Comparison of taste threshold in postmenopausal and non-menopausal women and men

Comparison of taste threshold in postmenopausal and non-menopausal women and men | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of taste threshold in postmenopausal and non-menopausal women and men Afsaneh Ekhtiari, Mohammad Javad Kharazi fard, Pouya Jalilvand, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4926228/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background One of the problems of women after menopause is the occurrence of changes in the taste sense.it could affect on reducing the quality of life .the researcher decided to conduct the present study to express this issue Methods This descriptive-analytical study was conducted on 113 people, including 38 menopausal women and 39 non-menopausal women and 36 men who were all qualified and matched in different factors was done. The taste threshold was evaluated by solutions of sucrose, citric acid, sodium chloride, caffeine and monosodium glutamate .The data were recorded after removing confounding items and judged through SPSS version 17 software and Kruskal-Wallis test. Results There was no significant difference between non-menopausal women and men in the distribution of the study subjects according to the taste threshold perception in different types of sweets (p = 0.911), but between menopausal women and non-menopausal women, as well as the group men had a significant difference and postmenopausal women had a higher taste threshold than both groups (p = 0.000) and (p-= 0.002). In the taste of sourness, there was no significant difference between non-menopausal women and men (p = 0.058), also there was no significant difference between menopausal women and men (p = 1), but there was a significant difference between menopausal women and non-menopausal women. and menopausal women had a higher taste threshold than non-menopausal women (p = 0.033). There was no significant difference between menopausal women and men in different types of umami taste (p = 1), but there was a significant difference between menopausal women and non-menopausal women, and menopausal women had a higher taste threshold than non-menopausal women (p = 0.005) Also, there was a significant difference between men and non-menopausal women, and men had a higher taste threshold than non-menopausal women (p = 0.007). There was no significant difference in the distribution of study subjects according to the taste threshold in different concentrations of saltiness and bitterness flavors in all three studied groups (p-= 0.195) (p = 0.091) Conclusions It seems that the taste threshold of sweet, sour and umami flavors was significantly higher in menopausal women compared to non-menopausal women. gustation menopause post menopause Salinity taste perception taste thresholds taste sense taste disturbance Background Dysgeusia is the most common taste disorder, which is defined as a qualitative disorder of the sense of taste [ 1 , 2 ]. This problem not only reduces the pleasure of eating, but also increases the risk of malnutrition due to loss of appetite and excessive consumption of salt and sugar [ 3 ]. Taste changes may play a role in lowering morale and reducing social interactions [ 4 ]. As previously reported, the prevalence of taste disorders increases with age. About 40% of the patients suffering dysgeusia are over 65 years old, and 30% of postmenopausal women complain of an unpleasant taste in the oral cavity [ 1 ]. Menopause influenced sucrose palatability and resulted in a reduced perception of sucrose taste consequently altering eating habits to prefer sweater food.. Studies also demonstrated sex differences between tastes and found females to prefer sweeter foods, which is likely mediated by gonadal hormones [ 5 ]. The stimulated and unstimulated salivary flow from the sublingual and submandibular salivary glands decreases in postmenopausal women, compared to premenopausal women [ 6 ]. Smoking, tobacco, some systemic diseases such as diabetes, pregnancy, chemotherapy, radiotherapy and menopause affect the sense of taste [ 6 – 7 ]. Male menopause or andropause is a stage of men's life in the middle age that usually happens between the ages of 40 and 55 years and the changes experienced in it affect their physical, mental and emotional health [ 8 ]. Decrease in muscle mass, irritability and depression, sleep disturbance, hot flashes especially in the head and chest area, prostate inflammation, and physical dysfunction, are among the complications caused by andropause [ 9 ].Due to the simultaneous occurrence of andropause symptoms in men with women's menopause, paying attention to andropause is of particular importance due to its effects on other aspects of couples' lives and the relationship it has with the quality of life of individuals [ 9 , 