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[Katherine]

Dear ladies,

I have silent reflux which has caused the area around my voice box to become swollen (shown by an endoscopy) and often after I eat, or if my mouth dries out, or if I am upset or anxious my throat gets irritated which can lead to wheezing. I have asthma and ILO so the reflux is aggravating those.

My symptoms seem to be worse before and during my period which makes me think it is progesterone related. I’ve read online today that taking progesterone can cause the muscle that stops acid reflux to relax, but the reflux only started several months after starting utrogestan. I don’t want to come off utrogestan as it makes me sleep much better and then I can function during the day.

 Has anyone else had reflux that may be linked to progesterone? I am wondering if there is an alternative progesterone I could take. I took utrogestan vaginally for a while but then couldn’t sleep. Any help would be much appreciated.

I should add that the doctor has suggested taking gaviscon after meals as well as before bed as a possible solution which I will do, but I want to address the root cause if possible as I don’t want to take that much gaviscon indefinitely.

Hi, I take utrogestan 2 hours before bed and gaviscon at bedtime as I’ve read not to take gaviscon within 2 hours of any other medication as the gaviscon can hinder absorption of medication. I don’t know if utrogestan counts, I need to ask my gp, but to be on the safe side I don’t take anything within 2 hours of utrogestan.

[Spiral1033]

Hi,

I'm not sure if I have anything to say that will help particularly but I am in a similar position.

I have problems with reflux generally (as do all my family actually) and it's been worse the last year. When I started hrt I switched from gel and utrogestan as I thought the utrogestan was causing worse heartburn but even when I switched to evorel patches I still had reflux. I thought maybe it was taking progesterone generally that was causing it as it did stop when I switched back to gel last week. But it's back again the past two days. So it could also be chocolate related (Easter eggs)...

I'll report back next week when I'm on the utrogestan again.

I do have a question for you though! When you say that the doctor says to take the gaviscon at bedtime does that mean you are taking at the same time as the utrogestan? I can't figure out if taking gaviscon at the same time would mean I'm not taking it on an empty stomach?

Thanks

[bombsh3ll]

Yep, progesterone (and for me progestins) increase acid reflux.

This is a normal phenomenon - as the pregnancy hormone, part of progesterone's job is to relax everything in preparation for giving birth.

This explains many progestogenic side effects such as backache, bloating and sluggish GI transit.

I take long term omeprazole and as required gaviscon, as for me personally the consequences of going without my combined pill would be much worse.

If you really don't feel comfortable with long term reflux medication you could look into fundoplication or the linx procedure.

[boomerang]

I usually get reflux towards the end of taking my progesterone as well!

[dangermouse]

Oestrogen and high-dose progesterone can relax the lower esophageal sphincter (LES) — the valve that keeps stomach acid from rising.

I get it immediately from oestrogen (even tiny doses) but if it’s definitely from the Utrogestan, this does build up in your fat tissues (even when taken orally) so could be building up. If you have a break it can take about 4 weeks to seep out fully.

[Spiral1033]

Can I take gaviscon at the same time as the utrogestan? As in at bedtime? Or would that not count as on an empty stomach?

[bombsh3ll]

It shouldn't make a difference - food in the stomach INCREASES the absorption of progesterone.

You could alternatively take the progesterone vaginally if you prefer.

[Katherine]

Yep, progesterone (and for me progestins) increase acid reflux.

This is a normal phenomenon - as the pregnancy hormone, part of progesterone's job is to relax everything in preparation for giving birth.

This explains many progestogenic side effects such as backache, bloating and sluggish GI transit.

I take long term omeprazole and as required gaviscon, as for me personally the consequences of going without my combined pill would be much worse.

If you really don't feel comfortable with long term reflux medication you could look into fundoplication or the linx procedure.

Thank you, I will look into these. I don’t feel that stopping utrogestan is an option as I just can’t function without sleep. I often wonder how women in peri and menopause can sleep when they just have a Mirena for their progesterone. But I guess not everyone has sleep issues in meno. I don’t mind taking gaviscon if there’s no effect on my health but 5tsp feels like a lot. I will have to look into that too. There’s so much to navigate!

[Katherine]

I usually get reflux towards the end of taking my progesterone as well!

Thanks for replying. I’m seeing a pattern here! It’s odd how the reflux didn’t start until about 9 months after starting utrogestan. Maybe something else kind of precipitated it.

[Katherine]

Oestrogen and high-dose progesterone can relax the lower esophageal sphincter (LES) — the valve that keeps stomach acid from rising.

I get it immediately from oestrogen (even tiny doses) but if it’s definitely from the Utrogestan, this does build up in your fat tissues (even when taken orally) so could be building up. If you have a break it can take about 4 weeks to seep out fully.

Thanks for the info. I did actually stop utrogestan for about 10 days at one point, in fact oestrogel as well, and I felt horrendous so went back on.

[Katherine]

Can I take gaviscon at the same time as the utrogestan? As in at bedtime? Or would that not count as on an empty stomach?

 I think you’re meant to leave a 2 hour gap between gaviscon and any other medications and supplements as it can hinder absorption but I’m not sure if hormones count.

[Katherine]

Hi ladies,
 
My gp has confirmed that loosening of the lower oesophageal sphincter can indeed be a side effect of utrogestan. And long term use of gaviscon can affect metabolism leading to higher magnesium and lower phosphate levels in the body.

I don’t feel that stopping utrogestan is an option for me right now, I am managing the reflux but stopping utrogestan would affect my life even more. I’m concerned though that long term inflammation of the throat can eventually lead to oesophageal cancer.

I guess I will have to get my throat checked again in a few months and hopefully if it has healed I will be able to stop the gaviscon and just reply on my dietary changes. It’s horrible having to make these choices not knowing what the long term outcome will be!

[Spiral1033]

Can I take gaviscon at the same time as the utrogestan? As in at bedtime? Or would that not count as on an empty stomach?

Thanks. I asked the pharmacist and they said it was fine to take at the same time. I'm going to check with the doctor when I next speak to them.

It's not been as bad so far this month so I suspect that what I was eating last month had an impact... Fingers crossed

 I think you’re meant to leave a 2 hour gap between gaviscon and any other medications and supplements as it can hinder absorption but I’m not sure if hormones count.

[Katherine]

Can I take gaviscon at the same time as the utrogestan? As in at bedtime? Or would that not count as on an empty stomach?

Thanks. I asked the pharmacist and they said it was fine to take at the same time. I'm going to check with the doctor when I next speak to them.

It's not been as bad so far this month so I suspect that what I was eating last month had an impact... Fingers crossed

 I think you’re meant to leave a 2 hour gap between gaviscon and any other medications and supplements as it can hinder absorption but I’m not sure if hormones count.

Thanks, that is good to know. I went through a phase of taking them at the same time before I questioned it and was concerned it might have had an impact of some sort so that is reassuring.

I’m glad it hasn’t been as bad this month. I should mention i follow the Acid Watcher diet and found it to be amazing. It stopped the night reflux and possibly the day. I don’t have any burning, so throat irritation is my main day symptom which has been greatly reduced.

[flo69]

The day I tried oral Utrogestan, I came close to going to A&E, I thought the pain must be a heart attack, but it was reflux, heartburn like I'd never had in my life.
I tried it three times orally, each time similar, it also made me so wired that sleep was impossible within two or three days of taking one.
Then I tried it vaginally and it still gave me heartburn!
I take tibolone now, only good side effects, what's not to like?