During perimenopause, the transitional phase leading up to menopause, women experience fluctuations in hormone levels, particularly a decline in estrogen. While menopause is a natural physiological event and not an illness or deficiency, it can be associated with certain changes in the body, including gum problems.
Common oral problems during menopause
Estrogen plays a role in maintaining healthy oral tissues, including the gums. The decline in estrogen levels can lead to periodontal changes that make them more susceptible to inflammation and other issues.
In this regard, women at the perimenopausal stage have reported various symptoms of gum disease, including:
- Gum inflammation
- Gum bleeding
- Gum sensitivity, and
- Increased risk of periodontal disease.
Post-menopausal women may experience other symptoms such as:
Burning Mouth Syndrome
This condition is characterized by a persistent burning or tingling sensation in the mouth, often affecting the tongue, lips, gums, and other oral tissues. BMS can cause discomfort and a feeling of scalding or irritation.
The exact cause of burning mouth syndrome is unknown, but hormonal changes during menopause, along with other factors like oral fungal infections, nerve damage, or psychological factors, may contribute to its development.
Treatment for BMS may involve managing underlying causes, alleviating symptoms, and practicing good oral hygiene.
Changes in Taste
Many postmenopausal women may experience changes in their sense of taste. This can include:
- A reduced ability to taste certain flavors
- Altered taste perceptions
- A persistent metallic or bitter taste in the mouth.
These changes can affect the enjoyment of food and may lead to changes in dietary preferences. Hormonal fluctuations during menopause can affect taste receptors and alter the perception of flavors.
Maintaining a healthy diet and seeking professional advice can help manage changes in taste and ensure proper nutrition.
Dry Mouth (xerostomia)
This is a common symptom experienced by postmenopausal women. It occurs when there is a reduced flow of saliva in the mouth, leading to a dry and sticky sensation. Dry mouth can contribute to:
- Difficulties in speaking and swallowing
- An increased risk of tooth decay and oral infections.
Hormonal changes during menopause, along with certain medications, can contribute to decreased saliva production.
These symptoms can be alleviated by staying hydrated, avoiding alcohol and caffeine, using sugar-free gum or lozenges to stimulate saliva production, and maintaining good oral hygiene practices.
Causes of gum problems during menopause
These symptoms can be attributed to the hormonal changes and decreased estrogen levels at this time. The mouth contains numerous estrogen-receptor cells, which rely on the hormone for proper functioning. These cells are primarily found in the mucus-producing membrane that lines the mouth and the salivary glands.
Estrogen promotes the production of mucus and saliva in the mouth, which is vital for keeping the mouth moist and creating a sterile environment that prevents the rapid growth of bacteria. However, with reduced estrogen levels, the membrane produces less mucus, resulting in severe dryness, which in turn creates an environment where bacteria can multiply quickly.
A study conducted in Sweden in 2003 found that menopausal women with low estrogen levels had significantly lower saliva production and higher levels of bacteria in their mouths compared to women of a similar age who were receiving supplementary estrogen for one year. The decrease in saliva circulation and the increased bacterial presence can have detrimental effects on oral health.
Without sufficient estrogen, bacteria can attack the teeth and gums, leading to the development of gum disease, with the symptoms listed above.
If left untreated, the condition can progress to periodontitis (advanced gum disease), causing symptoms like:
- Gum recession, and ultimately
- Loose teeth that are prone to falling out
Additionally, women who smoke and those who are thin tend to experience an earlier onset of menopause, which may further contribute to gum problems
Prevention and treatment of oral problems during menopause
It is important for women going through perimenopause and menopause to pay close attention to their oral health and take appropriate measures to maintain their oral health. Maintaining good oral hygiene practices, such as regular brushing and flossing, along with visiting the dentist for routine check-ups and cleanings, becomes even more crucial during this phase.
Proper oral hygiene can help prevent gum problems and reduce the risk of periodontal disease. In addition, most of the symptoms of gum disease can be relieved by estrogen supplements.
Hormone replacement therapy (HRT) for menopausal symptoms
Over the years, many women have turned to hormone replacement therapy (HRT) to aid in managing menopausal symptoms, including vasomotor symptoms like hot flashes.
However, a 2002 study conducted by the Women’s Health Initiative (WHI), found that postmenopausal women who used HRT, specifically estrogen-progestin therapy, have a greater risk of cardiovascular disease, breast cancer, and stroke, especially if used for more than 5 years.
Consequently, new guidelines recommend short-term use of HRT specifically for controlling vasomotor symptoms. Estrogen replacement helps to maintain the density of the jawbone, which reduces the risk of tooth loss.
However such hormone replacement remedies have been observed to cause tender, swollen, bleeding gums.
Pros and cons of HRT
Although supplementing the body with hormones, typically estrogen and progesterone, can help to relieve menopausal symptoms, HRT has its pros and cons – like many medical treatments.
Pros of HRT
HRT is highly effective in alleviating menopausal symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. It can significantly improve the quality of life for women experiencing severe menopausal symptoms.
Estrogen plays a crucial role in maintaining bone density. HRT can help prevent or slow down the bone loss associated with menopause, reducing the risk of osteoporosis and fractures.
Estrogen has been linked to positive effects on cardiovascular health, including maintaining healthy cholesterol levels and reducing the risk of heart disease. HRT may benefit women with an increased risk of cardiovascular issues during the menopausal transition.
Improved Skin and Hair
Estrogen contributes to skin elasticity and moisture retention. HRT may help improve skin quality, reducing dryness and promoting a more youthful appearance. It can also help with hair thickness and texture.
Cons of HRT
Increased Risk of Breast Cancer
Long-term use of combined HRT (estrogen and progestin) has been associated with a slightly increased risk of breast cancer. The risk appears to be higher with prolonged use, and it decreases after discontinuation of therapy.
Increased Risk of Blood Clots
Hormone replacement therapy, especially oral forms, can increase the risk of blood clots, including deep vein thrombosis (DVT) and pulmonary embolism. This risk is more significant in women with certain medical conditions or those who are overweight or smoke.
Stroke and Heart Disease Risk
While estrogen may have positive effects on cardiovascular health, the use of HRT, especially in older women or those with pre-existing cardiovascular conditions, can increase the risk of stroke, heart attack, and other cardiovascular events.
Other Side Effects
Hormone replacement therapy may cause side effects such as breast tenderness, bloating, headaches, mood changes, and nausea. These side effects are usually temporary and diminish over time.
HRT may not be suitable for all women, as individual responses to hormone therapy can vary. Factors such as personal medical history, age, and overall health need to be considered when assessing the appropriateness of HRT.
In summary, perimenopausal and postmenopausal women should be aware of the potential impact of hormonal changes on their oral health. Maintaining good oral hygiene practices, seeking regular dental care, and discussing any concerns with healthcare professionals, including dentists and gynecologists, can help manage and prevent gum problems associated with this phase of life.
If you choose hormone replacement therapy (HRT) to aid in managing the symptoms of perimenopause, it’s essential that you discuss its potential benefits and risks with a healthcare professional. They can provide personalized guidance based on your medical history, symptoms, and individual risk factors, helping you make an informed decision about whether HRT is the right option for you. Regular monitoring and follow-up are important when using HRT to ensure its continued safety and effectiveness.