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Association Between Total Testosterone Levels and Painful Temporomandibular Disorders in Women: A Pilot Case-Control
Shikha Yadav1, Rajeev Aravindakshan2, Vidya D Sripad3
1Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Guntur, IND.
Background:
Temporomandibular disorders (TMDs) are prevalent musculoskeletal conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and associated structures, causing significant orofacial pain and functional limitations. Epidemiological data show higher TMD prevalence in women, particularly of reproductive age, suggesting hormonal influences. While estrogen is well-studied, the role of testosterone remains unclear.
Objective:
This pilot case-control study investigated the association between serum testosterone levels and painful TMDs in women aged 18-30 years.
Methods:
Forty-seven female participants were recruited: 17 (36.2%) cases with clinically diagnosed painful TMDs and 30 (63.8%) age-matched controls without symptoms. Inclusion criteria included regular menstrual cycles (21-40 days); exclusion criteria included TMJ surgery or trauma, inflammatory joint diseases, hormonal disorders, and use of hormone-modifying medications. TMD diagnosis was based on the TMD pain screening questionnaire (scores ≥3 indicated cases). Serum total testosterone levels were measured using a Roche cobas® e 411 electrochemiluminescence immunoassay analyzer (Roche Diagnostics GmbH, Mannheim, Germany). Statistical analyses included analysis of covariance (ANCOVA) to compare testosterone levels and Pearson's correlation analysis to assess the relationship between testosterone levels and TMD duration.
Results:
The mean serum testosterone level in the TMD group was 18.0 ng/dL (SD = 6.97), compared with 19.3 ng/dL (SD = 11.68) in the control group; the difference was not statistically significant (P = 0.90). No significant correlation was observed between testosterone levels and TMD duration or severity. Logistic regression indicated neither age nor testosterone significantly predicted TMD.
Conclusions:
Serum testosterone levels are not significantly associated with the presence or severity of painful TMDs in women aged 18-30. These findings highlight the multifactorial nature of TMDs and suggest that testosterone may not play a primary role in their pathogenesis. Further research with larger samples and consideration of hormonal fluctuations during the menstrual cycle is warranted.
