Table.
Effect of Sex and Gender on Gastroesopahgeal Reflux Disease
| Effect of sex and gender | References | |
|---|---|---|
| Prevalence | ||
| Symptom-based population study | Women > men | 96 |
| Women = men | 21–25 | |
| Endoscopy-based study | ||
| Reflux esophagitis | Men > women | 9,26–38 |
| NERD | Women > men | 2,7,15,16,34,39 |
| Barrett’s esophagus | Men > women | 7,21,40–51 |
| Effect of aging | ||
| Reflux esophagitis | Increase with aging in both men and women: | 29,30,37,52 |
| Age of women > men | 29,30,37 | |
| Increase after menopause (after 50s) in women: | 29,30, | |
| Barrett’s esophagus | Age of women > men | 47–49 |
| Increase after menopause (after 60s) in women: | 7,54 | |
| EAC | Age of women > men | 57,59 |
| Symptoms | ||
| Heartburn or regurgitation | More frequent in women > men | 28,97 |
| Extra-esophageal symptoms | Women > men | 9,28,79 |
| Comorbid anxiety or depression | Women > men | 79 |
| Treatment | ||
| Response to PPIs | Men > women | 110–114,116 |
| Dose escalation of PPIs | Women > men | 115 |
| Postmenopausal HRT in women | Increase the risk of gastroesophageal reflux symptoms | 123,125 |
| Reduced esophageal cancer risk | 120,121 | |
NERD, non-erosive reflux disease; EAC, esophageal adenocarcinoma; PPIs, proton pump inhibitors; HRT, hormone replacement therapy.