Adolescents taking oral contraceptives may experience headaches and more tenderness in the jaws and temporomandibular joints when they are touched. The study was recently published in the Journal of Oral Rehabilitation.
The underlying biological function appeared to be due to a reduction in estrogen and testosterone levels triggered by the use of oral contraceptives (OC), the authors wrote.
“The results of this population study clearly demonstrate the existence of hormonal effects on tenderness to palpation in the masticatory system, which underscores the necessity of meticulously recording the use of OC in the medical histories of the patients,” wrote the authors, led by Dr. Henriette Stasche of the University of Leipzig in Germany (J Oral Rehabil, July 21, 2026).
In comparison to men, women are twice as likely to experience temporomandibular disorder (TMD) symptoms, and about 80% of TMD patients are women. One of the main signs of TMD is tenderness in the masticatory muscles and/or the temporomandibular joints (TMJs).
For many females, this type of pain often occurs during puberty and reaches its peak during their reproductive years. Although many factors have been advanced as contributors to this phenomenon, it remains challenging to find a clear answer as to why females are disproportionately affected, according to the study.
To investigate whether there was a correlation between taking OCs and increased tenderness to calibrated palpation of the masticatory system, 111 girls between the ages of 14 and 18 who underwent dental and general exams with blood samples were included in the study.
The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to evaluate self-reported headaches in the past month, as well as tenderness to calibrated palpation of the masticatory muscles and TMJs. Lab tests analyzed their levels of estrogen, testosterone, and the sexual hormone binding globulin (SHBG). In the statistical analyses, calculations were made employing logistic regression for comparisons, according to the study.
Among the girls in the study, 26 (23.4%) regularly took OCs. In the patients who took birth control pills, self-reported headaches and tenderness to touch in the masticatory system were much higher, the authors wrote.
In multivariable models, the relationship between OCs and headaches and tenderness was confirmed. For tenderness to palpation, OCs presented a coefficient of about three. It was about six for headaches, they wrote.
Furthermore, taking birth control pills was linked to a fivefold reduction in estrogen, a 50% reduction in testosterone, and a threefold increase in SHBG. This finding indicated that the underlying mechanism may be induced by hormones, the authors wrote.
Nevertheless, the study had limitations. Patients who received treatment for TMJ pain were not included in the study, the authors wrote.
“The use of oral contraceptives has been associated with an increased risk of self-reported headaches and heightened tenderness to palpation in the masticatory system in female adolescents,” Stasche and colleagues wrote.
