GERD not linked to vaginal estrogen
Dear Dr. Roach: As I seem to be highly prone to urinary tract infections, I’ve been using vaginal Estrace for decades. I’m 82 years old. I’ve developed serious gastroesophageal reflux disease, and note that there’s a connection with female hormones. Two of my health care providers disagree on whether vaginal Estrace is or is not linked with GERD. I read a study online that made the link, but it doesn’t tell whether the women studied used oral or vaginal Estrace, or both. Is there a way to determine this?
C.D.C.
Answer: Several studies have confirmed that oral estrogen, and the combination of oral estrogen with progestin, increase the likelihood of symptomatic gastroesophageal reflux disease. There has not been a connection with vaginal estrogen, nor would I expect there to be, since the blood levels of estrogen in a woman using vaginal estrogen are not higher than a woman not using vaginal estrogen. Unfortunately, anyone can develop GERD symptoms. It’s just that vaginal estrogen doesn’t increase that risk.
Dear Dr. Roach: I’m a 71-year-old man, and my mind is still sharp. Nonetheless, I do seem to have “senior moments.” A couple of years ago, I was about to purchase a popular memory drug and decided to ask the pharmacist about it. He told me I’d be wasting my money. He said I should do things like working puzzles, crosswords, sudoku, cryptograms, etc. to keep my mind sharp. I’m physically active as well. I’d very much value your ideas about this.
T.W.
Answer: I am in complete agreement with your pharmacist about over-the-counter supplements to prevent or treat dementia, which I doubt you have.
There is a debate about the use of mind and memory exercises — whether they really have an effect on preventing dementia.
Physical activity has been shown to reduce dementia risk. The one area I did not hear you mention is diet. A whole-food plant-based diet has been shown to reduce dementia risk.
For the cost of an unproven supplement, most people would able to improve their diet a great deal, which has unquestioned long-term benefits.