The Tribune

Dr Andre Clarke

Menopause is the permanent end of menstruation and fertility. It is defined as occurring 12 months after a woman’s last menstrual period. In brief, menopause is when the menses (some Bahamians refer to it as the “health”) stop in a woman. It is a normal physiological occurrence and is not an illness or a deficiency.

It is common for a woman to have a number of symptoms when she is in a menopausal state, but it is not an absolute. Hot flashes and night sweats are amongst the more prevalent symptoms reported. However, it has been noted that an estimated 50 per cent of women have no symptoms during this part of their life.

It is known that menopause is the herald of a decline in a female’s hormonal levels. It is during this time that hormones fluctuate; usually around the age of 47. The average age for menopause in the Caribbean region is generally accepted to be around the age of 51. Of note, women who smoke and who are thin may tend to experience an earlier menopause when compared to the non-smoker and the overweight.

When menopause ensues there is a reduction in the female hormone oestrogen. Oestrogen is made largely in the ovaries of a woman and is the reason for the female characteristics that develop during puberty. When these levels of ovarian oestrogen decrease in menopause there is an associated increase of many postmenopausal diseases. The most common of these postmenopausal diseases are osteoporosis and heart disease.

In addition to the physical systemic changes that occur in post menopause (that can indirectly affect the mouth) there are mouth changes that also occur. These changes may be time dependent (their frequency increasing with advancing age) as well as linked to the hormonal changes associated with menopause.

Mouth discomfort is often reported as a complaint amongst menopausal and postmenopausal women.

These peri-menopausal women report occurrences of pain; burning sensations; altered taste perception and dryness of the mouth.

The use of HRT (hormone replacement therapy) currently has no guidelines to ensure the relief of mouth symptoms. When a dental health care professional looks into the mouth of a menopausal woman, the tissues in the mouth often time look pale and shrunken. The gums may appear dry and shiny; bleed easily and also have the abnormally pale colour that the other tissues have. However, some menopausal women with mouth discomfort have a normal mouth appearance and this suggests to the examining dental professional, that the mouth discomfort may be due to a cause other than menopause.

Even though there are no comprehensive guidelines for the usage of HRT in the treatment of mouth discomfort, women do seem to benefit. There is a reduction of mouth discomfort in those women who have both abnormal and normal mouth tissue appearance.

It is up to the astute dental professional to look for and to manage any head and neck symptoms that the menopausal woman complains of. Sometimes these symptoms are outside of the mouth and include the face becoming flush and a feeling of warmth on the neck, face and head. These can be minimized by using palliative methods and also advising a consult with a medical healthcare professional.

Palliative methods usually include wearing loose fitting collars and chains around the neck; and applying cold towels to the warm areas of the neck and head. Triggers of hot flashes should also be avoided before dental appointments (eg caffeine, exercising and hot beverages).

Remember, menopause is a normal life experience and is not a disease or illness. It does impact the lives and mouths of thousands of women in the region Therefore, discerning dental professionals will be compassionate to all of those that come into their offices with mouth problems of a menopausal origin.

• This article is for informational purposes only. It is not intended and may not be treated as, a substitute for professional medical/dental advice, diagnosis, or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication.”

If you have questions, please send email to dr_andreclarke@hotmail.com