote. “Further research is needed to determine whether HT is associated with an increased risk of GERD in postmenopausal women.”