Menstruation Gingivitis: Why Your Gums Hurt Before Your Period

If your gums hurt before your period, this could be due to menstruation gingivitis. Learn more about the causes, symptoms, and treatments.

woman suffering from toothache and holding coffee cup
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Periods can be painful. Even before they start you could experience pain like cramps. You might also feel as though your teeth hurt before your period. Technically, it's not your teeth that hurt—it's your gums. And it's a condition known as menstruation gingivitis.

What Is Menstruation Gingivitis?

Gingivitis is inflammation of the gums, which is the soft tissue around your teeth. Usually, gingivitis is a form of early-stage gum disease caused by excessive amounts of plaque on your teeth. Risk factors for gingivitis include poor oral hygiene, a family history of gingivitis, smoking, and diabetes.¹

Menstruation gingivitis is an inflammation of the gums that isn't necessarily caused by poor oral hygiene. It is a type of gingitvitis associated with female sex hormones during a menstrual cycle.²

Research suggests that menstruation gingivitis is most likely to start in the days leading up to a period and go away once menstruation begins.² A 2019 study examined 318 participants with mostly good oral hygiene for signs of gingivitis during different stages of their menstrual cycle. The results showed that 25% of 106 participants had signs of gingivitis leading up to their period. Meanwhile, only 5% of a different set of 106 participants had signs of gingivitis during their period. Among the final set of 106 participants who were looked at after their period, no one had gingivitis.³

What Causes Menstruation Gingivitis?

The association between the menstrual cycle and the gums involves hormonal changes. The increase in the hormones estrogen and progesterone that occurs right before a period can increase blood flow to the gums, making your gums more sensitive to plaque and bacteria.⁴

Even small amounts of plaque can irritate the gums when these hormonal changes occur.³ In turn, the gums can become inflamed, red, and swollen. They may also bleed more frequently, especially with brushing and flossing.²,⁴

However, these hormonal changes are brief and temporary. During the menstrual cycle, the rise in estrogen and progesterone levels happens during the luteal phase, which typically occurs after ovulation and 14 days before menstruation. These hormones plummet right as menstruation begins.⁵ Menstruation gingivitis symptoms typically peak and recede within that same pattern as well.²,⁴

Menstruation Gingivitis Symptoms

The symptoms of menstruation gingivitis are the same as those of gingivitis that isn't related to menstruation. Starting as early as two weeks before your period, you may notice bright red, swollen gums. Your gums may also bleed.⁴ It is common for gingivitis to be painless, though some people may experience pain in the gums.⁶

It might feel more uncomfortable to brush and floss your teeth during this time, but it's important to maintain a consistent daily oral hygiene routine, as it can help reduce inflammation and bleeding and also prevent more serious gum disease.¹,⁴

When to See a Health Care Provider

Gingivitis symptoms are usually not severe and will go away after menstruation. But you can talk with your provider about ways to manage inflammation.⁴

If symptoms continue or occur beyond menstruation, this could be a sign of a more serious gum condition or gingivitis unrelated to hormones. A dentist can figure out the cause of your symptoms. When caught early, gingivitis can be managed and even reversed with the right treatments, avoiding further complications.⁶

Diagnosis

When diagnosing gingivitis, a provider will examine all of the soft tissue around the teeth for signs of inflammation, such as redness and swelling. Gums that excessively bleed during oral cleanings can be another sign of gingivitis. A provider may measure the space around the teeth and gums to evaluate the extent of any gum disease.⁷

If symptoms only occur in the week or two before menstruation in someone with a history of healthy gums and good oral hygiene, it is likely to be menstruation gingivitis. A provider would be able to rule out other types of gingivitis.

How to Manage Menstruation Gingivitis

Once menstruation gingivitis sets in, symptoms should resolve quickly once menstruation starts.² In the meantime, continue with a brushing and flossing routine every day. Keeping your mouth clean can help reduce plaque and bacteria buildup and may help prevent inflammation or infection.¹,⁷

Visit your dentist if symptoms are not manageable at home or if they persist after your period.⁶

How to Prevent Menstruation Gingivitis

There's no sure way to prevent menstruation gingivitis, but similar to preventing gum disease, cleaning your gums and teeth regularly helps prevent plaque and bacteria buildup.

Practicing good oral hygiene every day—not just before you get your period—may help reduce symptoms and maintain healthy gums. Brushing twice a day with a fluoride toothpaste and flossing regularly after meals will help clean your mouth, reducing plaque buildup.¹,⁷ Mouthwash rinses may be an additional step to remove remaining plaque and food debris.⁸

Having routine professional cleanings done by a dentist at least once a year, combined with an at-home oral care routine, can help reduce menstruation gingivitis in the long run.¹,⁷

Other Hormonal Changes Associated With Gingivitis

The menstrual cycle isn't the only time that hormones can lead to gingivitis.

Puberty

Increasing levels of estrogen and testosterone in prepubescent children can cause increased gum sensitivity. Known as puberty gingivitis, the change tends to happen earlier in adolescence for girls and later for boys.⁶

Oral Contraceptives

Use of oral contraceptives may cause female sex hormones levels to rise, similar to a natural menstrual cycle, and may also lead to collagen buildup in the gums. These changes may lead to gum sensitivity and gingivitis.⁶,⁹ One 2019 study suggests that women who take birth control pills with a combination of estrogen and progestin for over 18 months, may be more likely to develop gum bleeding and inflammation.⁹

Pregnancy

Hormonal changes during pregnancy are associated with gingivitis as well, but the difference is in duration of symptoms. While menstruation gingivitis is short term, pregnancy gingivitis can last for several months. This gingivitis usually happens between the second and eighth month of pregnancy. A dentist may recommend more frequent cleanings if needed.⁴,¹⁰

Summary

It's not unusual for your gums to become inflamed just before your period starts. As hormones rise and fall during a menstrual cycle, some people can experience menstruation gingivitis. And it's not necessarily a sign of poor oral health.

If your gingivitis symptoms only occur in the days leading up to your period and then suddenly resolve when your period begins, it could be menstruation gingivitis. Other types of hormonal changes can lead to gingivitis as well. Usually, gingivitis related to hormones is not a major cause for concern, and you should make sure to keep up with your oral hygiene.

Sources

  1. Centers for Disease Control and Prevention. Periodontal Disease.
  2. American Academy of Periodontology. Gum Disease and Women.
  3. Setijanto RD, Rahayu MV, Bramantoro T, Wening GR, Rudhanton RA, Ramadhani A. Gingival Inflammation in 2 Phases of Menstrual Cycle and its Relation to Oral Hygiene of Female Dentistry Students. J Int Oral Health. 2019;11:388-92. doi:10.4103/jioh.jioh_232_18.
  4. American Dental Association. Hormones and Dental Health: What Every Woman Needs to Know.
  5. Reed BG and Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. Endotext. 2018.
  6. Rathee M and Jain P. Gingivitis. StatPearls. 2022.
  7. National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease. 2018.
  8. American Academy of Periodontology. Gum Disease Prevention.
  9. Prachi S, Jitender S, Rahul C, Jitendra K, Priyanka M, Disha S. Impact of oral contraceptives on periodontal health. Afr Health Sci. 2019;19(1): 1795–1800. doi:10.4314/ahs.v19i1.56.
  10. Centers for Disease Control and Prevention. Pregnancy and Oral Health.
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