Association between menopause, postmenopausal hormone therapy and peptic ulcer disease in Taiwanese population

Menopause is associated with various health conditions such as osteoporosis, obesity, cardiovascular and psychological disorders. However, limited information is available on the relationship between perimenopause and hormone replacement therapy with the occurrence of digestive ulcers. Therefore, we conducted this population-based study of over 17,000 participants in the Taiwan Biobank to examine the association between menopause and peptic ulcer disease (PUD). In addition, we also examined associations between the types of menopause and postmenopausal hormone therapy with PUD. Menopausal status, hormone replacement therapy during menopause, and the presence of PUD were determined using self-reported questionnaires. The participants were grouped according to whether or not they had entered menopause. The participants were further categorized based on the cause of menopause: natural or surgical. Binary logistic regression was utilized for correlation analysis. Of the 17,460 individuals enrolled for analysis, 9620 (55%) were classified into the postmenopausal group and 7840 (45%) into the premenopausal group. After adjusting for various factors, the postmenopausal group had a 1.19 times higher risk of developing PUD compared to the premenopausal group (odds ratio [OR]: 1.19, 95% confidence interval [CI]: 1.03 to 1.38, p = 0.021). Moreover, surgical menopause was significantly associated with PUD (OR, 1.38; 95% CI, 1.16 to 1.63; p < 0.001), but natural menopause was not (OR, 1.12; 95% CI, 0.96 to 1.30; p = 0.147). In addition, the women with natural menopause who received postmenopausal hormone therapy had a significantly higher prevalence of PUD than those who did not (OR, 1.37; 95% CI, 1.13 to 1.67; p = 0.001). However, no significant association was found between postmenopausal hormone therapy and PUD among the women with surgical menopause (p = 0.291). In conclusion, menopause was associated with an elevated risk of PUD, and this relationship may differ by menopause type, with a more pronounced effect observed in surgical menopause. These findings highlight the importance of considering menopausal status and type in future research on gastrointestinal health in women.