Effect of cyclic hormonal changes during normal menstrual cycle on esophageal motility

Pregnancy has an inhibitory effect on motility of the gastrointestinal tract most likely related to increased levels of circulating female sex hormones. Similar fluctuations of hormones occur during the normal menstrual cycle, but to a much lesser degree. We studied the effect of these sequential hormonal changes on esophageal motility and acid exposure by performing an ambulatory esophageal motility/pH study (AEM/pH) during the follicular (days 2-4) and luteal phases [days 4-8 after the luteinizing hormone (LH) surge] of the menstrual cycle. Ten normal menstruating women aged 21-39 years, (mean age 31) were studied with a Konigsberg catheter positioned such that the pH probe was 5 cm above and pressure transducers 7 and 15 cm above the LES. Ovulation was predicted by LH detection kit, and serum progesterone levels were obtained in the luteal phase. Each study was performed for 16 hr and included meal, upright, and supine periods. Peristaltic contractions increased during the meal periods and decreased during supine periods. Simultaneous and isolated contractions increased during supine periods and decreased with meals. Number and amplitude of distal esophageal contractions did not differ significantly between follicular and luteal phase during meal, upright and supine periods. Median percentage of time of distal esophageal pH<4 and median acid clearance were similar between the two phases. In conclusion, esophageal motility and acid exposure, as measured by AEM/pH, are not affected by the hormonal changes that occur during the menstrual cycle.