Heartburn Symptoms in Women

Have you ever noticed a warm, burning sensation in your upper belly or a “sour taste” in your mouth shortly after a meal?

If you’re in any stage of menopause and experience these symptoms, it turns out you’re not alone. In fact, some research shows 47% of menopausal women and 42% of perimenopausal women report feeling the same digestive discomforts,¹ often known as heartburn.

Considering nearly half of women deal with heartburn during menopause, it begs the question— is there a link between menopause and the occurrence of heartburn? And if so, what’s the connection?

Let’s take a closer look.

What is Heartburn?

Heartburn is a common condition that occurs when stomach acid rises up into your esophagus, which is the tubular organ connecting the pharynx to the stomach.² The condition causes a burning pain in your chest or upper abdomen, often just behind the breastbone.

Typically, when you swallow your food, the lower part of your esophagus, known as the esophageal sphincter, acts as a band of muscle that relaxes to allow food and liquid to flow easily into the stomach.³ However, if the lower area of the esophagus isn’t working properly, and doesn’t tighten back up after food flows through, stomach acid can rise back up into the esophagus, causing heartburn. Since gravity plays a role in digestive functioning, this is the same reason heartburn pain can seem worse when lying down or bending over.⁴

It’s common for anyone to experience heartburn every once in a while, especially after a large or spicy meal. However, heartburn that becomes frequent or interferes with quality of life, may be a sign to schedule an appointment with your healthcare provider.

Heartburn Symptoms in Women During Menopause

Heartburn can range in severity, but common heartburn symptoms in women often include⁵:

• A burning sensation in the chest or upper abdomen, which is usually worse after a meal
• Pain or discomfort that increases when lying down or bending over
• A “sour,” acidic taste in the mouth
• Frequent coughing or hiccups

A more severe form of heartburn is known as gastroesophageal reflux disease (GERD). This condition often becomes chronic and can cause more significant damage to the digestive system if left unresolved.⁶

A Word of Caution – Heartburn vs. Heart Attack

Heartburn symptoms can mimic those of other, more serious medical conditions. While heartburn itself isn’t an urgent medical emergency, it’s important to rule out other, more serious issues that may be causing your symptoms, like heart attack or stomach ulcers, especially if you’re experiencing sudden and/or frequent chest or upper abdominal pain. If your chest pain lasts for more than a few minutes or goes away and comes back, be sure to call 911 or visit your nearest emergency room or urgent care.⁷

What’s the Link Between Menopause and Heartburn?

We now know heartburn during menopause can be quite common, but why?

During menopause, hormonal changes, including decreased levels of estrogen, can affect the digestive tract.⁸ Additionally, hormonal fluctuations can alter the production of stomach acid. Declining estrogen levels may also lead to an increase of prostaglandins, which are chemicals that inhibit stomach acid secretion.⁹ These specific hormonal imbalances are one of the main reasons premenopausal and menopausal women may be more vulnerable to heartburn and its associated symptoms.

Menopause Heartburn Remedies

While chronic heartburn may require a visit to your healthcare provider, you can consider making a few lifestyle changes that may help to decrease or eliminate mild, occasional heartburn. Let’s take a look at a few.

Consider Avoiding Trigger Foods

Trigger foods are known foods that cause heartburn in certain people. Any food that increases the acid in your stomach or further relaxes digestive muscles, may exacerbate symptoms.

Common foods that can trigger heartburn include¹⁰:

• Tomato products such as marinara or ketchup
• Onions and garlic
• Spicy foods
• Fried foods
• Oranges, lemons, limes, and other citrus products
• Peppermint
• Chocolate
• Alcohol
• Large and/or high-fat meals
• Carbonated beverages
• Coffee

Consider limiting or eliminating these foods from your diet to see if it helps to ease your heartburn symptoms.

Try to Eat Smaller Meals

Large meals require higher amounts of stomach acid for digestion. Unfortunately, high levels of stomach acid typically equals higher chances of heartburn. Consuming smaller quantities of food, on the other hand, can help to reduce the pressure in your stomach, limiting stomach acid from rising back up to where it came from.¹¹

Switch Up Your Sleep Position

Thanks to the effects of gravity, heartburn may worsen when lying down.

To combat this, try finishing your last meal at least three to four hours before bedtime. Do your best to stay upright until then to help alleviate (or prevent) heartburn and its symptoms.¹² 

Additionally, adjusting your sleep position may help.¹³ Some studies show sleeping on your left side can help to reduce heartburn episodes, while sleeping on you right side or on your back may increase chances for acid reflux.¹⁴

Maintain a Healthy Weight

Extra weight increases pressure within the abdomen. As the stomach is squeezed, there is a heightened chance that stomach acid will travel upward into the esophagus, contributing to heartburn.¹⁵

Fortunately, this means that some cases of heartburn may be adequately managed or alleviated by incorporating a few weight management techniques. In fact, in one study, it was shown that 97% of 332 adult subjects who lost weight, reported a significant decrease in their GERD symptoms. Among them, 65% experienced a “complete resolution” of symptoms.¹⁶

Maintaining a healthy weight is directly associated with healthy lifestyle choices, changes in diet, incorporating exercise, and investing in stress management. Consider working with a healthcare provider or nutritionist to help to come up with a plan that best suits your needs and current health status.

Heartburn During Menopause is Common, But You Don’t Have to Suffer

Heartburn during menopause can be common, but there are ways to manage the symptoms. If your heartburn symptoms persist or worsen, be sure to contact your healthcare provider to explore other options for managing the condition and its associated symptoms.

Resources

1. https://onlinelibrary.wiley.com/doi/10.1111/j.1745-7599.2008.00316.x
2. https://www.ncbi.nlm.nih.gov/books/NBK482513/#:~:text=The%20esophagus%2C%20historically%20also%20spelled,the%20stomach%20for%20further%20digestion.
3. https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223
4. https://www.sleepfoundation.org/physical-health/gerd-and-sleep#:~:text=Reflux%20can%20worsen%20when%20lying,sleep%20for%20those%20with%20GERD.
5. https://www.mayoclinic.org/diseases-conditions/heartburn/in-depth/heartburn-gerd/art-20046483
6. https://www.pfizer.com/news/articles/heartburn_acid_reflux_or_gerd_what_s_the_difference
7. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack
8. https://www.healthline.com/health/menopause-constipation
9. https://pubmed.ncbi.nlm.nih.gov/3040310/
10. https://www.pepcid.com/understanding-heartburn/acid-reflux-diet
11. https://www.medicalnewstoday.com/articles/is-it-better-to-eat-several-small-meals-or-fewer-larger-ones#Meal-frequency-and-chronic-disease
12. https://www.verywellhealth.com/eating-before-bed-3014981#:~:text=Give%20yourself%20about%20three%20hours,keep%20you%20up%20at%20night.
13. https://www.sleepfoundation.org/physical-health/gerd-and-sleep#references-80910
14. https://www.tums.com/about-heartburn/causes/side-sleeping-and-heartburn
15. https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease/gerd-and-obesity
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853378/#:~:text=At%206%20months%2C%20majority%20of,5.5%3B%20P%20%3C%200.01).