Gingivitis can worsen during different phases of the life cycle: • The onset of puberty • During monthly menses • With use of oral contraceptives Hormones have an effect on the mouth throughout the life cycle. In puberty, women may experience inflammation of the gums, hyperplasia of the gums and pain. The same symptoms may occur monthly during menses or with birth control use, although modern lower dose OCPs result in less oral symptoms. Treatment includes good oral hygiene including brushing twice daily and flossing daily. Regular check-ups with a dental provider to rule out other issues and cleanings can also help symptoms. Menopause cause the gums to atrophy. They may appear dry and shiny and bleed more easily. For some women they may have less saliva production which results in xerostomia (dry mouth) which is a risk for caries. Taste can be altered. Women should be encouraged to attend to oral hygiene during this phase of their life and continue regular visits with their dentist. While hormone replacement therapy (HRT) may improve these symptoms, oral symptoms are not an indication for HRT due to the many potential risks of HRT. Any consideration of HRT should take into account a women’s other risk factors and menopause symptoms. References American Dental Association Council on Access, Prevention and Interprofessional Relations. Women’s Oral Health Issues. 2006. Available at: http://www.ada.org/sections/professionalResources/pdfs/healthcare_womens.pdf (Accessed April 15, 2014) Buencamino MCA, et al. How menopause affects oral health and what we can do about it. Cleveland Clinic Journal of Medicine. 2009; 76(8):467-475.