Burning Mouth Syndrome
Burning Mouth Symptom (BMS) is a relatively rare and unknown symptom that sometimes occurs during the menopause transition. The feeling can best be described as burning your tongue after consuming a hot beverage - a feeling of tingling, burning, or numbness. However, this relatively unusual symptom occurs without external cause or obvious trigger.
Up to 33% of menopausal women reported Burning Mouth Syndrome (BMS)
The symptoms tend to recede overnight and increase in intensity during the day, sometimes causing sleep disturbances due to an inability to fall asleep from late evening pain. BMS can last for a number of years, but the condition is not permanent and will ease once your hormones stabilize post-menopause.
Why is this happening?
The medical community defines BMS as the feeling of your mouth or tongue burning for no known cause or otherwise identifiable medical or behavioral reason. Additional medical terms used to describe and diagnose BMS are glossodynia, stomatodynia, and dysesthesia. It is known that the chance of suffering from BMS is highest for women aged 40 - 60. This fact leaves researchers suspecting that one of the underlying causes may be related to natural and temporary changes in a woman’s hormones.
Other impacted areas
Other symptoms which could be related or exacerbated by BMS are:
- Increased allergies
- Digestive changes
- Gum problems
- Itchy skin
- Tingling in the extremities
- Sleep disturbances
Diagnosis
Although there is no precise test to determine if you are suffering from (hormonal) peri-menopausal mouth sensations, a trained medical professional is able to analyze your self-reported symptoms and your body’s progression through the stages of peri- or post-menopause, in order to make an informed diagnosis. To make the diagnosis your doctor will likely ask if you are experiencing any of the following:
- Pain or uncomfortable sensations in your mouth area
- Tingling in your mouth
- Burning or scalding feelings around your mouth, lips, or tongue
- An excessively dry mouth
- A bitter or metal-like taste
- Loss of taste
Possible triggers or risk factors
- BMS can be triggered by physiological and nervous system reactions to foods and medications. Spicy food, hot beverages/ food, speaking for long durations and stress are known triggers. However, it can also present without any obvious cause. BMS is more common during the post-menopause phase.
- Women have reported that the burning sensation intensifies throughout the day and is worst during the evening and night. For some women this may make it more difficult to fall and stay asleep at the start of the night.
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Treatments & remedies
There is bad news regarding the treatment of BMS, unfortunately. At this point in time, there is no cure for BMS and most treatment options focus on reducing pain and discomfort, rather than elimination of the symptom entirely. We will keep a close eye on research in this area and will provide updates to this section when better treatment options become available.
In the meantime, there are a wide range of treatment options available, based on anecdotal reports of effectiveness. Let’s review supplemental, prescription, hormonal, non-hormonal, lifestyle, and holistic alternatives.
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Nutrition
Positive nutrition is particularly important when hormonal changes are taking place in the body. Drinking adequate amounts of fluids, maintaining excellent nutrient levels in your food choices, and refraining from (or limiting) substances (alcohol, drugs, tobacco) which interfere with your body’s function will promote your overall well being.
Specifically for (pain) management control of BMS symptoms, the following remedies may provide relief:
- High fluid diet - helps with the dry mouth feeling, and provides relief for the burning sensation
- Sucking on ice chips
- Avoid spicy food and hot liquids
- Using a toothpaste formulated for sensitive teeth or containing bicarbonate of soda
- Avoiding acidic foods
Exercise
There are no specific exercises that you can do to reduce the severity of BMS. Having said that, being in good mental and physical life certainly won’t make it worse. And it is worthwhile to think of how you are maintaining a positive mental space and reducing stresses, so menopausal symptoms can be identified and controlled before they cause excessive stress and comorbidity.
Mindset
It is very difficult to perform scientific studies regarding lifestyle choices, menopause, and rates of success. What we do know is that, anecdotally and across cultures, women turn to positive lifestyle choices as a baseline treatment for a variety of symptoms, including BMS.
Supplements
Research into the efficacy of alpha lipoic acid (ALA) as a treatment for BMS indicates that there may be some positive effect. A recent study showed that 600 mg/day supplement of ALA provided some level of relief to 64% of the patients tracked, after one month of treatment. ALA is an antioxidant that is naturally produced by the body and can be found in some foods, such as potatoes, tomatoes, and spinach. ALA is used for neuropathy treatment and is thought to improve glucose metabolism and promote the production of nerve growth factor (NGF).
