WTH?! (What The Health?!) is a Scary Mommy series answering health questions relevant to moms and women that we don’t talk about enough. Think: “What is this weird pregnancy symptom? WTF is happening to me postpartum? Are these signs of perimenopause?” Let’s normalize these and other women’s health issues by talking about them more in a relatable, less clinical, and no-BS way.
You know that feeling when you eat something spicy or hot, and your mouth feels like it's on fire? Well, what if you experienced that burning sensation randomly for years without any clear explanation?
That's what happened to Sandra Ebejer, 47, from New York, who has been dealing with burning mouth syndrome for about eight years now. She sporadically feels burning on the roof of her mouth, lips, and cheeks — sometimes a mild sensation and other times intense pain. And for years, she had no idea what was causing it.
"All the dentists and doctors I mentioned it to looked at me kind of sideways, like they had no idea," she tells us. "They would check me out, and they said nothing looks wrong."
It wasn't until a few years ago that a dentist suggested to her it could be related to hormones, given she was in her early 40s.
"A lot of girlfriends my age are going through perimenopause, and we share stories about night sweats, hot flashes, and all the things that you expect. But when I talk about this, everyone is shocked," she says. "They've never heard of it before."
Scary Mommy asked experts about everything you need to know about burning mouth syndrome, from what causes this symptom during perimenopause and menopause to what you can do about it.
So, what is burning mouth syndrome?
Burning mouth syndrome (BMS) "is a condition when your mouth feels like it's burning, tingling, or numb, but there's no obvious reason like eating something spicy," Dr. Cheryline Pezzullo, a general dentist and clinical assistant professor at NYU Dentistry, tells Scary Mommy.
It can affect any part of your mouth (lips, tongue, gums, roof of your mouth) and even your throat. You may also experience a metallic taste or loss of taste, says Dr. Fatima Khan, a dentist based in Texas.
Why can this happen during perimenopause, and how common is it?
"Hormones can control a lot more than just sex," says Dr. Heather Hirsch, founder of the Menopause and Midlife Clinic at Brigham and Women's Hospital and author of Unlock Your Menopause Type. "And there is a lot of data to show that a low estrogen state can cause burning mouth syndrome… It's uncommonly talked about, but a commonly known symptom among menopause experts."
Around 7-15% of women going through perimenopause or menopause can experience this strange feeling in their mouths, Pezzullo says.
While the relationship between hormone changes and BMS is not completely clear, Pezzullo and Khan explain some reasons why they may be connected:
- Estrogen can affect pain perception and taste, so lower levels can alter taste buds and cause pain in the mouth.
- You may produce less saliva, which leads to a dry mouth.
- Your immune system's response may be impacted, leading to inflammation in the mouth.
- You may have a decline in some nutrients (vitamins B6 and B12, folate, and iron), which can bring on BMS symptoms.
- Mood changes are common during perimenopause, and stress and anxiety can trigger BMS.
How do you know if hormones are causing BMS or if it's something else?
Hormones aren't the only reason you may experience BMS. Underlying medical conditions, psychological stress, nutritional deficiencies, and medication side effects can also influence it.
While there is no specific test to diagnose burning mouth syndrome, Pezzullo recommends visiting the dentist if you're experiencing discomfort. A dentist will chat about your symptoms, examine your mouth, and possibly do tests to rule out other potential causes.
Is there anything you can do to relieve the pain?
Here are a few tips from Pezzullo on how to soothe the burning sensation:
- Sip on cool water.
- Suck on ice chips.
- Avoid spicy or acidic foods.
- Use a mild toothpaste.
- Chew sugarless gum.
"If the burning persists, we might recommend treatments like certain mouth rinses, medications that can help control nerve signals in your mouth, or even cognitive behavioral therapy to manage the discomfort," she explains.
Hirsch says she's seen hormone replacement therapy (replacing estrogen) as one of the most helpful ways to alleviate BMS for women during perimenopause/menopause.
Remember: It's likely temporary, and you don't have to suffer in silence.
The burning sensation may last for months or even longer, but the good news is that it often improves over time. And while you're dealing with BMS or any perimenopause symptom, remember that you don't have to suffer alone.
Talk to your friends. Join Facebook groups for people dealing with similar symptoms. Find doctors who specialize in perimenopause and menopause to talk through what to expect. (You can check the North American Menopause Society's website to find a certified menopause practitioner in your area.)
"My advice for women who are experiencing any perimenopausal symptom is to try and find other women who are dealing with it," Ebejer says. "[Then] it doesn't feel like you're totally alone."
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