Hormones and Bad Breath: What's the Connection?

During certain stages in a woman’s life, such as pregnancy, postpartum and menopause, hormones can fluctuate quite dramatically. While some of the consequences of these fluctuations are fairly well-known – changes in mood, swelling, hot flashes, etc – others, like bad breath, are not. Let’s talk about how these various stages can influence your breath and why…

Throughout pregnancy, you'll experience a distinct shift in your hormone balance. Notably, levels of the hormones estrogen and progesterone will rise, making your gums more susceptible to inflammation and infection from bacterial plaque. This can result in increased risk of gum disease, which is a common cause of bad breath.

Pregnancy hormones can affect your breath in other ways, too. Morning sickness, for example, can not only leave your breath smelling like vomit, but it can also cause dehydration and dry mouth. When you don’t have enough saliva, odor-producing bacteria are able to thrive. And if you experience cravings for particularly strong foods, your breath can also pay the price.

Postpartum refers to the period after giving birth. In theory, as your hormones return to normal, you should expect your bad breath to resolve too. However, it can take up to six months after giving birth for estrogen and progesterone to return to pre-pregnancy levels. During this time, while your risk of gum disease is still elevated, you should try to pay extra attention to your oral hygiene. 

That brings us to another common problem, though – adjusting to life with a new baby can be incredibly tough, and bad breath can happen when a new mother is struggling to keep up with her own oral hygiene and other personal needs. This is especially true if they’re dealing with hormonal problems like postpartum depression. 

The American Academy of Periodontology notes that some medications – including oral contraceptives – can affect your oral health. Certain forms of hormonal birth control work by elevating levels of estrogen and progestin (synthetic progesterone) – in your body to prevent pregnancy. Just as they do during pregnancy, these hormones can affect how your gums respond to bacteria, increasing your risk of gum disease and bad breath. The Cleveland Clinic states that this effect is more pronounced in the first months of starting these oral contraceptives, so if you’ve recently started a new birth control pill, it may be the culprit behind your bad breath. 

During menopause, levels of the hormone estrogen start to decline. In addition to causing widespread physical and emotional side effects, this hormonal change can cause oral health changes like dry mouth. That’s when you don’t produce enough saliva to keep your mouth sufficiently moist. Saliva is important for keeping the mouth clean, so a dry mouth means that the oral bacteria responsible for bad breath can flourish.

Whether your bad breath is caused by hormonal fluctuations or something else, improving your oral hygiene routine is always a good first step. Make sure to:

• Brush twice a day with plaque-removing fluoride toothpaste.
• Clean between your teeth daily with dental floss or another type of interdental cleaner.
• Clean your tongue by gently scraping or brushing off bacteria.
• Rinse with an antibacterial mouthwash.

A study published in the journal JDR Clinical and Translational Research states there's evidence of a connection between periodontal disease and some pregnancy and birth complications. So in addition to meticulous oral hygiene, it’s important to schedule regular dental check-ups and cleanings to keep plaque, tartar and gum disease at bay. This will help to combat bad breath during pregnancy, too. 

If you suffer from morning sickness, it may be tempting to reach for the toothbrush right away to freshen up. However, the acid in vomit temporarily weakens your tooth enamel, and brushing during this time can damage your teeth. Wait around an hour to brush. In the meantime, it may help to add some baking soda to warm water and use it as a rinse. If your morning sickness is particularly intense, speak to your dentist about ways to protect your oral health during pregnancy. 

We know that it can be hard to keep up with your usual routines in the months after birth, but oral hygiene is still critical during this time. If you find yourself struggling to maintain your oral health, ask your dentist or hygienist for advice. 

Bad breath from contraceptives tends to be worse in the first few months. If it doesn’t resolve after this time, and oral hygiene doesn’t seem to help, check in with your prescribing doctor for advice. They may recommend a different medication. It’s also worth checking in with your dentist or hygienist too, just to make sure your bad breath isn’t actually down to an oral health problem. 

If bad breath and other menopause symptoms are bothering you, speak to your doctor to see what treatments are available. Some women find relief from oral and general health symptoms with medications that replace the declining hormones. Your dentist may be able to help with dry mouth, bad breath and other oral side effects too, so schedule a visit to discuss your concerns. 

The connection between bad breath and hormones is one more example of how oral health affects your entire body – and vice versa. If you’re experiencing bad breath during pregnancy, postpartum, or menopause, or as a side effect of contraceptives, speak to your doctor and dentist. With their support and a stellar oral hygiene routine, you can keep your mouth healthy and your breath fresh throughout every stage of life.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.