Molecular-Level Evaluation of Prostaglandin Impact on Saliva and Oral Microbiota During Menstruation

Abstract

Systemic hormonal fluctuations that characterise the menstrual cycle exert profound effects on many physiological systems, including oral health. Prostaglandins are bioactive lipid compounds synthesised through the cyclooxygenase (COX) pathway and are among the key mediators involved, which show elevated levels during menstruation. These molecules are critical modulators of inflammation, vascular tone and tissue remodelling in the reproductive system. Nevertheless, their effect is not limited to reproductive tissues, and they affect salivary gland function and the oral microbiome, whose mechanisms are still poorly understood. Of specific interest is Prostaglandin E2 (PGE2), a predominant prostaglandin isoform which has been implicated in influencing salivary secretion dynamics and modifying the protein composition of saliva, which in turn modulates the microbial environment of the oral cavity. This is a narrative review aimed at elucidating the molecular mechanisms by which prostaglandins, primarily PGE2, influence salivary flow, the salivary proteome and oral microbial ecology throughout the menstrual cycle. The aim is to review the evidence from molecular biology, proteomics and microbiome research and propose a translational framework that links systemic endocrine fluctuations to local alterations in the oral cavity. Understanding this dynamic relationship may provide novel insights that can be used for developing gender specific diagnostic biomarkers and targeted therapeutic strategies to transform gender specific precision care in oral health.