Title : Interrelationship between Polycystic Ovary Syndrome (PCOS) and Temporomandibular Disorders (TMD) A multisystemic approach to chronic pain in women
Abstract:
PCOS is one of the most common endocrine disorders that affects women of childbearing age. Its prevalence ranges from 6% to 15% worldwide, depending on the diagnostic criteria used. Polycystic ovarian morphology, hyperandrogenism, and ovulatory dysfunction are all signs of PCOS. It is often connected to higher levels of psychosocial stress, insulin resistance, and long-term low-grade systemic inflammation. Temporomandibular Disorders (TMD) are the second most common cause of orofacial discomfort after dental pain. TMD includes a number of musculoskeletal and neuromuscular diseases that affect the temporomandibular joint (TMJ), the muscles that help you chew, and other related tissues. Even though TMD has been studied a lot in relation to biomechanics and stress-related problems, more and more data points to a hormonal and systemic cause, especially in women.
Objective: This poster's goal is to critically look at the two-way and multi-factorial interaction between PCOS and TMD by combining the most recent information on similar pathophysiological pathways, overlapping clinical features, and what this means for integrative patient therapy. The study's purpose is to make individuals more aware of how endocrine, inflammatory, and psychological aspects linked to systemic illnesses like PCOS may make people more likely to get chronic musculoskeletal pain syndromes like TMD.
Methods: A comprehensive narrative review of peer-reviewed literature from PubMed, Embase, and Scopus (2010–2024) was conducted using the following keywords: Polycystic Ovary Syndrome (PCOS), Temporomandibular Disorders, chronic inflammation, orofacial pain, sex hormones, central sensitization, psychosocial stress. Studies involving hormonal profiles, cytokine levels, pain sensitivity, and quality of life metrics in women with PCOS and/or TMD were prioritized. A detailed narrative evaluation of peer-reviewed literature from PubMed, Embase, and Scopus (2010–2024) was done using the following keywords: PCOS, temporomandibular disorders, sex hormones, central sensitization, orofacial discomfort, chronic inflammation, and psychological stress. Research on women with PCOS and/or TMD that looked at their hormonal profiles, cytokine levels, pain sensitivity, and quality of life indicators was given top priority.
Results: Several pieces of data point to the fact that women with PCOS are more prone than the general population to have TMD symptoms. Higher amounts of testosterone and DHEAS in particular may affect muscle tone, joint laxity, and collagen metabolism, which could influence how the TMJ works. People with chronic TMD also have higher levels of pro-inflammatory cytokines such IL-6, TNF-α, and CRP. These levels are worse when people have insulin resistance and high insulin levels. Anxiety, sadness, sleep problems, and catastrophizing pain are all psychosocial factors that make central pain more sensitive. These factors also have a big effect on both disorders. People with PCOS and TMD both have a lot of high stress reactivity and sympathetic nervous system hyperactivity, which makes chronic pain worse.
Discussion: In women's health, the intersection of PCOS and TMD is a clinical overlap that doesn't get enough attention. It happens when local musculoskeletal dysfunction and systemic endocrine imbalance come together. A biopsychosocial paradigm is needed to fully understand and treat various disorders that are linked to each other. Gynecologists, endocrinologists, orofacial pain experts, and mental health specialists all need to work together to develop assessments and treatments. Comprehensive care should include hormone testing, dietary and metabolic regulation, cognitive-behavioral therapy, physical therapy, and dental or medical therapies that focus on pain.
Conclusion: It is now possible to diagnose and treat more women who have orofacial pain because it is known that PCOS and TMD may be linked. Clinicians should keep a close eye out for systemic factors in female TMD patients, especially those with irregular menstrual cycles, hyperandrogenism, or metabolic dysfunction. To improve the quality of life and ease the burden of chronic pain in this group of people, we need to use a variety of methods that are tailored to each person.
Keywords: Chronic pain in the face and mouth, temporomandibular disorders, hormonal imbalance, inflammation, central sensitization, and polycystic ovary syndrome The Biopsychosocial Model, Multidisciplinary Care, and Women's Health
