Hormonal imbalances and neuroendocrine influences in temporomandibular disorders: A scoping review of the evidence.

BACKGROUND

Temporomandibular disorders (TMD) display a marked female predominance and fluctuate across reproductive stages, suggesting hormonal and neuroendocrine contributions.

OBJECTIVES

To map the evidence on hormonal imbalances and neuroendocrine influences in TMD across six domains.

METHODS

A scoping review following JBI and PRISMA-ScR. Searches of MEDLINE/PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library from inception to July 2026 identified 3,147 records. The review protocol was registered on OSF (https://osf.io/qf2we).

RESULTS

274 studies were included, comprising 168 human studies and 106 preclinical studies. Human evidence consistently supports associations between hormonal factors and TMD. Estrogens, progesterone, and androgens modulate TMJ tissue remodeling, inflammation, and nociceptive processing. Reproductive endocrine disorders are consistently associated with TMD. Estrogen receptor polymorphisms are consistently associated with TMD. HPA axis dysregulation is consistently associated with TMD.

CONCLUSIONS

Hormonal and neuroendocrine factors are consistently associated with TMD through multiple mechanisms. Standardized longitudinal studies and validated patient-reported outcomes are needed.