Can GERD be traced back to estrogen use?

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.

DEAR READER >> 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.” I can’t come up with a word or remember a name. 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 things like working puzzles, crosswords, sudoku, cryptograms, etc. to keep my mind sharp. I already do that, and have been doing so for years. I’m physically active as well.

I’d very much value your ideas about this.

— T.W.

DEAR READER >> I am in complete agreement with your pharmacist about over-the-counter supplements to prevent or treat dementia, which I doubt you have. Even the prescription treatments that are available are only modestly effective.

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 area I did not hear you mention is diet. A whole-food plant-based diet has been shown to reduce dementia risk.