Menopause has always been one of those big mysteries to me…the secret society of womanhood that most woman shoulder or their own on secretly panic reading information at 2am about before its ‘too late’.

Before writing this blog it literally didn’t occur to me to find out much more about it, mostly because I was so busy trying to work out what the hell my hormones are doing now, let alone what they’ll be up to in the future. Plus when I was at school I attended a mandatory information afternoon about periods which told me I would have cramps, my boobs might be sore and at certain times of the month I might feel more sensitive than usual - thanks so much to that person for glossing over the true joys of PMS btw. As I plodded through my late 20s and early 30s, I casually assumed that there might be some sort of similar mandatory girl power gathering at 7pm some rainy Thursday with other women from my postcode once I turned 45, explaining just exactly what a hot flush is etc and how to make it all go away…turns out this doesn’t happen..so I needed a plan B.

Last year I read a pretty life changing book about periods (now don’t roll your eyes) called Period Power by Masie Hill which helped me see through the fog of hormones and helped me understand a bit more about why my body was behaving or misbehaving in the way that it was.

When I decided to write about Menopause the first thing I did was download her next book Peri-Menopause Power on Audible. If you’re reading this because you feel Menopause is on the horizon for you, or even if its not I would 100% recommend you get this book IMMEDIATELY - its ok I’ll wait while you add it to your basket. Got it? OK! Parts of it are pretty heavy but even as something to dip in and out of, it will 100% open your eyes to what the not so far away future might hold for you. What can I say luck favours the prepared.

As a Dental Hygienist I know that gum health is related to hormone change and it seems fairly sensible to me then that Menopause will effect gum health in some shape or form. The jury is out on this a bit but it turns out there are so many reasons why Menopause and Peri-Menopause might be effecting the inside of your mouth right now.

First of all lets start with a few facts, Menopause is a one day kind of thing. More specifically it is the 1 year anniversary of your last period. Mind Blown. Peri-Menopause and Menopausal symptoms can start fifteen (yes FIFTEEN) years before your periods stop and for up to four years afterwards so its pretty important that we recognise what we are so we can make the whole thing as easy as possible.

When we talk about menopausal symptoms most of us will think of a hot and sweaty woman of a certain age fanning herself with a copy of take a break magazine. This caricature is not only offensive but grossly inaccurate. In actual fact you could have entered into Perimenopause - the time before your period has stopped for 1 year - if you have any of the following symptoms…

Irregular Periods
Super Heavy Periods
Very Light Periods
Disturbed Sleeping
Brain Fog
Night Sweats
Metallic Taste in Your Mouth
Burning Sensation in Your Mouth
Brittle Bones
Mood Swings
Low Mood
Weight Gain Around Your Middle
Catastrophic Rage
Sore Boobs
Hot Flushes

Some of these changes might be really obvious to you, some of them not so much, but some of these changes might also be happening in your mouth.

Lets talk about sex…hormones - cheeky. Menopause comes about because of initial oestrogen levels becoming higher and then after a point declining over the years and becoming low. Low oestrogen levels have been associated with increased risk of Gum Disease and ultimately tooth loss in the future, although this becomes less likely if you’re taking some form of hormone replacement therapy.

Gum Disease is all about bone levels. Teeth live their best lives snuggling into your jaw bone. As Gum Disease progresses this bone is broken down and becomes less and less until eventually the tooth will fall out, this is how we can loose technically healthy teeth through Gum Disease. The thicker and more dense this bone is the longer it will take to break down if Gum Disease unfortunately gets going.

During Peri-Menopause bone levels decrease and become less dense kind of like honeycomb. Alveolar bone in your jaw is already starts life like this to keep your head light. As your bone levels decrease further this means we’ve got less to work with, and Gum Disease can progress more quickly in peri and post menopausal women. Its been proven that women who have experienced a reduction in bone density through menopause are also more likely to see higher levels of clinical attachment loss (which just means a loss of the tissues like bone and gum that hold your teeth in place) than those women who have higher levels of bone density. In real life you might notice this as a receding gum line or the teeth looking longer than they once did or feeling some sort of movement in your teeth. If this is the case you should see your Dental Hygienist or Dentist right away.

Hormone Replacement Therapy can help delay the onset of this process and if you are showing signs of loss of bone density treatments like bisphosphonates are available and you should absolutely speak to your GP about this to see if they will be suitable for you. Calcium and Vitamin K are also recommended but load bearing exercise a few times a week should be done alongside any treatment to improve your quality of life in the future.