OTC Products
- Capsaicin is an over-the-counter treatment which has been found effective for treatment of BMS. Topical use of capsaicin in cream form or mouth-rinsing with a 1:2 dilution of hot pepper to water provides nerve desensitization and a relief of BMS pain for some women. Capsaicin is also prescribed pharmaceutically by physicians.
Prescription
- BMS has been found to respond to treatment from non-hormonal pharmaceuticals including tricyclic antidepressants, benzodiazepins, and gabapentin (an anticonvulsant). These medications are known to effectively treat neuropathic pain symptoms and low-dose treatment has been effective for BMS. It is unclear how these medications are effective, however they may have a sedative-hypnotic or analgesic effect.
- Capsaicin is the crystalline form of a chemical compound found in chili peppers and has been found to be an effective treatment option for BMS if it’s taken in relatively high doses. Capsaicin in higher doses is issued in patch form under a doctor’s direction.
Hormone Treatment
Hormone Replacement Treatment (HRT) is not considered effective for relief of BMS symptoms.
Holistic Treatment
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FAQ
What are the symptoms of Menopause?
There are roughly 34 symptoms of Menopause with the most commonly experienced being:
- Irregular periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Fatigue
- Sleep problems
- Mood changes and irritability
- Weight gain
- Thinning hair and dry skin
Medically reviewed and detailed symptom fact sheets can be found here, and a general overview of what (peri) menopause is and entails can be found here.
References
Dahiya P, Kamal R, Kumar M, Niti, Gupta R, Chaudhary K. Burning mouth syndrome and menopause. Int J Prev Med. 2013 Jan;4(1):15-20. PMID: 23411996; PMCID: PMC3570906.
How Do You Treat Burning Mouth Syndrome in Your Practice? Med Acupunct. 2019 Feb 1;31(1):49-56. doi: 10.1089/acu.2019.29107.cpl. Epub 2019 Feb 7. PMID: 32952785; PMCID: PMC7497973.
Hung-Pin Lin, Yi-Ping Wang, Hsin-Ming Chen, Ying-Shiung Kuo, Ming-Jane Lang, Andy Sun, Significant association of hematinic deficiencies and high blood homocysteine levels with burning mouth syndrome, Journal of the Formosan Medical Association, Volume 112, Issue 6, 2013, Pages 319-325, ISSN 0929-6646
Kohorst, J. J., Bruce, A. J., Torgerson, R. R., Schenck, L. A., & Davis, M. D. P. (2015). The prevalence of burning mouth syndrome: a population-based study. British Journal of Dermatology, 172(6), 1654–1656.
Palacios-Sánchez B, Moreno-López LA, Cerero-Lapiedra R, Llamas-Martínez S, Esparza-Gómez G. Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical trial. Med Oral Patol Oral Cir Bucal. 2015;20(4):e435-e440. Published 2015 Jul 1. doi:10.4317/medoral.20410
Sardella A, Lodi G, Tarozzi M, Varoni E, Franchini R, Carrassi A. Acupuncture and burning mouth syndrome: a pilot study. Pain Pract. 2013 Nov;13(8):627-32. doi: 10.1111/papr.12031. Epub 2013 Jan 21. PMID: 23336607.
Vaidya R. Burning mouth syndrome at menopause: Elusive etiology. J Midlife Health. 2012;3(1):3-4. doi:10.4103/0976-7800.98809
https://www.uspharmacist.com/article/capsaicin-risks-and-benefits
https://www.drshyamayurveda.com/blog/burning-mouth-syndrome
https://www.mountsinai.org/health-library/report/menopause
Burning Mouth Syndrome
Burning Mouth Symptom (BMS) is a relatively rare and unknown symptom that sometimes occurs during the menopause transition. The feeling can best be described as burning your tongue after consuming a hot beverage - a feeling of tingling, burning, or numbness. However, this relatively unusual symptom occurs without external cause or obvious trigger.
Up to 33% of menopausal women reported Burning Mouth Syndrome (BMS)
The symptoms tend to recede overnight and increase in intensity during the day, sometimes causing sleep disturbances due to an inability to fall asleep from late evening pain. BMS can last for a number of years, but the condition is not permanent and will ease once your hormones stabilize post-menopause.
