The document discusses how hormones affect periodontal disease in women throughout their life cycle. It covers puberty, where an increase in certain hormones can lead to increased gingivitis. During menstruation, hormones like estrogen and progesterone prepared the uterus for pregnancy. Premenstrual syndrome can occur before menstruation due to changes in hormone levels, causing mood changes. The monthly reproductive cycle has two phases: the follicular phase where estrogen rises and the luteal phase where progesterone rises, preparing the uterus if pregnancy occurs.

2. Content:

3. Introduction:
• Throughout a woman's life cycle, the
hormonal influences that take place
can affect the therapeutic decision
making in Periodontics.
• However at times there are various
contributing factors that exaggerate
the existing periodontal disease.
• One such is observed in female
patients where, as a result of
hormonal influences seen during
their life cycle.

4. • Hormones are specific regulatory molecules that modulate
reproduction, growth and development, maintenance of
the internal environment, as well as energy production,
utilization, and storage.
• Hormonal effects reflect physiological/ pathological
changes in almost all types of tissues of the body.

5. Puberty:
• 11 to 14 years in most women.
• Prevalence of gingivitis increases, without an increase in the amount of
plaque.
• Gram negative anaerobes, implicated in association with puberty gingivitis.
• Kornman and Loesche (1979) postulated that these anaerobic organisms
may use ovarian hormones as a substitute for vitamin K growth factor.
• Prevotella intermedia and Capnocytophaga species have been implicated in
the increased bleeding tendency observed during puberty.

6. Clinical Features:
• Exaggerated response to local
factors.
• Hyperplasic reaction of the gingiva
may occur.
• Inflamed tissues become
erythematous, lobulated, and
retractable.
• Easily Bleeds.
• Inflammatory hyperplasia seen.

7. • Chronic regurgitation of gastric
contents on intraoral tissues which
is a common complaint in the
puberty phase.
• Bulimia and anorexia nervosa.
• Perimylosis typically on the palatal
surfaces of maxillary anterior teeth
varies with duration and frequency
of eating disorder.

8. Management:
• Education of patient and caregiver.
• Preventive care, such as teeth brushing and
flossing.
• Mild Gingivitis- Respond well to scaling and
root planning.
• Severe cases of gingivitis
a. Scaling and
root planning
b. Microbial
culturing
c. Antimicrobial
mouthwashes

9. MENSES:
• During the reproductive years, the ovarian cycle is
controlled by the anterior pituitary gland which secretes
follicle stimulating hormone (FSH) and Luteinizing
hormone (LH) are produced from anterior pituitary
gland.
• Under the influence of FSH and LH, estrogen and
progesterone are steroid hormones produced by the
ovaries during the menstrual cycle.
• Average ovarian cycle lasts for 28 days, which is
interrupted only by pregnancy.
• During the reproductive cycle, the purpose of estrogen
and progesterone is to prepare the uterus for

11. Pre menstrual syndrome ( PMS):
• During the peak level of progesterone (about 7 – 10 days prior
to menstruation) PMS also occur.
• No significant differences in estrogen and progesterone levels
between women who suffer PMS and women who do not.
• Depression, irritability, mood swings, and difficulty with memory
and concentration due to reduced neuro transmitters.
• PMS women have lower of certain neuro transmitters such as:
• Enkaphalins
• Endorphins
• Amino butyric acid (GABA)
• Serotonin

12. The monthly reproductive cycle has two
phases monthly reproductive cycle has two phases: The monthly reproductive cycle
has two phases: