# Impact of menopause on clinical periodontal outcomes: a systematic review

## TL;DR

This review suggests menopause may worsen periodontal health, but more high-quality studies are needed to confirm this link.

## Contribution

The study systematically evaluates the association between menopause and periodontal outcomes, highlighting the need for stronger evidence.

## Key findings

- Postmenopausal women showed greater clinical attachment loss and deeper probing depths.
- Increased inflammation signs were observed in postmenopausal women.
- Evidence certainty was rated moderate to low due to methodological variability.

## Abstract

To investigate whether menopause is associated with adverse clinical periodontal outcomes by systematically comparing postmenopausal and premenopausal women.

A systematic review of observational studies was conducted following PRISMA guidelines. Electronic databases were searched up to March 2025 March 2025 for observational studies reporting clinical periodontal parameters in postmenopausal women not undergoing hormone replacement therapy. Risks of bias and certainty of evidence were assessed using ROBINS-I and GRADE frameworks.

Nine studies met inclusion criteria. Postmenopausal women showed greater clinical attachment loss, increased probing depths, and more pronounced signs of inflammation. However, the certainty of evidence was rated as moderate to low, mainly due to methodological variability.

While the observed trends suggest that menopause is a clinically relevant factor in periodontal health, the current evidence base is weak. High-quality prospective studies are urgently needed to confirm these findings before informing clinical practice or developing new guidelines.

Findings contribute to the current understanding of systemic influences on periodontal disease, with relevance to aging, women’s health, and menopause as a physiological stage of life.

The online version contains supplementary material available at 10.1007/s00784-026-06813-y.