10 ]. As there is no standard assessment method for taste disorders, the heterogeneity in study methods prevents the decisive conclusion of the most appropriate method of assesing taste disorders. Examination results may reflect the patient's experience [ 4 ]. There are contradictions in this field and it is necessary to carry out more research [ 4 , 11 – 13 ]. Therefore, the researcher decided to conduct the present study on menopausal and non-menopausal women and men referring to the Faculty of Dentistry and affiliated hospitals. Tehran Islamic Azad University of Medical Sciences in 2021. Subject and Methods This descriptive-analytical study was approved by the ethics committee of the Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University (IR.IAU.DENTAL.REC.1400.052). Study subjects voluntarily participated in this study, the objectives of this research were explained to all the people participating in the research, and they were assured that the results of the research will be confidential and after obtaining consent, written consent was obtained from all the volunteers. The 113 study subjects which where referred to the Faculty of Dentistry of Tehran Islamic Azad University of Medical Sciences, aging between 45–55 years, good oral hygiene (PI ≤ 2), a maximum BMI of 30 kg/m2, were divided into three groups; Group A (test group): including 38 female post-menopausal Group B (first control group): including 39 female premenopausal Group C (second control group): including 36 male subjects All the people studied in the three groups had no systemic disease and did not consume any chemical or herbal medicine continuously. A BMI equal to 30 kg/m2 was considered as the boundary between normal weight and obesity [ 14 ]. Patients with poor oral hygiene (PI > 2)[ 15 ], systemic diseases, especially those affecting taste sense, such as anemia, diabetes mellitus, oral neurological sensory disorders, Sjogren's syndrome, xerostomia, using removable prostheses or orthodontic appliances, candidiasis, people with a history of radiotherapy and cancer, pregnancy, zinc deficiency, cerebral infarction, chronic sinusitis, history of gastrectomy, history of chronic otitis, suffering from Covid-19 [ 17 ], obesity [ 18 ], chemotherapy [ 19 , 20 ], consumers of antibiotics, neurological drugs, cardiac drugs, endocrine or psychoactive medications and antihistamines, anti-neoplastic, bronchodilators, anti-inflammatories, smoking cessation drugs, antifungals and antivirals were excluded from the study [18, 21[. In dentate people, the Turesky et al. modification of Quigley-Hein plaque index was used as an index to determine the amount of plaque on the buccal and lingual surfaces. After using the disclosing tablets, the teeth were evaluated and recorded according to the the criteria provided by Turesky et al. (1970). Plaque index (PI) was calculated by dividing the sum of all scores to the number of examined surfaces. PI ≤ 2 was considered a good oral hygiene and PI > 2 was considered as a poor oral hygiene [ 15 ]. Based on the score obtained from the plaque index, study groups were matched in terms of oral hygiene status. Contraindications to caffeine consumption including patients with severe anxiety, cardiovascular diseases or symptomatic cardiac arrhythmia, gastric ulcer or gastroesophageal reflux disease, hepatic and renal failure disorders, seizures, and pregnancy were also excluded [ 22 ]. Xerostomic patients were excluded from the study. The following questions were asked to diagnose xerostomia; 1. Is your saliva too little, too much, or you don't pay attention to it at all? 2. Do you need to drink liquids to help swallow dry foods? 3. Do you feel dry in your mouth while eating? A very little response to first question and positive response to question 2 or 3 were considered as patients experiencing some degree of xerostomia [ 23 ]. Solutions preparation The solutions were prepared at the Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Tehran Islamic Azad University of Medical Sciences. During the study, the solutions were kept at refrigerator temperature (3° Celcius). For this purpose, sodium chloride powder, sucrose, citric acid, caffeine and monosodium glutamate (Merck, Darmstadt, Germany) for pharmaceutical purposes were used.the desired concentrations were prepared after performing the relevant calculations by dissolving the calculated values in pure water in (Table 1 ). Table1: different concentrations of each 5 substances in study Also, a sample containing pure water was provided to people for rinsing their mouths between testing different concentrations of various solutions. The solutions were prepared in separate containers with a volume of 500 cc and were kept in the refrigerator for up to one week. Before use, the solutions were brought to room temperature (22–25°C) in