BY GABRIELLE LICHTERMAN
- If you’re experiencing heartburn after ovulation, you’re not alone. Here are ways that fluctuations in estrogen and progesterone could be impacting your body and behavior, upping your risk of heartburn, plus simple steps you can take to dodge the painful condition.
UPDATED July 19, 2022 (originally published August 17, 2017)—Are you getting heartburn during your luteal phase, which is the phase of your menstrual cycle that spans the day after ovulation through the day before your next period (also known as your Week 3 and Week 4)?
You’re not alone. I regularly get inquiries about painful post-ovulation heartburn from women with menstrual cycles.
Unfortunately, this is an area of research that is still woefully understudied by scientists.
Not only that, but the conclusions of the few studies that have been conducted have been frustrating since they have not detected a direct link between menstrual cycle-related hormones (such as estrogen and progesterone) and heartburn. Just a couple of these studies include research from 2003 out of Nicolae Testemițanu State University of Medicine and Pharmacy in Romania and research from 2009 out of Hospital Clínico San Carlos in Spain.1,2
However, even though researchers haven’t been able to prove a direct link exists between heartburn issues and hormones during menstrual cycles, a link could still exist. Truth is, I get so many women inquiring about post-ovulation heartburn that there’s a reasonably good chance of a connection…one that simply hasn’t been confirmed yet in a study.
And, based on how hormones are proven to impact your body and behavior, I actually have a few ideas why hormones could be increasing your risk of heartburn after ovulation. Below is what I think may be happening, plus simple tips that you can use to keep heartburn symptoms in check after ovulation as well as every day of your monthly cycle.
How can hormones impact heartburn?
Despite scientists not yet finding a direct link between hormones and heartburn, there are many reasons to suspect they could. These include:
High estrogen during ovulation may loosen your lower esophageal sphincter. This is the ring of muscle that separates your throat from your stomach. When tight, this ring prevents stomach contents from seeping up and causing the unmistakable sting of heartburn. However, this important body part could potentially get looser during your ovulatory phase, which are the three days mid-cycle when your egg is released from the follicle and can get fertilized. That’s because multiple studies show that peaking estrogen on these cycle days makes tendons, ligaments, soft tissue and muscle less tense and more easily stretched.3 If estrogen has the same effect on your lower esophageal sphincter, it means that food and acid could possibly make its way up your throat. Since your body’s level of estrogen drops swiftly and steeply right after your egg is released, you would notice heartburn potentially caused by this hormone issue during ovulation when estrogen is at its highest level.
High progesterone during the luteal phase slows down digestion. Once you reach ovulation, progesterone starts to rise. This hormone continues to climb steadily throughout the first 8 days of your luteal phase, then it drops during the final 6 days, but overall it’s higher than when compared to the first half of your cycle. This is important to note because this hormone slows down your body’s digestive process. This leads to foods staying in your stomach and gut longer, which can cause bloating and pressure that pushes stomach contents up into your throat.
You may be eating bigger portions. During the second half of your cycle, elevated progesterone makes you significantly hungrier than you were during the first half of your cycle (the follicular phase, which is your Week 1 and Week 2). As a result, starting soon after ovulation, you may be eating meals and snacks more frequently throughout the day and/or consuming larger portions of food. All this extra consumption can cause fullness and pressure in your stomach that pushes whatever you’ve eaten right back up your food pipe.
You may be eating more heartburn-triggering foods. As progesterone rises, it has another effect on your eating habits: This hormone gives you cravings for foods high in fat (such as French fries, cheese, potato chips, butter and ice cream). Some researchers believe it’s because progesterone is pushing you to consume more calories in case you got pregnant during ovulation and are now eating for two. (Your body doesn’t get the memo that you’re not pregnant until the start of your premenstrual Week 4.) Thing is, fatty foods are known to be a key culprit behind heartburn. That’s because fat relaxes the lower esophageal sphincter–that vital ring of muscle that acts like a dam between your throat and stomach contents. Plus, fat-rich food is slower to digest, which means it stays in your stomach and gut longer, causing more pressure that can move stomach contents upward.
Unfortunately, fatty foods aren’t the only heartburn trigger you’re more likely to be consuming during your post-ovulation days. High progesterone also prompts tiredness, which could have you running for cup after cup of caffeinated tea or coffee. Sadly, these beverages can also relax the lower esophageal sphincter, allowing stomach contents to seep up.
More bad news? Chocolate can be a factor in causing heartburn by loosening the lower esophageal sphincter as well as spurring a greater amount of acid and slowing digestion.
And, since we’re on the subject of foods, here are a few more that can contribute to heartburn: citrus, peppermint, spearmint, onions, garlic, tomatoes and carbonated beverages.
Luckily, it’s likely that not all of these foods will cause heartburn in you. You’re probably more sensitive to some than others. And you may be able to still consume them in a smaller amount without experiencing an issue. Experimenting and talking with your healthcare provider will help you understand how certain foods impact your heartburn specifically.
