Got that burning sensation in your chest again? Find yourself reaching for the Mylanta or Gaviscon a little too frequently? Reflux can occur at any age, but it’s more common for women once perimenopause starts to creep in.
While your risk might be higher, that doesn’t mean you just have to put up with it! Let’s look at the root cause of this unpleasant symptom and what you can do about it.
Reminder – reflux does not always equal high stomach acid!
Before we dive into the specifics, I did want to touch on what reflux actually means. We used to think that it was always excess stomach acid, thus the treatment option of antacids. But now holistic practitioners are taking a different perspective.
Slowed motility (movement of food through the digestion tract), fermentation and gas build-up can all push stomach acid back up into the oesophagus and throat. So even if you have a normal amount of acid, it can be pushed to the wrong place and cause symptoms. In fact, people with hypochlorhydria (low stomach acid) can experience reflux symptoms!
Even if the cause is excessive stomach acid, that doesn’t come out of nowhere. Gut infections, excess body fat and even inflammation can lead to overproduction of stomach acid. That’s why we don’t just want to pop some antacid medications and get on with the day.
Reflux in perimenopause
Those in perimenopause and menopause either experience acid reflux for the first time or they see a significant worsening of symptoms if they had it previously. Many experience uncomfortable burning sensations, upper abdominal pain and bloating.
In one study of nearly 500 women, 42% of those in perimenopause and 47% of those who were menopausal complained of increased reflux. Given that 80% of these women had not previously been diagnosed with an upper digestive disorder such as GERD (gastroesophageal reflux disease), that’s a lot of women who are suddenly experiencing symptoms! This tells us that hormonal shifts have a role to play in its development.
It’s also a common ‘new’ symptom for many of the clients I work with. But not only is it annoying and painful – it can have long-term side effects, so we want to deal with it properly.
Medications such as PPIs (e.g. Nexium) and antacids may relieve your symptoms, but they also have long-term side effects. For example, it can lead to nutrient deficiencies such as calcium – you know, the one you want enough of to protect your bone health! That’s why I much prefer taking the holistic approach to managing symptoms.
Why does it pop up when we have enough to deal with??
Now that you know it’s more common, why the heck does it have to be? We’re already juggling all of the balls, and now you’ve got to deal with this on top of everything!
There are specific mechanisms that are at play here, and they all come back to our fair-weather friend, oestrogen.
When oestrogen plummets during perimenopause, cortisol rises as a response. As a fight-flight response hormone, cortisol sloooows the motility of your gut, and digestion comes to a grinding halt.
Low oestrogen can affect stomach acid and bicarbonate, the neutralising agent for stomach acid. By throwing off this balance, it increases symptoms of acid reflux. Oestrogen is also believed to protect the mucosal (mucus) layer in the stomach, so as it drops, this protective layer can degrade and leave you more vulnerable to digestive issues.
Then there are also the effects of ageing on the gut. Lower oestrogen levels can reduce muscle tone and peristalsis, and there’s a reduction in stomach acid/enzyme production with age. This is where it’s important to remember that reflux doesn’t equal high stomach acid – instead, the reduced digestion caused by ageing feeds into that fermentation and gas build-up scenario.
On the other hand, high oestrogen can also cause issues. Lower oestrogen levels can speed up gut transit time, whereas higher can slow it down. Many on HRT experience reflux, and the increased oestrogen is to blame (at least in part, if not fully!)
You can see why it’s so common that it seems inevitable for many! But that doesn’t mean you have to suffer the effects for months, years or even decades to come.
Steps to alleviate your reflux symptoms naturally
Now let’s talk about what you can do if you’re experiencing reflux.
Eat slowly (please!) – Sit, chew your food properly, savour it. When it comes to digestion, your mouth & chewing is the first mechanical step in the process. What if you’re having a smoothie? Leave some texture to it so you can chew, or have some nuts & seeds first.
Add your bitter and sour foods – these are neglected in the Western-style diet, but they help to stimulate parts of the digestive process. Need some inspiration? Give my super-simple salad dressing recipe a go.
Ditch the snacks – ain’t nobody (or no body) made for snacking. Eating lots of small meals and nibbles isn’t making your reflux, weight or blood sugar levels any better. Your digestive system loves similar, regular meal times each day as well as regular breaks from eating.
Track your triggers – everyone will have different triggers, so make sure you know yours. While you do the underlying repair work, avoid them as much as possible. The goal is to fix the root issue so you don’t have to avoid those triggers long-term!
Consider mechanical or functional contributors – I know when my thoracic region of the spine goes out of alignment, reflux is not far behind! Manual therapists can help to address some of these issues, whereas others will need further investigation and testing to figure out what’s contributing.
Work with your healthcare team – your GP is a great stop for diagnosis, and of course your friendly naturopath can offer holistic support options. There are plenty of nutritional and herbal heroes that can help with reflux, so working with your practitioner can help to identify which are a fit for your needs.
Sick of pain, heartburn and other ghastly digestive woes on top of your perimenopause symptoms?
Digestive problems are really common as we age, but they don’t have to be normal!
Your digestive health has a massive impact on your hormones, especially in your 40s when the road to menopause begins for many. Enhancing your gut health is a simple way to reduce your symptoms – I’m talking less chaos and more calm!
If you’re navigating chaotic mood swings, digestive distress and fluctuating hormones, I’m here to help you feel calm, balanced and in control. Book a free 15-minute discovery call to learn how we can have you feeling better than ever!