Women and Periodontal Disease
Hormonal fluctuations or changes that occur during puberty, menstruation, pregnancy and menopause may affect the gums and increase a woman's risk to periodontal disease. Any pre-existing periodontal disease can become more severe.

Pregnancy Gingivitis
During puberty, increased level of hormones such as progesterone and oestrogen cause increased gum sensitivity, leading to a greater reaction to food particles and the presence of plaque. The gums become swollen, turn red and may feel painful to touch.
Some women experience similar symptoms 3 to 4 days prior to their period. Others may experience menstruation gingivitis, which is characterised by bleeding gums, a bright red swelling of the gums between teeth and sores or ulcers in the mouth. The symptoms usually clear up once the period starts.
It is important to maintain good oral hygiene during these hormonal changes so that the bone and gums surrounding the teeth are not affected.
Some pregnant women may experience pregnancy gingivitis, beginning in the second or third month of pregnancy. It may increase in severity throughout the pregnancy. The gums become swollen, red, may be painful on touch and bleed.
In some cases, the strong reaction to food particles and plaque forms painless swellings or lumps called pregnancy epuli. These may disappear after pregnancy but some remain, requiring surgical removal by a dentist.
Menopausal or post-menopausal women may experience discomfort in the mouth, including pain and burning sensations in the gum tissue, altered taste and dry mouth. Hormonal replacement therapy (HRT) may relieve these symptoms but a consultation with a doctor is always required to assess the risk-benefit ratio of each woman first.
Saliva substitutes are available in the form of rinses and gels to help relieve the painful symptoms.