19: The Menopause-TMJD Connection with Dr. Priya Mistry
Ep. 19
As if menopause didn’t already come with enough challenges, many women are surprised to discover that the hormonal rollercoaster doesn’t just impact reproductive health—it can also wreak havoc on your jaw.
Fluctuating estrogen levels during menopause have been linked to TMJ (temporomandibular joint) disorders, which can cause jaw pain, clicking or popping sounds, difficulty chewing or speaking, and even headaches or facial pain. These symptoms are often overlooked or dismissed, yet they can seriously affect your daily life.
To better understand this connection, I spoke with my sister, Dr. Priya Mistry—a TMJ specialist who’s helped countless patients find relief from chronic pain. In our conversation, she explained the link between menopause and TMJ, how these symptoms often overlap with other conditions like sleep apnea, and what women can do to protect their jaw health during midlife.
Listen to the full episode:
What Is TMJ?
TMJ stands for temporomandibular joint, the hinge that connects your jaw to your skull—right near your ears. If you place your fingers in front of your ears and open your mouth, you’ll feel it in action. We all have TMJs. What most people are actually referring to when they say “I have TMJ” is a TMJ disorder—and that’s a whole different story.
A TMJ disorder (sometimes called TMJD) happens when there’s dysfunction in the jaw joint or surrounding muscles. This can show up as clicking or popping when you open your mouth—but it doesn’t have to. In fact, you can have a perfectly silent jaw and still suffer from daily headaches, neck pain, jaw tension, facial pain, ear ringing, dizziness, or even stuffy ears.
What makes TMJ disorders especially tricky is their overlap with other conditions. Hormonal migraines, Meniere’s disease, vestibular issues, and even trigeminal neuralgia can all cause similar symptoms. That’s why so many women go undiagnosed or misdiagnosed—particularly during menopause, when hormone fluctuations can quietly worsen underlying jaw tension.
The jaw joint is one of the most used—and least understood—joints in the body. It’s unique because both sides work together, and it’s the only joint that ends with your teeth. That means your bite—whether it’s misaligned, tight, or strained—can directly affect the muscles and ligaments around your jaw.
TMJ disorders are more than just a noisy jaw. And if you're experiencing unexplained headaches, facial pain, or ear pressure—especially during menopause—it might be time to look a little closer at what your jaw is trying to tell you.
Understanding the Hormonal Drivers of TMJD in Women
So why are more women—especially in midlife—experiencing TMJD symptoms? It turns out, hormones like estrogen and relaxin play a key role. Both are found in higher levels in women and directly impact the jaw joints.
Relaxin is the hormone that helps loosen ligaments during pregnancy, but it doesn’t act selectively—it can also loosen the ligaments that stabilize the disc inside your jaw joint. That laxity can lead to misalignment or even dislocation.
Estrogen and relaxin together are associated with degeneration in the TMJ, which may explain why so many women, particularly during perimenopause and menopause when hormone levels drop, start to notice jaw pain, stiffness, or popping.
But it doesn’t stop there.
These same hormonal changes also reduce the tone in the muscles of the throat, which can impact breathing during sleep. Even women who have never struggled with sleep apnea may suddenly find themselves waking up gasping for air—or not sleeping deeply—without realizing what's happening.
TMJD and Sleep Apnea: What You Need to Know
Most people associate sleep apnea with overweight, older men with large necks. But that stereotype is outdated and excludes the many women who are missed or misdiagnosed.
Many women in midlife—often petite—may actually have anatomical risk factors like narrow airways or small jaws (sometimes made worse by earlier orthodontic work). For example, teeth extractions that pull the jaw backward can reduce the space for the tongue, forcing it toward the airway and increasing the likelihood of obstruction.
Women often don’t snore, and they may not have the “classic” symptoms. But that doesn’t mean they’re not struggling to breathe at night. Tracking oxygen levels with wearables like an Oura ring or smartwatch may offer early insight if a sleep study is delayed.
There’s also a strong link between poor sleep and TMJ dysfunction. When your body senses low oxygen, it enters fight-or-flight mode—leading to more clenching and grinding, especially at night. Over time, this can wear down the joints and muscles in the jaw.
Unfortunately, TMJ disorders (and many conditions that affect mostly women) are under-researched. While the National Institutes of Health has noted a connection between TMJ and sleep apnea, much of the nuance—especially how menopause impacts this relationship—still needs to be explored.
What to Watch For: Hidden Symptoms of TMJD
Many women experiencing perimenopause or menopause are surprised to learn that symptoms like chronic headaches, neck pain, stuffy ears, dizziness, or even earaches may be linked to TMJ dysfunction.
These signs don’t always point directly to the jaw, which is why they’re often overlooked. But everything in this area is connected — muscles, joints, nerves — and calming tension in the jaw can often relieve these persistent, confusing symptoms.
Why Treating TMJD Requires a Whole-Body Approach
TMJ issues rarely exist in isolation. The jaw is deeply connected to other parts of the body — especially the neck, spine, and even the pelvic floor. Fascial lines and muscle chains mean tension in one area can show up as pain in another. That’s why collaboration is key.
Working with physical therapists, gentle upper cervical chiropractors, and pelvic floor specialists allows for more complete healing. Dr. Mistry shared one powerful case of a patient, whose locked jaw released immediately after a targeted neck adjustment — a reminder that treating TMJ isn’t just about the jaw.
Dr. Mistry’s Comprehensive Approach to Treatment
Patient History:
Dr. Mistry starts by gathering a thorough history, asking about symptoms such as joint noises, headaches, or jaw pain. She probes into when these issues began, looking for patterns and connections with past injuries or treatments.Detailed Physical Exam:
After the history, Dr. Mistry performs a full physical exam, including a postural assessment. The patient stands against a grid to reveal any misalignments, such as uneven shoulders or a tilted head. She emphasizes that the jaw, spine, shoulders, hips, and feet all interact, and imbalances in one area can affect the others.Jaw and Muscle Alignment:
Dr. Mistry uses advanced technology to determine the correct alignment of the jaw, showing how the muscles and joints should ideally function. She distinguishes between a night guard (which only protects teeth) and a TMJ orthotic (which aligns the jaw and relaxes the muscles).Bite Adjustments:
In some cases, Dr. Mistry makes small, precise adjustments to the way the teeth come together. These changes can reduce muscle strain and alleviate pain, improving overall comfort.Clear Treatment Plan:
By the end of the first appointment, patients have a clear understanding of their treatment plan, which may include an orthotic or bite adjustments. Dr. Mistry also provides detailed information on payment options and flexible plans, making the treatment accessible to all.
Want to learn more about TMJ/TMD and stay informed on the latest treatment options? Be sure to connect with Dr. Priya Mistry for valuable resources and insights.
Connect with Dr. Priya Mistry
More about Dr. Priya Mistry
Dr. Priya Mistry is a 2007 honors graduate from the University of the Pacific Arthur A. Dugoni School of Dentistry. With a focus on TMJ/TMD and head and neck pain, she trained under Dr. Arthur L. Parker, a TMJ pioneer, and earned Diplomate status from the American Board of Dental Sleep Medicine. Dr. Mistry is also a member of the International College of Cranio-Mandibular Orthopedics (ICCMO).
Through her social media presence and podcast Unclenched (co-hosted with Dr. Alexandra George), Dr. Mistry raises awareness about TMJ/TMD and its impact on overall health. She educates dentists through courses and webinars and has been featured on various news channels. In her personal life, Dr. Mistry enjoys hiking and staying active with her family in the Pacific Northwest.