Navigating Menopause and Heartburn: Tips for Managing Symptoms

Can heartburn be a symptom of menopause?

Most of us get heartburn from time to time but if you’ve noticed it happening more regularly in your 40s and 50s – or around the time you enter perimenopause – it could be related to the menopause.

Fluctuating hormone levels are thought to be the most likely reason.

We know an increase in oestrogen and progesterone can cause or make heartburn worse which explains why it’s more common in pregnancy.

What isn’t yet clear is how they are linked to heartburn at a time when these hormone levels are decreasing.

Oestrogen and progesterone are both known as muscle relaxants which can hamper the effectiveness of the muscular ring, allowing stomach acid to travel upwards.

Oestrogen is also known to act as an anti-inflammatory which may protect the oesophagus from acid refluxing from the stomach.

While scientists are still working on the answer to the role these hormones play in causing heartburn, studies show hormone replacement therapy (HRT) could also play a part.

One study into the use of oestrogen replacement therapy showed it increased the risk of gastroesophageal reflux disease symptoms (such as heartburn) by 32%.

There are also other menopause factors which can be related to heartburn.

A common symptom of perimenopause and menopause is anxiety, along with stress it’s a known trigger of heartburn and acid reflux.

Hormonal changes can also cause weight gain and being overweight increases the risk of having acid reflux.

How can you avoid menopause heartburn?

Aside from other menopausal symptoms such as anxiety, stress and weight gain, what you eat can exacerbate heartburn.

Spicy or fatty food, tomatoes, citrus fruits and chocolate have all been linked to the condition.

Caffeinated drinks and alcohol can also cause or make it worse alongside smoking, various medicines such as ibuprofen or a bacterial infection in the gut.

While there’s no magic wand for preventing heartburn there are things you can do to help to reduce the risk of it happening by making a few dietary and lifestyle changes.

• Try to avoid the foods and drinks which trigger your symptoms. If you’re not sure what they are, keeping a diary for a couple of weeks can help to identify them.
• Keep meals smaller and more frequent rather than having three larger meals a day.
• Try not to eat three to four hours before going to bed.
• If heartburn is impacting your sleep, try raising the head end of your bed 10-20cm so your head and shoulders are above your waist to help stop stomach acid from travelling upwards.
• Sleeping on your left side may help to relieve acid reflux as it helps the muscular valve to contract. It can also help to digest food more effectively as the stomach is naturally positioned on the left.
• Aim to cut down on alcohol and if you smoke look to seek help from a smoking cessation service or your GP to help you quit.
• Regular exercise – even if it’s a daily walk – isn’t just good for helping to lose weight, it’s also great for boosting your mood and distracting you from stress and anxious thoughts.

When to seek help

If you keep getting heartburn, ask your pharmacist for advice.

Antacids and alginates can help to relieve symptoms in the short term but they won’t cure the root cause.

Your pharmacist may suggest stronger treatments such as omeprazole, a proton pump inhibitor (PPI) widely used to heartburn, indigestion and acid reflux treatment that reduces the amount of acid your stomach makes.

Pyrocalm Control is the first branded 20mg omeprazole available over the counter that provides up to 24-hour confidence in heartburn control.

Used for the short term treatment of reflux symptoms. It can take two to three consecutive days to see an improvement in symptoms.

Available from your local pharmacy and supermarkets – find out where to buy

If lifestyle changes and heartburn relief medicines aren’t helping and you have heartburn most days speak to your GP.