Why this is happening
The medical community defines BMS as the feeling of your mouth or tongue burning for no known cause or otherwise identifiable medical or behavioral reason. Additional medical terms used to describe and diagnose BMS are glossodynia, stomatodynia, and dysesthesia. It is known that the chance of suffering from BMS is highest for women aged 40 - 60. This fact leaves researchers suspecting that one of the underlying causes may be related to natural and temporary changes in a woman’s hormones.
Other impacted areas
Other symptoms which could be related or exacerbated by BMS are:
- Increased allergies
- Digestive changes
- Gum problems
- Itchy skin
- Tingling in the extremities
- Sleep disturbances
Diagnosis
Although there is no precise test to determine if you are suffering from (hormonal) peri-menopausal mouth sensations, a trained medical professional is able to analyze your self-reported symptoms and your body’s progression through the stages of peri- or post-menopause, in order to make an informed diagnosis. To make the diagnosis your doctor will likely ask if you are experiencing any of the following:
- Pain or uncomfortable sensations in your mouth area
- Tingling in your mouth
- Burning or scalding feelings around your mouth, lips, or tongue
- An excessively dry mouth
- A bitter or metal-like taste
- Loss of taste
Possible triggers or risk factors
- BMS can be triggered by physiological and nervous system reactions to foods and medications. Spicy food, hot beverages/ food, speaking for long durations and stress are known triggers. However, it can also present without any obvious cause. BMS is more common during the post-menopause phase.
- Women have reported that the burning sensation intensifies throughout the day and is worst during the evening and night. For some women this may make it more difficult to fall and stay asleep at the start of the night.
Treatments & Remedies
There is bad news regarding the treatment of BMS, unfortunately. At this point in time, there is no cure for BMS and most treatment options focus on reducing pain and discomfort, rather than elimination of the symptom entirely. We will keep a close eye on research in this area and will provide updates to this section when better treatment options become available.
In the meantime, there are a wide range of treatment options available, based on anecdotal reports of effectiveness. Let’s review supplemental, prescription, hormonal, non-hormonal, lifestyle, and holistic alternatives.
Products
Research into the efficacy of alpha lipoic acid (ALA) as a treatment for BMS indicates that there may be some positive effect. A recent study showed that 600 mg/day supplement of ALA provided some level of relief to 64% of the patients tracked, after one month of treatment. ALA is an antioxidant that is naturally produced by the body and can be found in some foods, such as potatoes, tomatoes, and spinach. ALA is used for neuropathy treatment and is thought to improve glucose metabolism and promote the production of nerve growth factor (NGF).
- Capsaicin is an over-the-counter treatment which has been found effective for treatment of BMS. Topical use of capsaicin in cream form or mouth-rinsing with a 1:2 dilution of hot pepper to water provides nerve desensitization and a relief of BMS pain for some women. Capsaicin is also prescribed pharmaceutically by physicians.
- BMS has been found to respond to treatment from non-hormonal pharmaceuticals including tricyclic antidepressants, benzodiazepins, and gabapentin (an anticonvulsant). These medications are known to effectively treat neuropathic pain symptoms and low-dose treatment has been effective for BMS. It is unclear how these medications are effective, however they may have a sedative-hypnotic or analgesic effect.
- Capsaicin is the crystalline form of a chemical compound found in chili peppers and has been found to be an effective treatment option for BMS if it’s taken in relatively high doses. Capsaicin in higher doses is issued in patch form under a doctor’s direction.
Lifestyle
Positive nutrition is particularly important when hormonal changes are taking place in the body. Drinking adequate amounts of fluids, maintaining excellent nutrient levels in your food choices, and refraining from (or limiting) substances (alcohol, drugs, tobacco) which interfere with your body’s function will promote your overall well being.
Specifically for (pain) management control of BMS symptoms, the following remedies may provide relief:
- High fluid diet - helps with the dry mouth feeling, and provides relief for the burning sensation
- Sucking on ice chips
- Avoid spicy food and hot liquids
- Using a toothpaste formulated for sensitive teeth or containing bicarbonate of soda
- Avoiding acidic foods
There are no specific exercises that you can do to reduce the severity of BMS. Having said that, being in good mental and physical life certainly won’t make it worse. And it is worthwhile to think of how you are maintaining a positive mental space and reducing stresses, so menopausal symptoms can be identified and controlled before they cause excessive stress and comorbidity.
It is very difficult to perform scientific studies regarding lifestyle choices, menopause, and rates of success. What we do know is that, anecdotally and across cultures, women turn to positive lifestyle choices as a baseline treatment for a variety of symptoms, including BMS.
Holistic
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