Menstrual Cycle Changes

Hormonal fluctuations that are normal during specific times in a woman’s life can have a tremendous effect on the oral cavity. Such is the case with the hormonal changes observed during the monthly menstrual cycle. Changes in the oral cavity are most often experienced a few days before menstruation, when progesterone levels are high. Progesterone causes dilation of the blood vessels, resulting in inflammation and an obstruction in the normal repair mechanisms of the gums. The result is red, swollen gums that may bleed easily and become painful. These changes can be more severe if there is pre-existing periodontal disease.

These changes occur as an exaggerated response to bacterial plaque and irritants. If the condition doesn’t resolve soon after menstruation, a dental care provider should evaluate it. Women that experience changes in their gums during their menstrual cycle may be more susceptible to Rapid Progressive Periodontitis, a particularly aggressive form of periodontal disease in which there is rapid and accelerated bone loss around the teeth.

A few days before the menstrual cycle, some women also experience an activation of cold sores (herpes labialis). These sores crop up on the lips and usually heal by themselves within fifteen days. Although treatment is not required, if they are painful, they can be treated with topical ointments to help ease the discomfort.

Aphthous ulcers may also become active during the days before the menstrual cycle. These ulcers occur on the soft tissue inside the mouth also take about fifteen days to heal. Topical anesthetic ointments may be applied to the ulcers if they are painful. Severe aphthous ulcers may need to be treated with topical corticosteroids.

Some women may also experience swelling of the salivary glands. The parotid salivary gland on the cheeks is most often affected. If the swelling is related to the hormonal changes experienced during the menstrual cycle, the changes are temporary and should reverse within a few days.

The oral changes related to the menstrual cycle are transient and should reverse after a few days. If they don’t, treatment could include scaling and root planing and reinforcement of oral hygiene instructions. Antimicrobial mouth rinses may also be indicated. Because most of these changes are due to an exaggerated response to the amount of existing plaque buildup or to pre-existing gum problems, meticulous oral hygiene is critical to prevent exacerbations. Your dental care provider can help you identify these problems and help treat them so as to minimize their negative effects on the oral tissues.