From the Guidelines
Burning mouth syndrome can be associated with hormonal changes in a postmenopausal patient, even 10 years after menopause. The condition is characterized by burning sensations in the tongue and other parts of the oral mucosa, with no apparent dental or medical causes, and is predominantly seen in peri- and post-menopausal women 1. Key factors to consider in the development of burning mouth syndrome include:
- Hormonal changes, particularly the decline in estrogen levels, which can affect the oral mucosa and saliva production
- Neurophysiological aspects, suggesting a disorder of peripheral nerve fibers with central brain changes
- The presence of secondary causes, such as oral candidiasis, mucosal lesions, haematological disorders, auto-immune disorders, and pharmacological side-effects
Management of burning mouth syndrome in postmenopausal patients may involve:
- Hormone replacement therapy in appropriate candidates
- Topical treatments, such as clonazepam
- Supplements like alpha-lipoic acid
- Low-dose tricyclic antidepressants or gabapentin for neuropathic pain
- Lifestyle modifications, including avoiding irritants like spicy foods, acidic beverages, alcohol, and tobacco, and using artificial saliva products if necessary. It is crucial to rule out other potential causes of burning mouth syndrome, such as vitamin deficiencies, diabetes, thyroid disorders, or medication side effects, before attributing the condition to hormonal changes 1.
From the Research
Association with Hormonal Changes
- Burning mouth syndrome (BMS) has been found to be more common in peri- and post-menopausal women, suggesting a potential link with hormonal changes 2.
- The hypothesis that hormonal changes play a role in the development of BMS is supported by a high incidence of the condition in perimenopausal women 3.
- Hormonal imbalance is listed as a potential systemic cause of BMS, and hormone replacement therapy (HRT) may address the causes of BMS, although it is not typically used as a first-line treatment 2, 4, 5.
Postmenopausal Women
- BMS mainly affects women, particularly after menopause, with a prevalence of 18-33% in this population 4, 5.
- The condition is characterized by burning sensation, oral mucosal pain, altered taste sensation, and dry mouth, and is often associated with hormonal changes or psychological disorders in postmenopausal women 6.
- HRT has been studied as a potential treatment for BMS in postmenopausal women, and may be effective in addressing the underlying hormonal causes of the condition 3, 4, 5.
Duration of Menopause
- While the studies do not specifically address the duration of menopause, they do suggest that BMS can occur in postmenopausal women, regardless of the time since menopause 2, 4, 5.
- The exact timing of BMS onset in relation to menopause is not well established, but it is clear that hormonal changes play a role in the development of the condition 3, 2.