Bain-Marie. For conducting the experiment, disposable dental mirror, gloves, 5 ml syringe, abaisse-langue, five concentrations of citric acid, sodium chloride, sucrose, caffeine, and monosodium glutamate solutions, which were packed and coded by a pharmacologist in closed and labeled containers and stored at refrigerator temperature. The test time for the participants was between 9 and 10 AM and all the participants were recommended to avoid from eating, drinking and brushing their teeth two hours before the start of the test [ 24 , 25 ]. In this research, the whole mouth method was used. Participants were asked to rinse their mouths with distilled water [ 24 – 26 ]. Then, sitting in an upright position, at first 3 cc of the most diluted solution (solution number one for each taste) was given to the person to hold it in the mouth for thirty seconds and then pour it out. If the person expressed the desired taste correctly, his taste threshold for this taste was considered to be the first concentration, but if the person could not recognize the correct taste or recognized the taste incorrectly, the person was given solution number two, which had a higher concentration, and this continues until the correct taste is detected. The taste recognition by each person at any concentration was recorded as taste perception with correct recognition. In the intervals related to the use of different concentrations of a taste, 5 cc of distilled water was given to the person to rinse his/her mouth for 30 seconds to remove the effect of the previous solution [ 24 – 26 ]. Statistical analysis: The data were recorded after removing confounding items and judged through SPSS version 17 software. Kruskal-Wallis test was used to compare the perception level of different tastes in the three study groups according to the rank nature of the concentration variable. In addition, values less than 0.05 were considered statistically significant. Results The distribution of the studied subjects according to the threshold of taste perception in different flavors is given in descriptive( Tables 2 - 6 ). This research is based on 113 people, including 38 menopausal women (test group) with an average age of 51.5 years, 39 non-menopausal women (control group one) with an average age of 47.5 years, and 36 men (control group two) with an average age of 49.8 years, all of whom have The conditions were fulfilled. A total of 26 people were excluded from the study due to problems such as dry mouth, use of prostheses, medication, poor oral hygiene, or contracting corona virus during the past month. None of the people in the three groups used cigarettes or alcohol. They had no history of radiotherapy and chemotherapy and were not suffering from diseases. In addition, the people of the three groups were considered almost the same in terms of socio-economic status, in terms of the fact that they were clients of the department of oral and maxillofacial diseases and hospitals affiliated to Azad University. There was no significant difference between non-menopausal women and men in the distribution of the study subjects according to the taste threshold perception in different types of sweets (p = 0.911), but between menopausal women and non-menopausal women, as well as the group Men had a significant difference and postmenopausal women had a higher taste threshold than both groups (p = 0.000) and (p = 0.002)(Table 2 ). Table2 : Frequency of minimum concentration of sweet taste *Test group: menopausal women **Control group 1: non-menopausal women ***Control group 2: control group two In the taste of sourness, there was no significant difference between non-menopausal women and men (p = 0.058), also there was no significant difference between menopausal women and men (p = 1), but there was a significant difference between menopausal women and non-menopausal women. and menopausal women had a higher taste threshold than non-menopausal women (p = 0.033) (Table 3 ). Table3: Frequency of minimum concentration of perceived salty taste *Test group: menopausal women **Control group 1: non-menopausal women ***Control group 2: control group two There was no significant difference between menopausal women and men in different types of umami taste (p = 1), but there was a significant difference between menopausal women and non-menopausal women, and menopausal women had a higher taste threshold than non-menopausal women (p = 0.005) Also, there was a significant difference between men and non-menopausal women, and men had a higher taste threshold than non-menopausal women (p = 0.007). (Table 4 ) Table4 : Frequency of minimum concentration of umami taste *Test group: menopausal women **Control group 1: non-menopausal women ***Control group 2: control group two There was no significant difference in the distribution of study subjects