A new research explains one thing most individuals—medical doctors included—are lacking: when estrogen declines, your gums grow to be extra weak to irritation, tissue loss, and illness.
For those who’re already seeing early indicators—bleeding, unhealthy breath, gum recession—it’s not only a dental challenge. It’s an entire physique one.
As my very own three grownup daughters inch nearer to perimenopause, I’m writing this article with them in thoughts. There are such a lot of issues I want my spouse Roseann and I knew when she went by way of menopause in her 40s. We realized most of this the onerous means.
So on this e-newsletter, you’ll study:
- how estrogen, saliva, and gum illness are related
- what function saliva truly performs in hormone stability
- what you are able to do proper now to guard your mouth for those who’re approaching or already in perimenopause
- the small, preventative steps you may take beginning at present—earlier than issues worsen.
And when you have a good friend, sister, or daughter who hasn’t heard this earlier than, please ahead this to her. As you’ll see by the top of this article, early motion might be the distinction between easy prevention and years of continual irritation, irreversible tissue loss, and 1000’s of {dollars} in dental reconstruction.
Most individuals don’t notice that perimenopause usually begins in your late 30s to early 40s, typically even earlier.
However as a result of the signs may be refined at first, many ladies don’t acknowledge them till a lot later—when harm is already occurring.
This new research was printed simply two days in the past, and I haven’t stopped desirous about it since. It confirmed what I’ve suspected for years.
Many many years in the past, I observed in my observe, that my sufferers in perimenopausal age observed dry mouth and disrupted sleep. I began seeing the identical sample again and again: bone loss, gum illness, elevated tooth decay, dry mouth, loud night breathing, mouth respiration.
Loud night breathing charges in ladies surge after menopause—analysis exhibits they practically double in comparison with premenopause, closing the hole with males. Research hyperlink this to declining estrogen and progesterone, which have an effect on airway muscle tone and sleep regulation.
This research adopted 372 postmenopausal ladies in Saudi Arabia to discover the connection between hormone alternative remedy (HRT) and gum illness. HRT helps easy the transition into menopause by decreasing the sharp hormonal decline. It doesn’t cease menopause—nevertheless it slows the drop, easing signs and decreasing danger—together with the danger of gum illness.
“The chances of getting periodontitis was 3.2 instances decrease in HRT customers in comparison with non-users.”
“After adjusting for medical and demographic variables, HRT customers had roughly six instances decrease odds of getting periodontitis.”
Estrogen, it seems, is a key consider defending towards gum illness.
Wait—our gums reply to estrogen?
They do. Your gums, salivary glands, and oral tissues all have estrogen receptors—the identical sort present in bones and reproductive organs.
Estrogen begins declining in your mid-to-late 30s—usually years earlier than menopause. As that drop begins, your oral tissues lose a few of their skill to manage irritation, heal, and preserve construction.
Ladies have all in all probability observed this, however no physician talks about it.
From the research: “Estrogen modulates immune responses by downregulating pro-inflammatory cytokines… and performs a vital function in sustaining bone metabolism.”
In plain phrases? Estrogen helps preserve your gums resilient. With out it, you’re extra weak to irritation and tissue breakdown—not simply within the mouth, however throughout the physique. Estrogen is a key regulator of immune exercise, serving to to stability inflammatory responses within the mind, intestine, coronary heart, and gums alike.
And it’s not simply gum tissues, it’s additionally mind tissue and different programs within the physique!
I used to present my mother estrogen injections when she was deep into her Alzheimer’s. The physician advisable it; I used to be simply the one administering. There could be a slight, short-term enchancment. In fact, that is anecdotal—my mother was already far passed by that time. However I keep in mind her perking up and talking extra lucidly afterward. Perhaps it was the estrogen. Perhaps it was simply the jolt of getting jabbed within the leg with a needle. Both means, I by no means forgot it.
Nobody talks about this. Not medical doctors. Not dentists. Not even most menopause specialists. You shouldn’t be dismissed with “you’re simply going by way of the change, don’t fear about it.” That mindset is a disservice.
This isn’t only a part—it’s a physiological shift that touches practically each system in your physique. For those who’re noticing extra loud night breathing, there’s seemingly extra dry mouth too. This stuff are related. And so they deserve consideration.
Upon getting gum illness, HRT doesn’t reverse it. It’s preventive—not healing.
Smoking elevated danger of gum illness 16x. Sure, we already know smoking is dangerous—however what shocked me is how dramatically it confirmed up within the knowledge. In line with the identical research, it was one of many strongest predictors of gum illness—greater than age, earnings, or any single medical situation. And but—what number of younger ladies are vaping proper now, fully unaware of the harm it might be doing to their gums, saliva, and long-term oral well being?
