The Impact of Female Hormones on the Periodontium—A Narrative Review

ABSTRACT Objective To provide an updated narrative review of current concepts relative to the impact of female hormones on the periodontium throughout the life stages of the female patient. To analyse the implications for the clinician and to amalgamate the main findings from a wide range of empirical studies and theoretical perspectives. Method Narrative review of the literature synthesising the findings of an extensive collection of literature, published between 2000 and 2024, retrieved from searches of computerised databases, hand searches, authoritative texts and personal communication. Earlier citations outside of the reference range are used to provide historical background to current opinion. The subjects included oestrogen, progesterone, testosterone, puberty, menstruation, contraception, pregnancy, menopause, and periodontal disease, periodontium, inflammation, and the inflammatory cascade. Results Drawing from an extensive collection of literature, this review offers insights into the dual function of oestrogen, progesterone, and testosterone in mediating inflammatory and anti‐inflammatory responses to local factors, primarily plaque biofilm, and the regulation of the inflammatory cascade. These responses differ between the life stages of puberty, menstruation, contraception, pregnancy, and menopause. Conclusions Key findings demonstrate that hormone fluctuations have a direct and indirect impact on the periodontium, altering the bacterial flora of plaque biofilm to a composition more conducive to the development of periodontal disease and modifying the tissue response to local factors, producing anatomic changes in the gingivae that compromise the periodontium and influencing the regulation of the inflammatory cascade. These factors increase the risk of periodontal disease and susceptibility to other oral conditions associated with female hormone fluctuations.