You may be drinking more alcohol. Researchers have found that there are certain phases in your menstrual cycle when you’re more prone to drinking a greater amount of alcohol. One is during your ovulatory phase. That’s because high estrogen makes the effects of alcohol more pleasurable.4 Another is during your premenstrual phase. That’s because you may be using alcohol to cope with negative effects of plunging estrogen, such as a lousy mood or aches.5 The problem is that, like so many other foods and beverages, alcohol can also loosen that vital lower esophageal sphincter, allowing partially digested food and stomach acid to leak upward. Alcohol can also spur a greater amount of acid that causes irritation in your belly. And, if you drink carbonated alcohol (such as beer or hard seltzer), the extra air can cause pressure that pushes up stomach contents into the esophagus.
You may be using more nicotine. Just like with alcohol, your hormones may have you turning to nicotine more frequently around ovulation and during your premenstrual phase–and for the same reasons: High estrogen during ovulation spurs more enjoyment from cigarettes, vaping and other nicotine-containing products and you may use cigarettes to help cope with negative effects of plunging premenstrual estrogen. But, smoking is yet another factor that can loosen that all-important ring of muscle separating your esophagus and stomach. Plus, it reduces your production of saliva, which your body uses as a natural way to neutralize acid. The less saliva you churn out, the more acidy your stomach gets.
Post-ovulation heartburn fixes
Now that you know all the ways that hormones can contribute to heartburn, what can you do to prevent the stinging irritation from happening to you?
First, go through the list above and see if there are ways you can change your eating, drinking and smoking habits to minimize your risk of heartburn. For example, try to feed yourself smaller meals, reduce your intake of fatty foods or cut back on alcohol and nicotine.
And to lower your risk of heartburn even further, try these tactics:
- Chew gum for about an hour after meals. Chewing a stick of gum prompts you to produce more saliva, which neutralizes stomach acid causing heartburn symptoms. In fact, patients with gastroesophageal reflux disease (GERD–a digestive disorder that causes frequent heartburn) who tried this easy method in a 2001 study found it helped ease their pain.6 Tip: Opt for a fruit-based gum over a minty one since peppermint and spearmint can relax the lower esophageal sphincter.
- Take “belly breaths”. Doing 10 minutes of deep diaphragmatic breathing—the kind of deep breathing that makes your belly rise and fall—three times daily can reduce heartburn symptoms within eight weeks. Why? Belly breaths are like exercise for your lower esophageal sphincter, tightening it, which prevents stomach acid from escaping.7 Bonus: Deep diaphragmatic breathing also reduces stress, another heartburn risk factor. It does this by reducing the output of the stress hormone cortisol and activating your parasympathetic nervous system (responsible for your body’s rest-and-digest process), which lessens excessive stomach acid production.
- Avoid eating too close to bedtime. Make a point to stop noshing at least two hours prior to turning in. You’ll give your body a chance to digest that last bit of food you’ve eaten for the day so your stomach is emptier. This means less food and acid that could potentially slide up your throat when you lay flat.
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Already have heartburn?
If you haven’t gotten your heartburn under control yet and want a fast way to douse the fire, consider purchasing an over-the-counter antacid medication that also contains alginate, which is an extract from seaweed that forms a foamy raft-like barrier that floats the top of your stomach, blocking food and acid from entering your throat. You’ll neutralize the burny acid while also avoiding further damage to delicate tissue in your esophagus. One to try: Gavison Double Action. (Note: Always read the label on all medications and consult with your healthcare provider before trying any new medication.)
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SOURCES:
(1) Carmen Anton, et al., “Hormonal influence on gastrointestinal reflux during pregnancy”, Revista Medico-Chirurgicala a Societatii de Medici Si Naturalisti din Iasi, 120 (2016): 568-572
(2) A. Alvarez-Sánchez, et al., “Does progesterone fluctuation across the menstrual cycle predispose to gastroesophageal reflux?”, The American Journal of Gastroenterology, 94 (1999): 1468-1471
(3) Simone D. Herzberg, et al., “The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis”, Orthopaedic Journal of Sports Medicine, published online July 21, 2017
Ellen Casey, Farah Hameed, Yasin Y. Dhaher, “The Muscle Stretch Reflex throughout the Menstrual Cycle”, Medicine & Science in Sports & Exercise, 46 (2014): 600-609
(4) Bertha J. Vandegrift, et al., “Estradiol increases the sensitivity of ventral tegmental area dopamine neurons to dopamine and ethanol”, PLOS ONE, published online November 6, 2017
Michelle M Martel, Tory Eisenlohr-Moul, Bethan Roberts, “Interactive effects of ovarian steroid hormones on alcohol use and binge drinking across the menstrual cycle”, Journal of Abnormal Psychology, (2017): 1104-1113
(5) Haley A. Carroll, Kathleen B. Lustyk, Mary E. Larimer, “The relationship between alcohol consumption and menstrual cycle: a review of the literature”, Archives of Women’s Mental Health, published online August 21, 2015
(6) Benjamin Avidan, et al., “Walking and chewing reduce postprandial acid reflux”, Alimentary Pharmacology and Therapeutics, published online July 7, 2008
(7) Andrew Ming-Liang Ong, et al., “Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms”, Clinical Gastroenterology and Hepatology, 16 (2018): 407-416.e2
Andreas J. Eherer et al., “Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study”, The American Journal of Gastroenterology, 107 (2012): 372-372
Andrew Ming-Liang Ong, et al., “Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms”, Clinical Gastroenterology and Hepatology, 16 (2018): 407-416.e2