Dear Karen,

Bleeding gums is a common symptom of menopause. In addition, menopausal gingivostomatitis may also affect a small percentage of women. This condition is marked by gums that look dry or shiny, bleed easily, and range from abnormally pale to deep red. Recent studies suggest that estrogen deficiency is the reason for these conditions and could place post-menopausal women at higher risk for severe periodontal disease and tooth loss.

There are several ways that declining estrogen affects the body, including the tissue of the oral cavity. As estrogen declines, body tissues lose their elasticity and shrink. The body's pH also changes, creating a more acidic environment. And, as we all know, the rate of bone loss accelerates.

In the mouth, dry, shrunken gum tissue separates from the teeth more easily, giving colonies of oral bacteria plenty of places to collect and grow. Bone loss in the jaw can also cause teeth to loosen, creating even more space. Combine this with a more acidic environment and the result is often bleeding gums and gingivitis and, in extreme cases, can result in loss of teeth.

In addition, hormonal changes in older women may result in discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue, and altered taste, especially salty, peppery, or sour.

Most women find that, in addition to the other systemic benefits it provides, natural estrogen replacement therapy is the best way to help relieve these symptoms.

Educating women on health care options is the personal mission of Marla Ahlgrimm, R.Ph., founder and CEO of Women's Health America. If you have a women's health care question, send it to Marla at This e-mail address is being protected from spambots, you need JavaScript enabled to view it . If your question is chosen for publication, we'll send you a free sample of one of our latest health care innovations.