Burning Mouth Syndrome and Menopause

Burning Mouth Syndrome (BMS) also known as Glossodynia or Stomatodynia is a collection of sensations that mainly affects women in their 40's to 70's. It has an increased prevalence 3 years before to 12 years after menopause. BMS may cause the sensation of

• burning
• pain
• tingling
• numbness
• increased thirst
• metallic /bitter or loss of taste
• dryness 

We have discussed in previous articles how menopause causes dryness, dry skin, dry vagina, dry eye, and even dry mouth! As your estrogen levels start to decline with menopause, so does your mouth's ability to produce saliva. This may be a caustic factor in the development of BMS.

Estrogen also plays a role in nerve health, did you realise your mouth is full of nerves, just bit your tongue or have a tooth cavity and you quickly realise just how important nerve health is to your mouth. Estrogen is both neuroprotective and neurotrophic. This means it protects your nerves from damage and it also plays a role in regenerating nerve cells.  

The most common location is the tip of the tongue, followed by the lips, lateral border of the tongue, and palate.

The diagnosis of burning mouth syndrome is a diagnosis by exclusion as there is no specific test for it. 

There are many factors potentially involved in its development.

Local factors include: lack of saliva, nerve damage, oral infections (candida, herpes etc), acid reflux, Lichen Planus, habits such as smoking, grinding and clenching, allergies/sensitivities - this can be to your dentures, toothpaste or food that you are eating, Salicylate-containing foods are big culprits here but any food you are sensitive too can be an issue. A classic salicylate issue causes skin irritation around the mouth/nose and lips - it's typically an external reaction rather than an internal issue but anything is possible.

Systemic factors include: Menopause, Diabetes (Type 2 diabetes is the most common cause of peripheral nerve damage. It is estimated 50% of people with diabetes will experience nerve pain), Sjogren syndrome, Other auto-immune conditions, Nutrient deficiencies such as B complex (especially B12), Vitamin D, Iron, Zinc, Magnesium and certain medications.

Psychological factors include: obsessive-compulsive over cleaning, stress, anxiety, depression.

These factors may aggravate BMS: eating hot/spicy foods, talking too much, stress. smoking, alcohol especially alcohol-based mouth wash.

Natural treatment options include the use of 

• Capsaicin (hot pepper/chili) you will rather love or hate this remedy. It is a miracle cure for some and for others, it just adds more heat to the fire. 
• Alpha-lipoic acid - this may help to restore nerve function and decrease nerve-related pain, its a strong anti-oxidant and may also improve insulin sensitivity. It's specific for the diabetic-related/nerve related burning mouth.
• Nutritional therapy: Vitamin D, B12, Zinc, Iron, Magnesium - if appropriate
• Cognitive-behavioral therapy
• High fluid diet avoiding any food you are sensitive to.
• Fish oil, for its anti-inflammatory benefits.
• These herbal medicines may be useful: Turmeric, Saffron, Nigella

We are here to help. Click here to learn about consulting with us, if you need help optimising your health during your menopausal transition.