Heartburn

• Gastrointestinal complaints are nearly three times more common in women during menopause.
• Declining oestrogen and progesterone levels affect digestion and can also weaken the muscle between the stomach and oesophagus, allowing stomach acid to rise.
• Symptoms can range from a burning sensation in the chest to regurgitation, pain, coughing, or difficulty swallowing.
• Diet, large meals, fatty and acidic foods, alcohol, caffeine, stress, and being overweight can also contribute to or exacerbate symptoms.
• Antacids and supplements can help manage persistent symptoms. Hormone therapy may also provide indirect relief.

During menopause, oestrogen and progesterone levels decrease. These hormones are thought to play a role in digestion. A decline in these hormones can lead to delayed gastric emptying (the process by which food moves from the stomach to the small intestine), bloating, and a weakening of the muscle between the stomach and oesophagus. This weakening increases the likelihood of heartburn and acid reflux.

Heartburn can cause unpleasant and painful symptoms. You may feel a temporary burning sensation in the chest, particularly after eating or when lying down. Stomach acid rises into the oesophagus, causing discomfort. Occasional heartburn that hasn’t become chronic is referred to as reflux. If reflux occurs frequently and over a prolonged period, it may develop into GERD (gastro-oesophageal reflux disease). GERD is a chronic condition with symptoms such as heartburn, chest pain, coughing, and difficulty swallowing.

Research indicates that gastrointestinal complaints are nearly three times more common in women during menopause. While this connection is still being studied, it highlights the significant role hormonal changes can play. Symptoms can range from heartburn and reflux to GERD, and women often experience these symptoms more intensely during menopause.

Other factors can also contribute to heartburn. Diet and certain beverages can trigger symptoms. Fatty or acidic foods, large meals, eating too quickly, alcohol, and caffeine are common culprits.

Lifestyle factors such as smoking, stress, and anxiety can increase the risk. Lying down or bending over immediately after eating increases pressure on the stomach, which can worsen heartburn. Being overweight also places additional pressure on the stomach.

Certain medications can increase stomach acid production or weaken the oesophageal sphincter, leading to symptoms. Additionally, specific stomach conditions can cause issues. For instance, an H. pylori infection (a bacterium that infects the stomach lining) can cause inflammation. A hiatus hernia, where part of the stomach pushes up through the diaphragm, can also contribute to problems.

There are several effective ways to manage heartburn. You don’t have to live with it. Supporting your body naturally with healthy nutrition, sufficient exercise, and rest can make a difference. Additionally, supplements, medications, and hormone therapy (HRT) may help.

When hormone levels change during menopause, it can affect energy levels, sleep, digestion, and metabolism. Healthy nutrition, regular exercise, and rest can help prevent or alleviate symptoms. Even small adjustments can make a noticeable difference.

When using medications or supplements, a balanced lifestyle supports your body in absorbing nutrients and processing medications, enhancing their effectiveness. Experts recommend the following for heartburn:

• Eat smaller meals throughout the day. Heavy, fatty, and spicy meals can trigger heartburn. You may also find that certain foods you previously tolerated are no longer agreeable during menopause. Adjusting your diet accordingly can help.
• Avoid eating just before bedtime. This can cause discomfort as stomach contents may enter the oesophagus when lying down.
• Avoid coffee, alcohol, and carbonated drinks like fizzy drinks, as these often trigger symptoms.
• Stress can worsen heartburn. Incorporate more breaks into your day and practise relaxation exercises such as yoga, walking, mindfulness, or breathing techniques. Research shows that reducing stress often alleviates heartburn.
• Exercise daily. Physical activity reduces stress, stimulates digestion, and improves metabolism.
• Use antacids for temporary relief. These reduce stomach acidity. If you experience persistent or severe symptoms, consult a doctor to identify the cause and determine the most appropriate treatment.

Replenishing the hormones that decline during menopause is one of the most effective treatments for various menopausal symptoms. Hormone therapy (HRT) directly addresses vasomotor symptoms such as hot flushes and night sweats, as well as vaginal symptoms like dryness. It can also sometimes (indirectly) alleviate other symptoms such as sleep disturbances, concentration issues, and heartburn.

HRT is not suitable for everyone, and a doctor will carefully assess whether this treatment is appropriate for your health and symptoms.

Many women are unaware that, in addition to hormone therapy, there are proven effective hormone-free medications to relieve menopausal symptoms. While hormone therapy can address multiple symptoms simultaneously, hormone-free medications often target a specific symptom. For example, certain antidepressants (SNRIs) for hot flushes, anti-inflammatory drugs for joint pain, or antacids for heartburn.

Hormone-free medications are always prescribed by a doctor. They can be a good option for those who cannot or do not wish to use hormone therapy. These medications work directly on the symptom without affecting your hormonal balance, allowing for targeted relief.

During menopause, your body’s processes for generating energy, building muscle, and repairing skin undergo changes. You can naturally support these processes with high-quality supplements. Magnesium, vitamin D, and omega-3 are recommended for all women during menopause. Supplements can also target specific symptoms such as hot flushes, poor sleep, and heartburn.

The effectiveness of supplements varies from person to person, depending on factors such as lifestyle and overall health. The quality of the product also plays a significant role. Choose high-quality supplements without unnecessary fillers.