The Effect of Menopause, Hormone Replacement Therapy (HRT), Alendronate (ALN), and Calcium Supplements on Saliva

Abstract

In menopausal women many physiological changes take place, most of which are due to decreased estrogen production. It is known estrogen influences oral health in a number of ways and saliva undergoes variations depending upon the levels of this hormone. The study was designed to evaluate the relationship of menopause, hormone replacement therapy (HRT), alendronate (ALN), and calcium supplements on salivary flow rate, saliva pH, and electrolytes. A group of a group of 14 osteoporotic women in menopause with an age average of 50.7 and 14 non-menopausal women with an age average of 42.4 and were selected as subjects. The oral status of the subjects was determined using the Community Periodontal Index of Treatment Needs (CPITN), the Decayed, Missing and Filled Teeth (DMFT) and the Decayed, Missing and Filled Surfaces (DMFS) indices. The non-stimulated whole saliva samples were subsequently collected from the women in both the control and experimental groups and then analyzed biochemically. The women comprising the experimental group received HRT supplemented with ALN and calcium; saliva collecting and analyzing procedures were repeated at the third and sixth months of the treatment. The most significant oral discomfort in women in the menopausal period was oral dryness, and this symptom was relieved after HRT with ALN and calcium supplements. The oral status of the non-menopausal women was better than the women in menopause. The salivary flow rate was decreased in the menopausal period and increased after HRT, ALN, and calcium supplementation. The saliva pH values were not affected by menopause and HRT with ALN and calcium supplementation. The level of Na+ was increased with menopause and did not change with HRT supplemented with ALN and calcium, whereas the K+ level decreased in the menopausal period and remained constant after HRT with ALN and calcium. The Cl- level was not affected by menopause and the HRT supplemented with ALN and calcium. The Ca++ level was not different in the two groups of women and did not change after HRT supplemented with ALN and calcium. HRT with ALN and calcium supplementation affected some factors in saliva positively.