Title |
Oral Contraception and Estrogen Replacement Therapy Are Not Linked To TMD Severity |
Clinical Question |
In a patient with TMD, do exogenous estrogens exacerbate the severity of TMD signs and symptoms? |
Clinical Bottom Line |
Exogenous estrogens do not put patients with TMD at increased risk for developing more severe signs and symptoms. |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
11258088 | Hatch/2001 | Postmenopausal women aged 37 to 82 | Cross-sectional observational study | Key results | Neither oral contraceptives nor replacement estrogens place patients at increased risk of developing TMD. There was no significant difference in muscle and joint signs and symptoms in women taking estrogen and those who were not. | 18686498 | Nekora-Azak/2008 | Postmenopausal women aged 42-72 | Cross-sectional observational study | Key results | Estrogen replacement therapy does not increase women’s risk of developing TMD. The p-value was 0.213 and therefore there was no significant difference in TMJ pain in women taking HRT and those who were not. | 15895836 | Sherman/2005 | Women with normal menstrual cycles | Cross-sectional observational study | Key results | Women with TMD who were normal cycling had higher pain intensity at menses and midluteal phases. TMD patients taking oral contraceptives had more stable palpation pain intensity in comparison to normal cycling women during menses, ovulation and midluteal phases, but intensity increased during the late luteal phase. It is evident that pain intensity fluctuates throughout the menstrual cycle in normal cycling women and in women taking oral contraceptives. However, more evidence is needed to support a protective factor from exogenous estrogens. | |
Evidence Search |
"Temporomandibular Joint Disorders"[Mesh] AND "Estrogens"[Mesh] |
Comments on
The Evidence |
Hatch: This cross-sectional observational study had similar groups of women at start who were all post-menopausal. There was more than 80% completion rate and all groups were treated the same. This was not a double-blind trial but there was adequate compliance, no recall bias was likely and no competing interests were evident. Nekora-Azak: This cross-sectional observational study had similar groups of post-menopausal women who were treated the same, and had more than 80% completion rate. The trial was not double-blinded but there was adequate compliance, no recall bias likely and no competing interests evident.Sherman: This cross-sectional observational study was composed of women with normal menstrual cycles at start who were all treated the same. More than 80% completed the trial, and there was adequate compliance. This was not a double-blinded trial, there was no recall bias likely and no competing interests were apparent. |
Applicability |
This is applicable to a patient who currently has TMD signs and symptoms and is either considering taking exogenous estrogens or is currently taking them. |
Specialty |
(General Dentistry) |
Keywords |
Estrogen Replacement Therapy, TMD, exogenous estrogens, oral contraceptives
|
ID# |
2192 |
Date of submission |
04/24/2012 |
E-mail |
haml@livemail.uthscsa.edu |
Author |
London Ham |
Co-author(s) |
|
Co-author(s) e-mail |
|
Faculty mentor |
Rita Renee Parma, DDS |
Faculty mentor e-mail |
parma@uthscsa.edu |
|
|
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
None available | |