Progesterone and Acid Reflux: Understanding the Connection

If you've felt the familiar, irritating ache of acid reflux, you've also likely dug around to find out what might be causing it.

There are common culprits, like eating spicy or acidic foods, but could your hormones be one of them? Here’s a closer look at how progesterone, acid reflux, and menstrual cycles can be linked.

Progesterone and Acid Reflux

There is a connection between progesterone and acid reflux, but first, some basics: Progesterone is a hormone that rises in the body during pregnancy and during the second half of the menstrual cycle, closer to when your period starts, according to Cleveland Clinic.

Progesterone allows the lining of the uterus to thicken, which helps the body get ready for a fertilized egg. If that doesn't happen, progesterone levels go down, and a menstrual period begins.

Acid reflux, or gastroesophageal reflux, is what happens when what's in your stomach doesn't flow through your system the way it should, but instead heads back up into your throat through your esophagus, according to Mayo Clinic. If that sounds painful, that's because it can be: It can cause heartburn, plus a bitter, uncomfortable taste in your mouth.

Progesterone can relax the lower esophageal sphincter, which is the muscle between the esophagus and stomach that helps the food and acid in your stomach stay where it belongs, according to the University of Rochester Medical Center. If it's not functioning right, it can lead to acid reflux, says Jason R. Rubinov, MD, a gastroenterologist and clinical instructor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.

This means that progesterone can indeed bring on or worsen reflux, including around the time you get your period. It's also why acid reflux is a common issue during pregnancy.

Other Hormones and Acid Reflux

As it turns out, estrogen, another hormone, can also play a role in acid reflux because it, too, can decrease the tone of the lower esophageal sphincter. That decrease in muscle tone can promote acid reflux, Dr. Rubinov says. This is why acid reflux sometimes occurs with hormone replacement therapy (HRT), which is used by some people around menopause, or with a group of medicines called selective estrogen receptor modulators, he says.

One research review found that women who used HRT to relieve menopause symptoms had a 29 percent increased risk of developing gastroesophageal reflux disease, or GERD, a condition characterized by chronic acid reflux.

People who are postmenopausal don't typically have a hormone-related increase in acid reflux, unless they're using hormone therapy, according to Rubinov. “At menopause, progesterone levels fall, which means that their effects on the lower esophageal sphincter decline, as well,” he says.

Acid Reflux and Other Factors

Of course, there are other factors besides hormones that can contribute to acid reflux, such as health conditions like a hiatal hernia and certain foods and drinks, including spicy or acidic foods, garlic and onions, chocolate, caffeine, and alcohol, according to Cleveland Clinic.

A weight increase may also lead to acid reflux because it can up the pressure on your lower esophageal sphincter, making it less likely to stay closed when it should, according to Harvard Health Publishing.

And while some medications might raise the risk of acid reflux, hypothyroidism medications don't appear to, even though acid reflux seems to be more common in people with the condition, Rubinov says.

3 Tips to Manage Acid Reflux

If you find that you get acid reflux more frequently around your period or other times, here are a few tips from Harvard Health Publishing to help manage and prevent it:

• ‌Avoid foods that trigger acid reflux.‌ These may include garlic, onions, fatty foods, and spicy foods, as well as chocolate, coffee, and alcohol.
• ‌Don't snooze right after eating.‌ Lying down too soon after you eat could cause acid from your stomach to go the wrong way. Try to finish eating three hours before you sleep, and avoid post-meal naps, as tempting as they may be.
• ‌Ask your doctor if any medications you‌‌'re taking could contribute to acid reflux.‌ Tricyclic antidepressants, bisphosphonates taken to increase bone density, and anti-inflammatory pain relievers are among some culprits that can irritate your esophagus and contribute to acid reflux.