Is the burning in my mouth part of the menopause?
PEOPLE DESCRIBE THIS AS THE WORST PAIN KNOWN TO MAN
TWO years ago, at 48, I started the peri-menopause and immediately had burning sensations in my mouth, intermittently. My dentist advised me to go to the doctor but all my blood tests came back normal. I read about something called ‘burning mouth syndrome’; could that be my problem?
BURNING mouth syndrome is a common but poorly understood condition. Typically sufferers feel a scalding within the mouth, and/or cheeks, tongue and lips – similar to after drinking a burning hot drink – and the feeling occurs either continuously or intermittently. It may also come with an unpleasant taste or a dryness of the mouth.
The condition is distressing, causing persistent discomfort and interruption of normal daily functions such as drinking and eating. The condition is labelled as harmless, despite the significant emotional burden.
Commonly, burning mouth syndrome affects women around the time of the menopause, possibly due to the change in hormones. But the reason is not completely clear and it can also affect men.
The cause of burning mouth syndrome is not known: the syndrome is simply a description of the symptoms rather than a specific pathological process. It is associated with mental health problems such as anxiety and depression; other mouth problems such as infections or dental issues; allergic reactions; vitamin deficiencies and it can also be the side effect of medications or poorly fitting dentures. There is no test that can specifically diagnose the condition. Treatment is difficult if the cause remains unidentified. Mouthwashes may provide some relief and chewing gum and plain water help ease the accompanying dryness. I WAS diagnosed with trigeminal neuralgia a couple of years ago and have been prescribed both carbamazepine and gabapentine, but neither of them solve the horrendous, agonising headaches I still experience daily. TRIGEMINAL neuralgia (TN) is often described as the worst pain known to man, having a severe and debilitating effect on those affected. The trigeminal nerve controls sensation in the face and vital movements such as chewing.
TN affects one side of the face with a sudden acute pain which sufferers describe as like an electric shock to the area. The pain comes in attacks, and during bad episodes hundreds of bursts of pain may occur intermittently in one day, with no predictable pattern. It is an extremely distressing condition associated with depression, isolation and a very poor quality of life.
The NICE guidelines for treatment of TN recommends the epilepsy medication carbamazepine as the first drug of choice and this can be prescribed by a GP. It is thought to help 70 per cent of patients and has a good initial response.
It does have side effects, including difficulties with concentration and fatigue, but it may be a necessary evil when weighed up with the benefits of treating the condition.
If medication is not effective, surgery can either partially destroy the nerve, or move blood vessels away from the nerve and decompress it.
This is considered ‘major’ surgery but is thought to offer the best results in terms of long-term relief. However, it is brain surgery, and brings potentially significant side effects.