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Burning Mouth Syndrome

Burning Mouth Syndrome (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.

The Lowdown on Burning Mouth Symptom

Why it happens and the science behind it, how it may impact your life, how you and your doctor can diagnose it and common triggers or risk factors.

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 symptoms which could be related or exacerbated by BMS are:

  • Increased allergies
  • Digestive changes
  • Gum problems
  • Itchy skin
  • Tingling in the extremities
  • Sleep disturbances 

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
  • 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.  

Physical symptom

Fight fire with fire

Strangely enough spicy foods can actually help with BMS: capsaicin (the compound that makes hot peppers hot) can disable the pain-signaling chemicals in nerve cells. Capsaicin is an over-the-counter treatment and 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.

Prevention and Treatment

Learn more about your options for prevention, management and treatment of Burning Mouth Symptom. This is not an exhaustive list of the treatment options available, but a good start.

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. 

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. There are also a wide range of treatment products available, based on anecdotal reports of effectiveness. 

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
  • 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.

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.
  • Using a toothpaste formulated for sensitive teeth or containing bicarbonate of soda may provide some relief, particulalry just before going to sleep
  • 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 Replacement Treatment (HRT) is not considered effective for relief of BMS symptoms.

FAQs

Are Asian women at an increased risk for BMS?

Across all age groups and both genders, Europeans are more likely to experience BMS than Asian or American residents (7% prevalence vs. 2-3% and 0.7%, respectively).

Is BMS worse at night?

For most women suffering from primary BMS, the pain typically gets worse over the course of a day. You may feel fine when waking up, with discomfort gradually increasing over the course of the day and peaking in the evening. It is unfortunately very common for this to make falling asleep more difficult.

With secondary BMS, the pain remains consistent.

What is Burning Mouth Syndrome and what does it feel like?

Burning mouth syndrome (BMS) is characterized by burning pain in the tongue or other oral mucous membrane often associated with symptoms such as subjective dryness of the mouth, paraesthesia and altered taste for which no medical or dental cause can be found.

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