{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:13:54Z","timestamp":1788527634581,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Background: Temporomandibular disorders (TMDs) exhibit a marked female predominance, suggesting a potential role for estrogen in their pathophysiology. However, evidence linking estrogen status to TMD remains inconsistent. Objective: To systematically review the association between estrogen-related factors and TMD prevalence and clinical presentation in women. Methods: PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched through September 2025. Observational studies evaluating hormonal contraceptive use, menopausal status, menstrual cycle variation, pregnancy, or estrogen receptor polymorphisms in women with TMD were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the Newcastle-Ottawa Scale. Due to substantial heterogeneity, a narrative synthesis was conducted. Results: Seven studies met the inclusion criteria, including six clinical studies involving 2735 participants and one mechanistic supportive study. Moderate-certainty evidence suggested associations between hormonal contraceptive use, menopausal\/climacteric status, and increased TMD risk or symptom severity. Additional low-certainty evidence supported associations involving menstrual cycle variation, pregnancy, and estrogen receptor polymorphisms. Conclusions: Current evidence suggests that hormonal factors may influence TMD risk and symptom presentation in women. However, heterogeneity in definitions of hormonal exposure and diagnostic criteria limits definitive conclusions. Further prospective studies using standardized diagnostic protocols and real-time biochemically validated hormonal assessments correlated with clinical symptoms are needed.<\/jats:p>","DOI":"10.3390\/ijerph23060717","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T08:00:36Z","timestamp":1779955236000},"page":"717","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estrogen Status and Temporomandibular Disorders: A Systematic Review"],"prefix":"10.3390","volume":"23","author":[{"given":"Alexandru","family":"Mazareanu","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, University of Medical Sciences Arizona (UMSAZ), Honolulu, HI 96813-3481, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Grigorov","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medlife Hospital, 900001 Constan\u021ba, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alin","family":"Pandea","sequence":"additional","affiliation":[{"name":"Regina Maria Hospital and Nord Hospital, 011171 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Iacob","sequence":"additional","affiliation":[{"name":"Private Dental Practice, 700506 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragos George","family":"Balaiasa","sequence":"additional","affiliation":[{"name":"Faculty of Physical Education and Sports, \u201cAlexandru Ioan Cuza\u201d University, 700506 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzvika","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Be\u2019er-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4047-9437","authenticated-orcid":false,"given":"Petr","family":"Konecny","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, Palack\u00fd University Olomouc, 779 00 Olomouc, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: Recommendations of the International RDC\/TMD Consortium Network and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. 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