Hormone therapy and psychosocial factors in menopausal women with painful TMD: a pilot cross-sectional study

INTRODUCTION: Temporomandibular Disorder (TMD) is a musculoskeletal condition prevalent in women, especially during menopause. This phase of life is marked by decreased estrogen levels, which can exacerbate pain and psychosocial symptoms. OBJECTIVE: This study aimed to evaluate the association between menopause with and without hormone replacement therapy, grade of chronic pain, jaw functional limitations, and symptoms of anxiety and depression in women with painful TMD. METHODOLOGY: This exploratory cross-sectional study was conducted with 45 women diagnosed with painful TMD, divided into three groups: women with regular menstrual cycles (RMC, n=15), women in menopause without hormone replacement therapy (M, n=14), and women in menopause with hormone replacement therapy (MWH, n=16). The evaluation was conducted using the following instruments: the Graded Chronic Pain Scale (GCPS-2), the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), the Jaw Functional Limitation Scale (JFLS-8), and the Pain Catastrophizing Scale (B-PCS). The data were analyzed descriptively using Jamovi software (version 2.3.21). Analysis of variance (ANOVA) was performed, followed by multivariate analysis of covariance (MANOVA). Tukey's post-hoc test was used to identify differences between groups. The significance level adopted for all analyses was 5%. RESULTS: The mean age of participants was 50.0 years (±13.7). The overlap between muscle and joint disorders was most prevalent among the groups. The interference score was significantly lower in the MWH group (p=0.003), as was also the case with depressive symptoms (p<0.001) and anxious symptoms (p=0.012). CONCLUSION: The findings highlight the association between menopause, especially with hormone replacement therapy, and emotional and psychosocial aspects related to pain, with lower scores for interference with daily activities, depression, anxiety, and fewer catastrophic thoughts about pain.