Saliva plummets in menopause. And saliva is your immune system’s frontline protection in your mouth. And that’s precisely why I like to recommend supplemental magnesium to 99% of my sufferers. It shouldn’t even be known as a complement—as a result of it’s important. Magnesium is important for over 300 enzymatic reactions, together with estrogen metabolism—and many ladies, particularly underneath stress, are chronically poor. For those who don’t have already got a magnesium you belief, right here’s the one I’ve taken day by day for practically ten years, and so has Roseann.
Why does saliva decline in menopause? Two of the most important salivary glands that offer your mouth decelerate throughout menopause (see my earlier e-newsletter on why saliva issues a lot.) Human salivary glands specific estrogen receptors—they depend on estrogen to operate correctly. With out it, saliva manufacturing drops. That’s why dry mouth is such a standard symptom. Estrogen instantly regulates how a lot saliva is there, so if it’s not there, then no saliva.
Schooling degree was as protecting as hormone remedy. Most likely as a result of the form of one who reads newsletters like that is already paying consideration—already connecting the dots.
What I’m telling my daughters
- Discuss to your physician about HRT. If it’s best for you, it might shield your gums lengthy earlier than they’re in hassle. (However do needless to say estrogen isn’t proper for everybody—particularly folks with breast most cancers that runs within the household, like ours. Once more, converse to your physician, as a result of it received’t be proper for everybody.)
- Discover your saliva:Is it dry whenever you get up? Does it really feel thick or sticky throughout the day? Wholesome saliva ought to really feel gentle, plentiful, and barely slippery. When it’s off, it could possibly imply your mineral stability is off, your estrogen is dropping, or your nervous system is underneath stress. It’s one of many first indicators your mouth—and your hormones—would possibly want help. Lack of saliva can result in cavities as effectively, not simply gum illness!
- Ditch the mouthwash: For those who’ve been following me for some time (or for those who’re considered one of my daughters), I do know you’ve already tossed the mouthwash. However right here’s why it issues: alcohol-based mouthwash disrupts your oral microbiome, dries out your mouth, and leaves your enamel extra weak to decay. As an alternative, use a tongue scraper to manually take away buildup and pair it with a microbiome-friendly toothpaste to maintain your oral ecosystem in stability—and probably shield extra than simply your enamel. There’s analysis linking oral irritation to systemic circumstances, together with heart problems and even mind well being.
- Hydrate with minerals: Mineral-rich water and balanced electrolytes assist saliva do its job. I add electrolytes to my water each single day.
- Replenish your magnesium — Magnesium isn’t elective. It’s important for estrogen metabolism, bone well being, and sustaining saliva that truly protects your enamel. If you’re low, your saliva turns into thinner, much less mineral-dense, and fewer efficient at buffering acids and rebuilding enamel. You lose the flexibility to restore in actual time. And since magnesium additionally helps mitochondrial well being and modulates stress response, it’s a cornerstone not simply in your mouth—however in your mind and hormones too.
- Get common sleep research: Estrogen and progesterone assist preserve airway muscle tissues toned—when these hormone ranges drop, your airway turns into extra vulnerable to collapse throughout sleep. For those who’ve had a sleep research prior to now, don’t assume it’s nonetheless correct—your danger profile has modified.
Your gums take extra abuse than simply about some other tissue in your physique. They’re the place bone, blood vessels, nerves, and the immune system meet the surface world.
They’re continually recovering from micro-injuries—tortilla chip scrapes, acidic drinks, micro organism, hormones—and nonetheless anticipated to heal flawlessly.
So when one thing shifts systemically, like a drop in estrogen, in fact your gums are going to be one of many first locations to indicate it.
P.S. This subject deserves greater than a e-newsletter. I’ll be dedicating a whole chapter to it in my upcoming e book with Penguin Life. For those who’re navigating perimenopause—or supporting somebody who’s—I need to hear from you.
What questions do you’ve gotten?
What’s been lacking within the conversations you’ve had along with your dentist, physician, and even your mates?
Reply to this e mail and let me know. Your questions would possibly form what makes it into print.
Know somebody who would respect this data?
Ahead it to them & inform them to join future emails right here.
References & Additional Studying
Ageel, R., Abaalkhail, B., & Natto, Z. S. (2025). Impact of hormone alternative remedy on periodontal well being in post-menopausal ladies in Jeddah, Saudi Arabia. BMC Ladies’s Well being, 25(1):383. https://pubmed.ncbi.nlm.nih.gov/40753442/
Harding, A. T., & Heaton, N. S. (2022). The influence of estrogens and their receptors on immunity and irritation throughout an infection. Cancers (Basel), 14(4):909. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870346/
Leimola-Virtanen, R., et al. (2000). Expression of estrogen receptor (ER) in oral mucosa and salivary glands. Maturitas, 36(2), 131–137. https://pubmed.ncbi.nlm.nih.gov/11006500/
Bixler, E. O., et al. (2001). Prevalence of sleep-disordered inhaling ladies: results of gender. Am J Respir Crit Care Med, 163(3), 608–613. https://pubmed.ncbi.nlm.nih.gov/11254512/