Effect of Hormonal Replacement Therapy on Gastroesophageal Reflux Disease and its Complications in Postmenopausal Women

Saleh, Sherif; Trujillo, Silvia Blair; Ghoneim, Sara; Charles, T J; Fass, Ronnie

doi:10.1016/j.cgh.2022.01.058

Cited by 8 publications

(26 citation statements)

References 8 publications

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“…COC increased the odds of developing GERD by 93% in the univariate analysis and 16% when accounting for common GERD risk factors. Our results support the results of other HRT‐based studies that show that COC supplementation increases the risk of GERD symptoms 3,9,13 . Importantly, COC have both estrogen and progesterone when compared to Nexplanon.…”

Section: Discussionsupporting

confidence: 89%

“…During pregnancy, when there is an increase in plasma progesterone, there is some data suggesting that it does increase the likelihood of GERD 19–21 . Progesterone‐only HRTs were previously shown to increase the risk of GERD 9 . However, this association disappeared when accounting for factors such as obesity and NSAID use.…”

Section: Discussionmentioning

confidence: 95%

“…Our results support the results of other HRT-based studies that show that COC supplementation increases the risk of GERD symptoms. 3,9,13 Importantly, COC have both estrogen and progesterone when compared to Nexplanon. Estrogen TA B L E 1 Demographics and of premenopausal women on no contraceptives with GRED compared with premenopausal women on COC with GERD and premenopausal women on Nexplanon with GERD.…”

Section: Discussionmentioning

confidence: 99%

“…However, in another study, 24‐h esophageal pH monitoring and esophageal manometry revealed no significant differences in both percent pH time <4 and lower esophageal sphincter pressures despite substantial differences in progesterone levels in the follicular phase as compared to the luteal phase in healthy premenopausal women 8 . A recent study showed that progesterone‐only HRT is not an independent risk factor for GERD in postmenopausal women 9 . Thus, the effect of progesterone alone on GERD remains to be fully elucidated.…”

Section: Introductionmentioning

confidence: 96%

“…8 A recent study showed that progesterone-only HRT is not an independent risk factor for GERD in postmenopausal women. 9 Thus, the effect of progesterone alone on GERD remains to be fully elucidated. Furthermore, in premenopausal women, there are no studies examining the role of progesterone alone contraception on the risk of developing GERD.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The effect of combined oral contraceptives and Nexplanon on gastroesophageal reflux disease in premenopausal women: A nationwide database analysis

Saleh

Liu

Trujillo

et al. 2023

Neurogastroenterology Motil

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Background: Pregnancy, combined oral contraceptives (COC), and hormone replacement therapy have been reported to increase the risk of gastroesophageal reflux disease (GERD). To date, no study has evaluated the effect of Nexplanon, a commonly used progesterone-based contraceptive, on GERD. We aimed to determine the effect of Nexplanon and COC on GERD. Methods:We performed a population-based analysis using the IBM Explorys national database . The study group included premenopausal women, defined as women less than 50 years of age while excluding the diagnosis of menopause. The effect of Nexplanon and COC on GERD (at least 30 days after Nexplanon/COC was initiated) was assessed by comparing it to premenopausal women who were not on contraceptives. Foregut surgery, esophageal dysmotility disorders, hiatal hernia, and delayed gastric emptying were excluded. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. A multivariate logistic regression analysis was conducted.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effect of combined oral contraceptives and Nexplanon on gastroesophageal reflux disease in premenopausal women: A nationwide database analysis

Saleh

Liu

Trujillo

et al. 2023

Neurogastroenterology Motil

Self Cite

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The association between menopausal hormone therapy and gastroesophageal reflux disease: a systematic review and meta-analysis

et al. 2023

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Importance and Objective Gastroesophageal reflux disease (GERD) is a chronic condition associated with several risk factors, but little is known about the association between hormone therapy (HT) and GERD in postmenopausal women. Evidence Review We investigated the association between ever or current menopausal HT use and GERD using a systematic review and meta-analysis. Studies published between 2008 and August 31, 2022, were pooled using a DerSimonian and Laird random-effects model, and outcomes were reported as adjusted odds ratios (aOR) with a corresponding 95% CI. Findings The pooled analysis of five studies found a significant direct association between estrogen use and GERD (aOR, 1.41; 95% CI, 1.16-1.66; I 2 = 97.6%), and progestogen use and GERD (two studies: aOR, 1.39; 95% CI, 1.15-1.64; I 2 = 0.0%). The use of combined HT was also associated with GERD (1.16; 95% CI, 1.00-1.33; I 2 = 87.9%). Overall, HT use was associated with 29% higher odds for GERD (aOR, 1.29; 95% CI, 1.17-1.42; I 2 = 94.8%). The large number of pooled participants, differences in study design, geography, patient characteristics, and outcome assessment resulted in significant high heterogeneity. Conclusions and Relevance There is a significant association between ever or current HT use and GERD. However, the results should be interpreted with caution, given the small number of included studies and high heterogeneity. This warrants careful evaluation of GERD risk factors when prescribing HT to reduce the risk of potential GERD complications.

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Causal relationship analysis between 35 blood/urine metabolites and gastroesophageal reflux disease: A Mendelian randomization combined meta-analysis study

Chen,

Xu,

Wen

et al. 2024

Medicine

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Gastroesophageal reflux disease (GERD) is a common condition worldwide. Despite numerous studies on GERD, the causal relationships between blood/urine metabolites and GERD remain unclear. This study aims to explore the causal relationships between GERD and 35 blood/urine metabolites. In this study, we conducted Mendelian randomization (MR) analyses for 35 blood/urine metabolites with GERD phenotypes from the FinnGen R10 and UKB databases separately. We then performed a meta-analysis of the inverse variance weighted results from the 2 MR analyses and applied multiple corrections to the significant P values from the meta-analysis. Finally, we conducted reverse causality validation for the corrected positive blood/urine metabolite phenotypes with GERD. After conducting MR analysis combined with meta-analysis and performing multiple corrections, we found significant positive causal associations between only 3 blood/urine metabolites and GERD, with no significant reverse associations. Among them, 2 are risk factors for the occurrence of GERD: alanine aminotransferase levels (odds ratio (OR) = 1.120, 95% confidence interval (CI) = 1.064–1.180, P = .0005) and urate levels (OR = 1.095, 95% CI = 1.044–1.147, P = .005). Additionally, sex hormone-binding globulin levels are protective against GERD (OR = 0.928, 95% CI = 0.896–0.961, P = .0009). Elevated levels of the metabolites alanine aminotransferase and urate are associated with an increased risk of GERD, identifying them as risk factors for the condition. In contrast, higher levels of SHBG are linked to a decreased risk of GERD, indicating that SHBG is a protective factor against the disease.

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Effect of Hormonal Replacement Therapy on Gastroesophageal Reflux Disease and its Complications in Postmenopausal Women

Cited by 8 publications

References 8 publications

The effect of combined oral contraceptives and Nexplanon on gastroesophageal reflux disease in premenopausal women: A nationwide database analysis

The effect of combined oral contraceptives and Nexplanon on gastroesophageal reflux disease in premenopausal women: A nationwide database analysis

The association between menopausal hormone therapy and gastroesophageal reflux disease: a systematic review and meta-analysis

Causal relationship analysis between 35 blood/urine metabolites and gastroesophageal reflux disease: A Mendelian randomization combined meta-analysis study

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