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Postmenopausal hormone therapy associated with increased risk for GERD symptoms, Nurses' Health Study data suggest

Thursday, October 16 2008 | Comments

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What's This? Women who use postmenopausal hormone therapy, including over-the-counter (OTC) hormone preparations, are at increased risk for symptoms of gastroesophageal reflux disease (GERD), suggests a recent analysis.

To evaluate the association between hormone therapy and GERD, researchers analyzed data for 51,637 postmenopausal women enrolled in the Nurses' Health Study. The participants had provided data about postmenopausal hormone therapy use biennially since 1976. In 2002, they provided information about GERD symptoms and about their use of selective estrogen receptor modulators (SERMs: tamoxifen and raloxifene) and OTC hormone preparations.

A total of 12,018 women in the cohort (23%) reported GERD symptoms occurring at least once weekly. Compared with the women who never used postmenopausal hormone therapies, those who had used them were more likely to develop GERD symptoms. The increased risk of GERD symptoms was significant among past hormone users (multivariate OR, 1.46; 95% CI, 1.36-1.56), current users of estrogen only (multivariate OR, 1.66; 95% CI, 1.54-1.79), and current users of combined estrogen and progesterone (multivariate OR, 1.41; 95% CI, 1.29-1.54).

The risk of GERD symptoms increased with increasing dosage of current estrogen use and with a longer duration of use (P<.001 for both trends). The risk of GERD symptoms seemed to decrease with time since discontinuation of estrogen therapy, but this trend was not statistically significant.

SERMs and OTC hormone preparations were also associated with GERD symptoms. Relative to those who never used postmenopausal hormone therapies, the odds of GERD symptoms were 39% greater among the current SERM users (OR, 1.39; 95% CI, 1.22-1.59) and 37% greater among the current users of OTC preparations (OR, 1.37; 95% CI, 1.16-1.62).

"Postmenopausal use of estrogens, SERMs, or OTC hormone preparations is associated with a greater likelihood of symptoms of GERD," the authors concluded. "This suggests a hormonal component to the pathophysiologic characteristics of GERD in women." (Jacobson BC, et al. Arch Intern Med 2008;168:1798–1804.)

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