Global burden of gastroesophageal reflux disease in women of perimenopausal age: trends and forecasts

Gastroesophageal reflux disease (GERD) is a highly prevalent disorder that diminishes quality of life. Hormonal fluctuations during the perimenopausal transition (age 45–54 years) may heighten susceptibility to GERD, yet the magnitude of the burden in this group remains poorly characterized. This study aims to quantify GERD trends in women of perimenopausal age and forecast disease trajectories to 2045. Data from the 2021 Global Burden of Disease (GBD) database were utilized. Age-standardized rates were calculated, annual percentage changes were estimated (EAPC) and Bayesian age–period–cohort (BAPC) models were employed to project trends to 2045. From 1990 to 2021, the global age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life year rate (ASDR) of GERD in women of perimenopausal age exhibited a decreasing trend (EAPC for both: −0.09, 95% confidence interval [CI] − 0.14 to −0.04), despite a marked rise in the prevalent cases. Latin America recorded the highest ASDR. Middle Socio-demographic Index regions experienced the greatest growth in prevalent cases. The BAPC model predicts a rise in the age-standardized incidence rate. The burden of GERD in women of perimenopausal age exhibits significant global heterogeneity. Incidence rates have risen persistently and are projected to increase through 2045. What is this study about?We looked at how often women aged 45–54 years worldwide experience gastroesophageal reflux disease (GERD), a condition causing heartburn and stomach acid problems. We tracked trends from 1990 to 2021 and predicted future burden through 2045 using global health data.Why focus on this age group?Women in this age group often experience hormonal changes linked to menopause.Key findings:A total of 77.6 million women aged 45–54 years had GERD in 2021 – up 108% since 1990. Latin America has the highest burden (Brazil worst affected). Richer regions saw declining rates, but middle-income areas had the fastest case growth (+165%). By 2045, new cases could rise to 7879 per 100,000 women.What does this mean?While GERD rates slightly improved globally, actual cases surged due to population growth. Women in midlife face unique risks due to hormonal shifts combined with rising obesity and stress.Recommendations:High-burden regions need better access to low-cost heartburn medications and weight management programs.Health workers should screen women aged 45–54 years during routine check-ups.Governments must address obesity and unhealthy diets through policy changes. What is this study about? We looked at how often women aged 45–54 years worldwide experience gastroesophageal reflux disease (GERD), a condition causing heartburn and stomach acid problems. We tracked trends from 1990 to 2021 and predicted future burden through 2045 using global health data. Why focus on this age group? Women in this age group often experience hormonal changes linked to menopause. Key findings: A total of 77.6 million women aged 45–54 years had GERD in 2021 – up 108% since 1990. Latin America has the highest burden (Brazil worst affected). Richer regions saw declining rates, but middle-income areas had the fastest case growth (+165%). By 2045, new cases could rise to 7879 per 100,000 women. What does this mean? While GERD rates slightly improved globally, actual cases surged due to population growth. Women in midlife face unique risks due to hormonal shifts combined with rising obesity and stress. Recommendations: High-burden regions need better access to low-cost heartburn medications and weight management programs. Health workers should screen women aged 45–54 years during routine check-ups. Governments must address obesity and unhealthy diets through policy changes.