Can premenstrual syndrome make GERD worse? (+3 tips)

In this article, we will discuss whether premenstrual syndrome (PMS) may aggravate gastroesophageal reflux disease (GERD). We also discuss symptoms of PMS and GERD. This article will also inform you about some of the treatment strategies for GERD.

Can premenstrual syndrome make GERD worse?

Yes, premenstrual syndrome (PMS) may worsen the symptoms of gastroesophageal reflux disease (GERD). The hormones related to your menstrual cycle cause the oesophagal sphincter to relax. This leads to heartburn and indigestion. 

In addition, women often report abdominal pain, diarrhoea, and constipation before the start of the menstrual cycle. The menstrual hormones known to make GERD symptoms worse include progesterone, estrogen, and follicle-simulating hormone (FSH). 

PMS-associated heartburn and indigestion go away on their own in healthy women. In the case of GERD, follow the direction and prescription of your doctor to lessen the symptoms. If the symptoms worsen even after the end of periods, consult your doctor for dose adjustment.

What does research suggest?

In one of the clinical studies, 0.6% of females (n=4693) complained of epigastric pain before the start of the menstrual cycle. They also complained of functional dyspepsia (2.5%) and postprandial distress (2.1%) (2).

In another clinical observation, it was established that GERD is associated with hormonal levels and digestive symptoms during the premenstruation and menstruation cycle. A casual genetic effect was seen between heavy menstruation bleeding and GERD (3)

What are the other symptoms of PMS?

Apart from worsening the GERD symptoms, PMS may also cause somatic and affective symptoms. Some of the somatic symptoms include (4):

  • Breast tenderness,
  • Abdominal bloating,
  • Dizziness,
  • Flushing,
  • Headache,
  • Excessive fatigue, and
  • Swelling.

Some of the affective symptoms that can affect the daily routine of women during the menstrual cycle include (4):

  • Depression,
  • Irritability,
  • Mood swings,
  • Confusion, and 
  • Social withdrawal.

What other factors worsen GERD symptoms apart from PMS?

Several factors may worsen GERD symptoms apart from PMS. Some of the factors include:

Hiatal hernia

Hiatal hernia squeezes next to your oesophagus, thereby weakening the surrounding tissues. This causes compression of the stomach and oesophagus, leading to acid reflux and heartburn.


Hormonal changes during pregnancy may cause temporary heartburn, indigestion, and acid reflux. The increased pressure and volume of the abdomen during pregnancy also cause stretching and weakening of the muscles of your diaphragm.


Food rich in fat, spices, and salt can cause indigestion, heartburn, and acid reflux. Bad food choices can trigger the oesophageal sphincter to relax, letting the food rest in your stomach for a longer time.


Obesity has a similar effect on the stomach, oesophagus, and diaphragm muscles as pregnancy. Excessive fat can increase pressure and abdominal volume, but it persists for a longer time, causing prolonged damage to the adjoining areas.

Stress and anxiety

Stress, anxiety, and depression may increase the occurrence of GERD symptoms like heartburn and acid reflux. One study suggests that patients with GERD (n=107) were more likely to experience depression (41.4%), anxiety (34.4%), and both anxiety and depression (27.13%) (6).


Some medications, such as Lexapro (antidepressant), ibuprofen (nonsteroidal anti-inflammatory drug), potassium supplements, alendronate (bone strengthening drug), and tetracycline antibiotics are known to worsen the symptoms of GERD.

How to manage GERD symptoms with PMS?

If you feel that your GERD symptoms are aggravating before the menstrual cycle, consult your doctor. Your doctor may prescribe over-the-counter medication or prescription drugs for the treatment of GERD.

Drug Example
Over-the-counter (OTC)
Antacids Aluminium hydroxide gel, calcium carbonate, and Pepto-Bismol.
Alginates Gaviscon
Proton pump inhibitors Omeprazole, Lansaprazole, and esomeprazole.
Prescription medication
Prescription-strength Proton pump inhibitors Omeprazole, Esomeprazole, Rabeprazole, Lansoprazole, Dexlansoprazole, and Pantaprazole.
Muscle relaxants Baclofen
Histamine (H2) receptor antagonist Famotidine and Nizatidine.

In my experience

I often get heartburn, lower back pain, and diarrhoea before the menstruation cycle. In my opinion, as a pharmacist, PMS-induced GERD symptoms are usually temporary and go away on their own.

However, if you feel your symptoms are worsening, consult your doctor immediately. You should strictly follow your prescription to ensure the safe and effective use of medication for the management of GERD.

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Dilbaz B, Aksan A. Premenstrual syndrome, a common but underrated entity: review of the clinical literature. Journal of the Turkish German Gynecological Association. 2021 Jun;22(2):139.


Yamamoto Y, Furukawa S, Watanabe J, Miyake T, Kato A, Kusumoto K, Takeshita E, Ikeda Y, Yamamoto N, Kohara K, Saheki S. Association between menstrual pain and functional dyspepsia in a Japanese young population. Neurogastroenterology & Motility. 2022 Aug;34(8):e14324.


Ren X, Wang Y, Chen H, Liu S, Bai H, Wang Y. A causal association between gastroesophageal reflux disease and risk of heavy menstrual bleeding with regular cycle: A Mendelian randomization study.


Borenstein J, Chiou CF, Dean B, Wong J, Wade S. Estimating direct and indirect costs of premenstrual syndrome. Journal of occupational and environmental medicine. 2005 Jan 1:26-33.


Madanick RD, Katz PO. GERD and pregnancy. Practical gastroenterology. 2006 Jun;30(6):30.


Mohammad S, Chandio B, Soomro AA, Lakho S, Ali Z, Soomro ZA, Shaukat F. Depression and anxiety in patients with gastroesophageal reflux disorder with and without chest pain. Cureus. 2019 Nov 8;11(11).