If, seemingly out of nowhere, your gums hurt when you brush your teeth or your mouth constantly feels dry even though you’re drinking so. much. water. know that it’s not just you.
Oral symptoms during menopause are totally a thing, and they can be traced back to those two key hormones we talk about so much: estrogen and progesterone.
Estrogen
What it does:
- Decreases bone resorption (which basically just means “breakdown”)
- Binds to receptors in oral tissues including your salivary glands
What happens during menopause:
Estrogen levels steadily decrease during the menopausal transition, which leads to thinning and weakened oral tissues and inflammation of the gums.
Progesterone
What it does:
- Supports bone metabolism
- Acts as a bone formation-stimulating hormone
What happens during menopause:
Like estrogen, progesterone levels decline during menopause, which leads to feelings of oral dryness.
Hormones also help our teeth and gums fight off minor infections and maintain a healthy supply of good-for-you bacteria. That’s why our mouths are especially susceptible to hormone fluctuations — even before menopause. In fact, many women experience gum changes during their cycles due to increases in progesterone, which can contribute to bright red swollen gums, swollen salivary glands, the development of canker sores, or bleeding gums…these symptoms usually pop up a day or two before our period, only to clear up shortly after the period starts.
Once we hit menopause, hormonal changes may contribute to the following conditions:
Xerostomia (aka dry mouth)
Xerostomia occurs with decreased saliva production, which leads to dry mouth — the most common oral symptom reported in menopausal women. Dry mouth, in turn, can result in periodontal disease since saliva is not readily available to moisten and cleanse the mouth by neutralizing acids produced by plaque.
Burning Mouth Syndrome (BMS)
You’ve just burnt your mouth on a too-hot spoonful of soup or sip of tea — except you haven’t…it just feels that way (think burning, tender, tingling, hot, scalding, numb sensations).
Gingivostomatitis [jin-je-vo-sto-ma-ti-tis]
What a mouthful of a name! (No pun intended.) Gingivostomatitis is a fancy way to talk about inflammation of the gums. It’s characterized by atrophic (terrible clinical term, we know) gums that readily bleed and appear either abnormally pale and dry or shiny and red. Other symptoms include canker sores, bad breath, fever, and swollen lymph nodes. Caused by hyposalivation (i.e. reduced saliva production), gingivostomatitis does not affect underlying connective tissue and bone.
Sores should disappear within 2-3 weeks without treatment, although your doctor may prescribe an antibiotic and recommend cleaning the infected area to promote and accelerate healing.
Periodontitis
Declining estrogen affects our bone health, putting us at a greater risk for osteoporosis and periodontitis (inflammation of the tissues surrounding the teeth). It can also lead to loss of bone in the jaw, which in turn exposes more of a tooth and leads to decay or tooth loss. Not-so-fun fact: osteoporosis makes us three times more likely to experience tooth loss, so it’s definitely important to smash these taboos, get the evidence-based facts, and talk to your doctor (or Elektra!).
Dr. Anna Barbieri, MD
Pro tip #1
Toothpaste with stannous fluoride is particularly good for gums since it reduces the risk of gingivitis and bleeding (and thus reduces the complications that can come from dry mouth). There is a small risk that this type of toothpaste may stain teeth, but that risk has decreased in recent years with a newly developed formulation. Common household brands like Crest and Colgate make stannous fluoride versions.
