How to prevent that uncomfortable feeling in your chest and how perimenopause, menopause and PCOS are associated with the symptom
Despite its name, heartburn (also known as acid reflux) is not a heart-related problem. It’s a burning feeling in your chest and throat that happens when the acid that is normally in your stomach travels up into your oesophagus (food pipe). This can leave an unpleasant taste in your mouth, cause pain and discomfort, give you bad breath and make you feel bloated and nauseous.
RELATED: Nutrition and gut health in menopause
What causes heartburn?
Heartburn is more common in people who are stressed and in people who are overweight. Certain foods and drinks can make symptoms worse or be the cause of heartburn. Drinks such as coffee and alcohol can trigger it, as can spicy and fatty foods (including chocolate). Symptoms are often worse after eating, when lying down and when bending over.
Is heartburn common in perimenopause and menopause?
There are cells lining your oesophagus and stomach that respond to the hormones oestradiol, progesterone and testosterone.
Fluctuating hormone levels can alter the amount of acid your stomach produces. One study of 497 women found that 42% per cent of perimenopausal and 47% per cent of menopausal women suffered from heartburn [1].
RELATED: 10 surprising menopause symptoms
Is there a link between heartburn and PCOS?
If you have polycystic ovary syndrome (PCOS), you may already have lower levels of oestradiol and progesterone (and you may have higher levels of testosterone). Women with PCOS tend to have less diverse gut microbiome and are more likely to experience gastrointestinal disturbances, such as heartburn [2].
Many women with PCOS are resistant to the action of insulin so their body produces higher levels of insulin, and PCOS is also associated with chronic inflammation – both of which can affect gut health. Research has also found that women with PCOS have elevated levels of some types of bile acids [3].
RELATED: Polycystic ovary syndrome (PCOS) and menopause
How can I treat heartburn?
Some people find that changing their diet and eating habits can improve heartburn. An anti-inflammatory diet, such as the Mediterranean diet, is beneficial, particularly if you have PCOS [4]
Eating smaller, more frequent meals, and avoiding eating 3-4 hours before bed can help. When sleeping, ensure your head and chest are above the level of your waist to stop stomach acid travelling up.
Medicine such as Gaviscon can treat heartburn by preventing stomach acid moving up into your food pipe and relieving the pain from your stomach producing too much acid.
RELATED: IBS and the menopause: what's the link
Many women find that when they are prescribed the right dose and type of hormones for their perimenopause and menopause symptoms, their heartburn improves. If you have PCOS, you’re likely to be used to having higher levels of testosterone, so you’re more likely to experience symptoms when levels begin to decline sharply during perimenopause and menopause and stay low thereafter. As a result, you may benefit from taking testosterone as part of your HRT.
If you experience persisting symptoms despite diet and lifestyle changes, this needs to be investigated by your doctor who can arrange any tests required. It is also important to seek medical review if you have other symptoms associated with the onset of heartburn such as weight loss, swallowing difficulties or pain on swallowing.
