The association of menstrual cycle, pregnancy, and menopause with recurrent oral aphthous stomatitis: a review and critique.
OBJECTIVE
To examine critically the postulated associations between recurrent aphthous stomatitis and the menstrual cycle, pregnancy, and menopause, and to determine why such associations had been accepted previously in the absence of convincing evidence.


METHODS
We used MEDLINE data base searches in 1988 and 1991 to identify all articles since 1966 referring to estrogen, progesterone, menstruation, menstrual cycle, menopause, or pregnancy, and to aphthous stomatitis. Similar searches were carried out in the Index to Dental Literature for the period 1942-1991, and in MEDLINE on CD-ROM in 1991. Articles uncovered were examined for further appropriate references in the 50-year period 1942-1991. We excluded letters, abstracts, and articles in journals that are not peer-reviewed.


METHODS
We discovered one retrospective study on aphthous ulceration and ovarian hormones, eight prospective studies, three uncontrolled trials on the use of hormones in aphthous stomatitis, one controlled trial, and four review papers.


METHODS
Each paper was carefully read, in translation where necessary, and opinions and findings were critically examined for source, authenticity, and statistical analysis. Each paper was also examined critically in terms of its review and acceptance of previous papers. The papers were too diverse in nature to permit a structured criticism.


CONCLUSIONS
No associations have been established between aphthous stomatitis and the premenstrual period, pregnancy, or menopause. No properly designed study has shown a therapeutic effect of ovarian hormones on aphthous stomatitis. Reasons for this lack and the need for large-scale studies are identified.
McCartan
B E
BE
School of Dental Science, Trinity College, Dublin, Ireland.
Sullivan
A
A
D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008593:Menopause; D008597:Menstrual Cycle; D011247:Pregnancy; D012008:Recurrence; D013281:Stomatitis, Aphthous / Q000188:drug therapy
D012739:Gonadal Steroid Hormones