Will hormonal treatment affect my GERD symptoms?

Question

Hello doctor,

I am a 32-year-old woman who has been experiencing frequent acid reflux and GERD for the past two years. I have noticed that my symptoms tend to worsen around my menstrual cycle, particularly during the premenstrual phase, when I often experience bloating and significant heartburn.

I am concerned about how GERD may affect pregnancy, as I understand that acid reflux can sometimes worsen during this time. Could GERD impact my ability to conceive or pose any risks during pregnancy? I am also wondering whether hormonal birth control pills can exacerbate GERD symptoms, as I have noticed an increase in reflux episodes recently, and whether an IUD might be a better option for me.

Additionally, I occasionally experience throat irritation and a chronic cough. Could these symptoms have any implications during pregnancy?
If I were to pursue IVF, would the hormonal treatments potentially worsen GERD symptoms?
I would like to know whether long-term use of proton pump inhibitors could affect fertility or pregnancy safety.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

In most cases, GERD does not affect fertility or make it impossible to get pregnant. Because progesterone weakens the lower esophageal sphincter, symptoms can get worse during PMS. Bloating can also make reflux worse. Stress and changes in how you sleep may also play a role.

Hormonal changes and extra pressure on the stomach during pregnancy can make acid worse, but GERD rarely puts the baby at risk. The most important things are your health and comfort, like not being able to sleep or having esophagitis.

Sometimes a sore throat or a persistent cough can happen, which is uncomfortable but not harmful to the baby. This can happen because of laryngopharyngeal reflux. If you wheeze, spit blood, or lose weight for no clear reason, you should see a doctor.

Some women who take estrogen/progestin pills for birth control say they have more acid reflux, but the proof is mixed. IUDs, whether they are made of copper or a hormone called levonorgestrel, are usually safe for the GI tract and can be a good choice if you need to avoid getting pregnant.

Hormonal treatments used in IVF may briefly make bloating or acid reflux worse in some people, but most people can control their symptoms with a healthy diet and safe medications.

Proton pump inhibitors (PPIs) do not make people less fertile, and when used as directed by a doctor during pregnancy, they are safe. Start with changes to your diet, antacids, or alginates. If needed, famotidine is safe to take, and PPIs like omeprazole or pantoprazole can be used at the lowest amount that works, preferably 30 to 60 minutes before breakfast.

Talk to your doctor about getting an endoscopy before you get pregnant if you have trouble swallowing, vomit blood, or have symptoms that do not go away.

I hope this answers your questions.

We appreciate your comments and use them to make patient care better.

Thanks.