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HRT Use Raises Risk of Stomach Trouble
Date:9/8/2008

nes had a 46 percent higher risk of having symptoms of GERD, compared with women who had never used postmenopausal hormones. Women currently using estrogen only had a 66 percent raised risk while those currently using combined estrogen and progesterone had a 41 percent increased risk.

The chances of developing GERD symptoms were higher with higher doses of hormones and longer duration of use.

Current SERM users had a 39 percent increased risk, while women taking over-the-counter preparations had an increased risk of 37 percent.

"This is important for a couple of reasons, one just for proof of principle in terms of the mechanisms and pathophysiology," Jacobson said. "We had always suspected [exogenous hormones] might do it. Now, we have more evidence that hormones do somehow cause people to get more heartburn.

The exact biological mechanisms aren't clear yet, but it looks like hormones may lower pressure in the esophageal sphincter.

Because of other risks, including heart attack and breast cancer, experts generally recommend that women limit their use of postmenopausal hormones.

And if a woman does take hormones and experiences heartburn, she might consider an alternative for her menopausal symptoms, Jacobson said.

"A woman [taking hormones who develops GERD] may need additional medication or she may make the decision with her doctor that it's not worth it to continue hormones," said Dr. Jennifer Wu, an obstetrician/gynecologist with Lenox Hill Hospital in New York City. "GERD is something we will have to keep an eye on when putting patients on hormones. It's not an obvious symptom to patients. . . . so we may need to inform patients ahead of time."

More information

The National Digestive Diseases Information Clearinghouse has more on GERD.



SOURCES: B
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