Exploring the association between menopause and burning mouth syndrome: an updated review

Burning Mouth Syndrome (BMS) is a chronic orofacial pain disorder characterized by a burning or dyesthetic sensation in the oral mucosa in the absence of identifiable clinical or laboratory abnormalities, predominantly observed in postmenopausal women. Despite its prevalence, the underlying causes remain poorly understood. This systematic review aims to synthesize current evidence on factors associated with BMS to inform future research and clinical management. A comprehensive literature search was conducted across PubMed, Web of Science, and Embase databases to identify relevant studies published between January 2000 and June 2025. After removing 108 duplicates from an initial pool of 688 records, 22 studies met the inclusion criteria. Eligible designs included cross-sectional, case-control, cohort, and descriptive studies involving individuals diagnosed with BMS. Methodological quality was assessed using the Newcastle-Ottawa Scale. BMS was consistently associated with female sex, menopause, hypothyroidism, chronic medication use, and sociodemographic factors such as older age, marital status, unemployment, and lower educational attainment. Some studies found no significant correlations between BMS and salivary biomarkers such as protein, opiorphin, Candida species, or diabetes, while the role of progesterone remains inconsistent across studies. Additional contributing factors included chronic pelvic pain, heightened pain sensitivity, depression, anxiety, stressful life events, poor sleep quality, diminished quality of life, and oral health issues such as denture use, xerostomia, periodontitis, dental procedures, and parafunctional habits. Lifestyle factors particularly smoking, alcohol consumption, and intake of acidic, spicy, or strong-flavored foods were reported to exacerbate BMS symptoms. The findings highlight the multifactorial nature of BMS and identify vulnerable populations at increased risk. While numerous associations have been documented, no single etiological factor can be definitively implicated, underscoring the complexity of BMS pathogenesis and the need for interdisciplinary approaches in diagnosis and management.