HRT and reflux/indigestion

[Samphire44]

I have been on HRT for 3 years. In the last 18 months I have had 3 bouts of weird digestive symptoms each last months at a time.

The first started in April 2023 and ran to July 2023, then again Oct 2023 to January 2024 and now had just started again. They seem to start for no reason (no dietary or other) trigger and are miserable.

Each time it starts with a reflux like burn in my oesophagus but not linked to food at all, it is there all the time even if fasting. I then get bloating and indigestion and intermittent burning but again not linked to food. The systems are always there but gradually fizzle out at about 3 months.

I have been to the GP and even had an endoscopy but they cannot figure out anything. I am now starting to think it could be linked to my HRT.

I initially wondered if the oestrogen was too low but tried upping it from 75mg to 87mg for a couple of months a year ago and go horrible symptoms (blood pressure went up a lot and was really dizzy). I am now wondering whether I should try lowering it.

I was wondering if anyone else has had these type of symptoms linked to their HRT and any success in lowering it? I did find this paper which seemed to suggest HRT could cause reflux https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689967/

The only issue is that I have been advised to use HRT due to low bone density so I am reluctant to come off it altogether. I was wondering if it would be worth trialling a reduction to 50mg and wondered if anyone else had a similar experience.

Unfortunately reflux is very common in middle age, so whilst there could be a link it could also be a coincidence. Mine is triggered by fat and sugar

Thanks for your reply. I just find it weird how it lasts a few months and then just stops for no reason and is constant, not linked to meals so I am wondering if it is hormonal i.e. oestrogen relaxing the lower oesophageal sphincter.

@Samphire44 Sorry to hear this. Hope goes away.
Separately, may I pick your brain? You say you’re on HRT for low bone density. I’m interested as GP very reluctant to prescribe HRT for me - I have osteopaenia which is now bordering osteoporosis level in spine. Did a rheumatologist prescribe/ recommend it? All gp said was that if I got osteoporosis they’d treat then, but naturally I’m keen to do what I can to avoid getting it!

I’m not clear why GPs are so reluctant to prescribe HRT - I’ve read the book Oestrogen Matters and seems to me much of the concern re breast cancer has been debunked.

The NHS don’t appear to recommend HRT for osteopaenia in absence other menopausal symptoms.

@EvelynBeatrice I was originally prescribed hrt for hot flushes at age 41. Because I was so young I had a bone scan which revealed the low bone density. I have since seen an nhs rheumatologist who said I should stay on the hrt for my low bone density.

Sorry to hear about your gp they sound pretty rubbish, I would see another one or invent some preimenopausal symptoms if they don't budge becuase oestrogen is very protective.

Thank you. Appreciate it.
It’s weird how focussed they are on breast cancer when many more women die of heart disease which HRT is very beneficial in assisting preventing!

@EvelynBeatrice I think it is a case of weighing up your personal risk factors and pros and cons. For me osteoporosis is a much bigger risk than breast cancer, for others the risks will be different.

I really don't like the wierd digestive symptoms though as I always felt great prior to hrt. It is so hard to know if it is the hrt or peri menopause causing them. When I get them I find it really hard to maintain my weight which is bad for my bone density. The gp seems clueless, just tells me to take a ppi to block stomach acid until I point out ppi's also reduce bone density.

Yeah. It seems to me that as you get older it’s a case of ‘choose your poison’. 😬