Association among menopause, hormone replacement therapy, and periodontal attachment loss in Southern Brazilian women

Background: The aim of the present study was to evaluate the association among menopause, hormone replacement therapy (HRT), and periodontal attachment loss (PAL). Methods: Three hundred twenty-eight women (40 to 69 years old) who participated in a previous oral survey in South Brazil were included. Women who reported not having their monthly menstrual cycles for ≥12 months were classified as postmenopausal. Postmenopausal women were categorized according to HRT. Women with ≥30% teeth with PAL ≥5mm were classified as having periodontitis. The data were analyzed using a multivariable logistic regression model and adjusted for age, smoking, socioeconomic status, and dental care. Results: The prevalence of periodontitis was significantly greater among postmenopausal women not using HRT (HRT-) than among premenopausal women (64.4% versus 46.3%; P = 0.005). Similarly, the multivariable analysis demonstrated a significantly higher chance of having periodontitis in postmenopausal HRT- women than in premenopausal women (odds ratio [OR], 2.1; 95% confidence interval [CI]: 1.1 to 4.0). In contrast, no significant differences were observed in the prevalence of periodontitis between postmenopausal women using HRT (HRT+) and premenopausal women (48.8% versus 46.3%; P = 0.77). After adjusting for cofactors, postmenopausal HRT+ women did not have a greater likelihood of having peri- odontitis than premenopausal women (OR, 1.2; 95% CI: 0.6 to 2.5). No significant differences in tooth loss were observed among the study groups after adjusting for confounders. Conclusions: Postmenopausal HRT- women had a greater chance of having periodontitis than premenopausal women. In contrast, postmenopausal HRT+ women and premeno- pausal women had similar periodontal status. HRT may have a beneficial effect on periodontal health.