When we think about some of the more ‘obvious’ changes there will absolutely be a knock on effect of your gum health too. Plaque control and gum health are best friends and if you’re not feeling your best if you’re feeling down or you’re tired from not sleeping well brushing and flossing your teeth might not be high on your priority list so if plaque hangs around for more than it should its much more likely that you’ll develop Gum Disease in the future. The best advice I can give you on this is do as much as you can when you can, and remember the times you feel like putting your gum health on the back burner are the times when your gums need you the most.

Unfortunately, as we saw up there, the years before and after menopause can lead to us popping on a few lbs round the our middles. Putting on weight means that inflammation in your body will increase. Sometimes ‘turning on’ this inflammation through weight gain can led to other inflammatory conditions one of which is Gum Disease. Its really important to maintain a healthy weight where possible to see loads of benefits in all aspects of your health but remember be kind to yourself, our bodies don’t like crash dieting or extreme exercising either, and if you want some tips on losing weight safely you can discuss this anytime with your lovely GP.

Aside from Gum Disease something that lots of my Perimenopausal patients experience is a burning sensation or a bad taste in their mouth called Burning Mouth Syndrome. This can be pretty mild or really severe and can vary a lot from person to person. The most likely form of Burning Mouth Syndrome (BMS) in Menopause is Secondary Burning Mouth Syndrome due changing Oestrogen levels but can also be a side effect of medications, allergies or nutritional deficiency of something like iron or B vitamins and for this reason should always be confirmed by your Doctor.

BMS is REALLY frustrating for my patients but there are some helpful things you can do at home that might help a little

Suck on ice chips
Sip cool water often as some people get a bit of relief after drinking
Limit the amount of spicy foods and hot beverages you eat and drink
Stop smoking
Don’t drink alcohol too often
Use an SLS free toothpaste, something like Sensodyne Sensitivity & Gum* is great
Do something that helps you relax regularly like yoga

Some of my patients really benefit from using something like Gengigel gel* or Gengigel mouthwash if they are experiencing BMS as it gives you the feeling of fullness back if you’re mouths feeling a bit dry but has a cooling and calming effect if your mouth is feeling a bit more sensitive than usual. Also if your gums are feeling more tender, the added benefit of Hyaluronic Acid in Gengigel means they’ll heal up more quickly. Gengigel also floods the affected area with water replenishing the area if your mouth is feeling dry while being resistant to your saliva meaning that it will stay in the affected area for longer. It also has an analgesic effect to help take away any tenderness or burning sensation.

If you feel though like you’ve tried all of the above…speak to your Dental Hygienist or Dentist to see about a specialist referral to shed some more light on the issue.

WOW I have really enjoyed learning a bit more about Menopause to bring you this blog, I know a lot of you guys reading this might know a bit more than me but….here are my TOP TIPS

Prepare yourself (and those around you) by getting some extra information
Visit your Dental Hygienist/Dentist every 3-6 months
Use something to clean in between your teeth at least once a day - you can get more info on this here, Brush Your Teeth Twice a Day for 2 minutes with an electric toothbrush like the Oral B iO*, with an SLS free toothpaste if you’re experiencing BMS
Exercise a few times a week mixing up cardiovascular exercises like walking and strength training with weights - kettle bells are amazing for this. Remember you should always speak to your Doctor if you are going to start a new exercise regime.
Do your pelvic floor exercises everyday - that’s just good sense.

I’ve had so many amazing conversations with my patients and my mum this week while writing this blog and the overriding consensus is once we reach Menopause and afterwards we are less sparkly and we loose part of ourselves, but we can be just as vibrant as we always have been as we move into this new phase. Lets remember after all, that Menopause is a life event, not a disease or a disorder and its what we as women are here to do. So I’m going to make it my mission to offer a safe and now somewhat educated space during my appointments if you want to chat because we have so much to learn from each other! Female health issues are often hushed up and can be awkward to talk about and if you’re not happy to talk about it then that’s ok… you do you. BUT if we cringe through the awkwardness for just a few more minutes we might help ourselves so much in the future.

I think Masie hits the nail on the head in Perimenopause Power when she says we prepare so much for job interviews, weddings, moving house etc but we prepare so little for Menopause that we miss what’s going on around us, in our mouths and beyond. Looking after our teeth and gums (and our whole bodies) in the years leading up to and after Menopause means we’re more likely to be smiling about it with a full set of teeth in the future..and that future looks pretty bright to me!