Can estrogen therapy be used to treat burning mouth syndrome in postmenopausal women?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: March 26, 2025 • View editorial policy

From the Guidelines

Estrogen therapy should not be considered a first-line treatment for burning mouth syndrome in postmenopausal women due to the lack of direct evidence supporting its effectiveness for this specific condition. When evaluating treatment options for burning mouth syndrome (BMS) in postmenopausal women, it's crucial to consider the underlying causes and the patient's overall health status. According to the study published in the British Journal of Anaesthesia 1, BMS is a complex condition characterized by burning sensations in the oral mucosa without identifiable dental or medical causes, often affecting peri- and post-menopausal women.

Key considerations for managing BMS include:

  • Ruling out secondary causes such as oral candidiasis, mucosal lesions, haematological disorders, auto-immune disorders, and pharmacological side-effects, as highlighted in the study 1.
  • Evaluating the patient's hormonal status and considering the potential impact of hormonal changes on oral health and pain perception.
  • Assessing the patient's quality of life and the severity of symptoms to determine the most appropriate treatment approach.

Given the current evidence, a comprehensive evaluation and management plan that addresses potential underlying causes and considers the patient's individual needs is essential. This may involve collaborations between healthcare providers, including dentists, primary care physicians, and specialists, to ensure a thorough assessment and appropriate treatment strategy. While hormone replacement therapy (HRT) may be beneficial for some postmenopausal women with BMS, particularly those with hormonal deficiencies, it should be approached with caution due to potential risks and the lack of FDA approval for this specific indication.

From the Research

Estrogen Therapy for Burning Mouth Syndrome

  • Burning mouth syndrome (BMS) is a chronic oral pain syndrome that primarily affects peri- and postmenopausal women 2, 3, 4, 5, 6.
  • The etiology of BMS is unknown, but it is thought to be neuropathic in origin 4.
  • Various treatments have been studied for BMS, including alpha-lipoic acid, clonazepam, psychotherapy, capsaicin, gabapentin, and hormone replacement therapy (HRT) in postmenopausal women 2, 3, 4, 5.
  • While HRT is mentioned as a potential treatment for BMS in postmenopausal women, the specific use of estrogen therapy is not explicitly discussed in the provided studies 2, 3.
  • However, it can be inferred that estrogen therapy may be a component of HRT, which is mentioned as a treatment option for BMS in postmenopausal women 2, 3.
  • Further research is needed to assess the effectiveness of various treatments, including estrogen therapy, for BMS 4, 6.

Treatment Options for BMS

  • Alpha-lipoic acid, topical clonazepam, gabapentin, and psychotherapy may provide modest relief of pain in BMS 4.
  • Other treatments, such as Catuama and bupivacaine, have shown significant positive results in symptom improvement 4.
  • Tricyclic antidepressants, α-lipoic acid, clonazepam, and cognitive-behavioral therapy are commonly used therapies for BMS 6.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Burning mouth syndrome.

BMJ clinical evidence, 2010

3
Research

Burning mouth syndrome.

BMJ clinical evidence, 2008

5
Research

Burning mouth syndrome.

BMJ clinical evidence, 2016

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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