SynthesisInternational journal of environmental research and public health2026
Estrogen Status and Temporomandibular Disorders: A Systematic Review.
Synthesis in International journal of environmental research and public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
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Abstract
backgroundTemporomandibular disorders (TMDs) exhibit a marked female predominance, suggesting a potential role for estrogen in their pathophysiology. However, evidence linking estrogen status to TMD remains inconsistent.
objectiveTo systematically review the association between estrogen-related factors and TMD prevalence and clinical presentation in women.
methodsPubMed, Embase, Scopus, Web of Science, and Google Scholar were searched through September 2025. Observational studies evaluating hormonal contraceptive use, menopausal status, menstrual cycle variation, pregnancy, or estrogen receptor polymorphisms in women with TMD were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the Newcastle-Ottawa Scale. Due to substantial heterogeneity, a narrative synthesis was conducted.
resultsSeven studies met the inclusion criteria, including six clinical studies involving 2735 participants and one mechanistic supportive study. Moderate-certainty evidence suggested associations between hormonal contraceptive use, menopausal/climacteric status, and increased TMD risk or symptom severity. Additional low-certainty evidence supported associations involving menstrual cycle variation, pregnancy, and estrogen receptor polymorphisms.
conclusionsCurrent evidence suggests that hormonal factors may influence TMD risk and symptom presentation in women. However, heterogeneity in definitions of hormonal exposure and diagnostic criteria limits definitive conclusions. Further prospective studies using standardized diagnostic protocols and real-time biochemically validated hormonal assessments correlated with clinical symptoms are needed.
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