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Health Alert:
Progesterone Contraceptives May Cause Periodontal Diseases
Related to Heart Disease, Rheumatoid Arthritis, Kidney Disease,
Diabetes and Cancer
... and What You Can Do!

© 2020 Health Realizations, Inc. Update

Over 22 percent of U.S. women have used an injectable contraceptive shot, such as Depo-Provera. The injection, which is generally given once every 12 weeks, contains the synthetic hormone progestin known as depo-medroxyprogesterone acetate (DMPA).

Injectable birth control shots that contain the synthetic hormone DMPA may be associated with poor periodontal health, including increased risks of gingivitis and periodontitis.

DMPA works to prevent pregnancy in three ways -- it prevents the ovaries from releasing an egg, thickens cervical mucus to act as a barrier preventing sperm from reaching the egg, and changes the lining of the uterus to prevent implantation.

Although Depo-Provera is very effective at preventing pregnancy, reporting a failure rate of less than 1 percent when used correctly, it is not without side effects. In fact, among the women who stopped using the shot, over 75 percent did so because of side effects. The most common side effect of the Depo-Provera shot is irregular bleeding -- headaches, nausea, fatigue, weight gain, acne, anxiety, depression, hair loss or excessive hair growth have also been reported.

Now, another concerning side effect has been added to this list, and it’s one that you probably would not expect from a birth-control shot: gum disease.

Contraceptive Shot Linked to Gum Disease

According to new research in the Journal of Periodontology, injectable progesterone contraceptives (DMPA, or Depo-Provera) may be associated with poor periodontal health.

The researchers analyzed data from 4,460 U.S. women ages 15-44 years and found those who were currently taking DMPA, or had taken it in the past, were more likely to have gingivitis and periodontitis. In its mildest form, gum disease is called gingivitis. Often due to poor oral hygiene, gingivitis causes your gums to become red and swollen, and bleed easily. If left untreated, gingivitis may progress into periodontitis, in which plaque begins to grow below your gum line.

The bacteria and the toxins they produce lead to chronic inflammation that can destroy your gums and bone supporting your teeth. This leads to teeth separating from the gums, forming infected pockets that can result in teeth loss and, as the disease progresses, heart disease, respiratory disease and diabetes.

As researchers noted:

"It has been suggested that progestins may have an inflammatory component and/or increase in prostaglandin synthesis. Thus, extended progestin use may be associated with higher risk of periodontal diseases."

If you’re a woman who is currently using the Depo-Provera (or another DMPA contraceptive) shot, or you have used it in the past, it’s therefore very important to monitor your teeth and gum health. In an American Academy of Periodontology (AAP) news release, Dr. Pamela McClain, AAP president, said:

"Hormones can play a role in woman’s periodontal health. These findings suggest that women that use, or have used, a hormone-based injectable contraception such as DMPA may have increased odds of poor periodontal health. I would encourage women that use or previously used this form of contraception to maintain excellent oral care, and to be sure to see a dental professional for a comprehensive periodontal evaluation on an annual basis."

Gum Disease Impacts Your Whole Body Health

The health of your teeth and gums is indicative of the health of your entire body

This new finding is especially serious because gum disease is a serious infection, and it does not remain contained to your mouth. In fact, when your gums become diseased, they release toxic bacteria into your bloodstream, which promote inflammation and negatively impact your heart and other organs. The combination of bacteria and inflammation present with gum disease has been associated with a number of serious chronic diseases, including:

  • Heart disease: Research published in the BMJ found that people who don’t brush their teeth regularly have an increased risk of heart disease. Among those who “rarely or never” brushed their teeth, the risk of a heart attack, stroke or other event was 70 percent higher than those who brushed twice daily.

    The rare brushers also had higher levels of C-reactive protein, a marker of inflammation and a potent indicator of heart disease.

    People with gum disease are actually nearly twice as likely to have heart disease, according to AAP. Gingivitis, cavities and missing teeth are also associated with heart disease, and can predict heart disease risk as well as cholesterol levels.

  • Diabetes: Gum disease is often considered the “sixth complication” of diabetes because people with diabetes are significantly more likely to have periodontal disease. Not only does having diabetes increase the risk of gum disease, but gum disease in turn increases blood sugar, which can lead to diabetes complications, according to a study in the Journal of Periodontology.

  • Rheumatoid Arthritis: Rheumatoid arthritis and periodontitis are both chronic inflammatory conditions, and they, too, are associated. Further, treating gum disease has been found to have a beneficial effect on the signs and symptoms of RA.

  • Cancer: Gum disease has even been linked to several types of cancer, including pancreatic, kidney and blood cancers.

So, your mouth-body connection is very real, and highlights the importance of maintaining healthy teeth and gums in order to protect your overall health. In addition to the diseases above, gum disease has also been linked to the following conditions:

  • Alzheimer's disease
  • Kidney disease
  • Respiratory diseases such as pneumonia and chronic obstructive pulmonary disease (COPD)
  • Pregnancy complications, including premature birth and low-birth weight babies
  • Osteoporosis

If You Currently Use, or Have Ever Used, an Injectable Progesterone Contraceptive ...

Make an appointment to have your oral health checked by your dental health care provider.

The sooner a problem is detected, the better your chances at reversing it and preventing more serious damage. Gingivitis can often be treated and reversed through proper dental cleanings and attention to oral hygiene. Even more advanced gum disease can often be treated with deep cleaning of your root surfaces below the gum line, known as scaling and root planning, provided proper oral hygiene practices are maintained.

In severe cases, however, surgery will be required and your best bet is to avoid and prevent gum disease entirely in the first place.

Brushing and flossing are the basics to keep your teeth healthy. The American Dental Association (ADA) recommends brushing your teeth twice a day and flossing daily for best results. You should also visit your dentist regularly -- at least once every 6 months -- to have your teeth professionally cleaned and get an oral health check-up.

Beyond these basics, a healthy diet will support your oral hygiene routine, making your teeth and gums strong and healthy. In addition, while further research is needed to confirm the link between synthetic DMPA-containing contraceptives and poor periodontal health, you may want to consider using a non-hormone form of birth control, such as condoms, particularly if you currently have (or have a family history of) gum disease or gingivitis.

Keep in mind, too, that gum disease, especially in the beginning stages when it’s most easily treated and reversed, is not always obvious. According to the AAP, some warning signs include:

  • Red, swollen or tender gums or other pain in your mouth

  • Bleeding while brushing, flossing, or eating hard food

  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before

  • Loose or separating teeth

  • Pus between your gums and teeth

  • Sores in your mouth

  • Persistent bad breath

  • A change in the way your teeth fit together when you bite

  • A change in the fit of partial dentures

If you notice any of these signs and symptoms, a trip to your dental health care provider is warranted to prevent more serious health damage from occurring.


Sources

U.S. Centers for Disease Control and Prevention, National Survey of Family Growth

American Pregnancy Association, Depo-Provera: Quarterly Injection

Perio.org

Journal of Periodontology

BMJ;340:c2451

Perio.org Gum Disease and Diabetes

J Periodontol;80(4):535-40.

JNCI J Natl Cancer Inst 99 (2): 171-175.


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