5 oral indicators you or your patient might be in perimenopause: What every dental hygienist should know

You may be wondering what perimenopause is. As registered dental hygienists, we’ve learned to break down medical terms into their roots, prefixes, and suffixes to uncover their meaning. The prefix “peri” is very much in our wheelhouse—it’s a medical term that means around or surrounding. When paired with the root word “menopause,” which refers to the end of menstrual cycles, perimenopause literally means “around menopause.” This describes the transitional phase leading up to menopause, a time when many women experience various symptoms due to hormonal changes.

In a study from Switzerland, the definition of perimenopause is expanded. “Perimenopause is related to substantial biological, psychological, and social changes. It describes the biological shift from reproductive to nonreproductive life, which is associated with significant alterations in the female hormonal system. Perimenopause is considered as a phase of strong fluctuations in sex hormones such as estradiol and progesterone. Endocrinological variations have been correlated with a higher risk of vasomotor symptoms or sleep disturbances. Such symptoms may then co-occur and have been shown to interact with depressed mood, suggesting the perimenopause as a window of vulnerability for mood disturbances.”¹

You might be wondering why I’m bringing up this subject. Isn’t this a phase of life for older women? I’m here to tell you that is a common misconception! While menopause itself marks the end of menstrual cycles, perimenopause is the transition leading up to it. The perimenopause phase can begin much earlier than most people think, sometimes in a woman's late 30s or early 40s. It’s not just about age; it’s about understanding all the changes that can affect health and well-being.

Physical changes to notice

Some women notice menstrual changes, such as irregular periods, hot flashes, tender breasts, vaginal dryness, urinary urgency, weight gain, headaches, or sore muscles and joints. Sleep can become erratic, and some women wake up drenched with night sweats. Other women note waking up with brain fog. These are just a few symptoms to watch for, and there are many more. If you’re experiencing some of these symptoms by the age of 40, it might be time to schedule a visit with a primary care provider.

Perimenopause oral indicators for the RDH

As estrogen levels drop and hormones fluctuate during perimenopause, this can cause changes in the mouth. It’s important for us to understand the oral indicators of perimenopause to provide better care and support for our patients. Here’s a list of the top five oral-related indicators that women describe.

1. Dry mouth (xerostomia): Less saliva production can make the mouth feel constantly dry, which increases the risk of tooth decay and bad breath.
2. Gingival sensitivity: A decrease in estrogen can lead to inflammation in the gums, causing them to bleed more easily and feel tender.
3. Burning mouth syndrome: Some women experience a burning sensation on their tongues or in their mouths during perimenopause.
4. Changes in taste (dysgeusia): A metallic or sour taste in the mouth is another potential symptom.
5. Bone loss: Estrogen loss can contribute to bone thinning, including the jawbone, which affects tooth stability and can lead to gingival recession.

Take care of yourself and your patients

Advise your patients to drink plenty of water to stay hydrated. You can also recommend hydrating gels to ease the dry mouth sensation. Some physicians recommend sucking on ice chips, but make sure your patients understand not to chew the ice. Be sure to mention limiting acidic foods, reducing alcohol, and avoiding cigarettes. Some antidepressant medications have been found to help reduce the symptoms as well.

Ask your patients detailed questions about their overall health. Since I have started to experience perimenopause, I’ve had more open conversations with my female patients in their late 30s and up. If I notice clinical signs such as xerostomia, gingival inflammation, or sensitive teeth, I gently bring up the topic of perimenopause. Women in general are caregivers, and they often overlook their own physical changes. You might be the first health-care provider to bring this topic to their attention.

Remember, perimenopause is a phase where the female body is constantly changing. It’s amazing how many women are surprised to learn that their oral health can be affected by their hormones. As clinicians, let’s help women navigate this transition with confidence and support.

Reference