according to the taste threshold in different concentrations of saltiness and bitterness flavors in all three studied groups (p-= 0.195) (p = 0.091) (Table 5 , 6 ) Table5 : Frequency of minimum concentration of sourness taste *Test group: menopausal women **Control group 1: non-menopausal women* **Control group 2: control group two Table6 : Frequency of minimum concentration of bitter taste *Test group: menopausal women **Control group 1: non-menopausal women ***Control group 2: control group two There was no significant difference in the distribution of the studied subjects in terms of height and weight between the two groups of women(p = 0.0820),but there was a significant difference between men and both groups ,and men had more height and weight(p = 0.000).there was no statistically significant difference in the distribution of the study subjects according to BMI between all three study groups.(p = 0.440)(Table 7 ) Table 7 Sample distribution based on body mass index(BMI) 95% Confidence Interval for Mean N Maximum Minimum Upper Bound Lower Bound Std. Error Mean ± Std. Deviation Test group * 38 0/00 0/00 0/0027 0/0025 0/00004 0/0026 ± 0/00024 Control1 group 39 0/00 0/00 0/0026 0/0025 0/00004 0/0025 ± 0/00025 Control group1 ** 36 0/00 0/00 0/0027 0/0025 0/00004 0/0026 ± 0/00023 N 113 0/00 0/00 0/0026 0/0025 0/00002 0/0026 ± 0/00024 *Test group: menopausal women **Control group 1: non-menopausal women ***Control group 2: control group two Discussion The study showed that in menopausal women, the threshold of taste sense in all tested tastes was lower than in non-menopausal women, and there was a significant difference in sweet, sour and umami tastes compared to non-menopausal women in the same age range. This difference was greatest in the sweet taste. Among the three studied groups, there was no significant difference in the taste threshold of salty and bitter tastes. Generally, men also had a higher taste threshold than non-menopausal women. In the low concentrations, most errors occurred in perception of umami taste as none of the three groups could recognize umami in the first concentration. The results of the current study are completely consistent with the studies of Dlilbasi et al. and Khasbage et al.In the study of these researchers, menopausal women also had an increase in the threshold of taste sense in all tastes, and this change was more noticeable in the sweet taste[ 27 ]. The similarity between the results of our study and the aforementioned studies may be associated with the use of similar samples, the use of the whole mouth method, and the use of solutions similar to our study. Pedada divya et al, revealed that a significantly higher percentage of postmenopausal women could not identify sucrose taste at different concentrations compared to premenopausal women that is similar with our results. A statistically significant number of postmenopausal women also couldn't identify the bitter taste at concentration (43.3%,) compared to premenopausal women. No significant difference in taste perception of salt and sour was observed between both groups at all tested concentrations which is different with the present study. In both groups, mean taste perception rankings were similar, with salt being most perceived, followed by sour bitter, and at least with sucrose. Salivary flow rates and zinc levels did not significantly differ between two groups[ 28 ]. In a study, Hashemipour et al, stated that the perception of the sweet taste is significantly higher in menopausal women than in non-menopausal women. Non-menopausal is less [ 29 ]. The justification of the similarity in the results can be attributed to the study on the samples in the same age range and similar social conditions of the patients referred to the dental faculty. Lack of change in the sour taste can be due to the use of patients' experiences instead of experimenting with different types of tastes. In the study of Kalantari et al.,6% of menopausal women and 4% of elderly men were unable to recognize sweet taste even in high concentrations [ 1 ], that the results of this study were consistent with our study. In the study of Saluja et al. the intensity of taste perception towards sucrose and sweet taste was lower compared to other tastes and menopausal women reported a change in the diet and a greater desire for sweeter foods [ 30 ]. Using whole mouth method and the use of concentration serial to test the solutions and remove similar confounding variables were the reasons for the similarity in the results. In the study of Yasuda et al., umami taste caused the most confusion in taste recognition [ 31 ], which can be due to the unknown nature of this taste and the inability to distinguish it from other tastes, as observed in our research. A study by Shirzaei et al., showed that taste disorders prevalence was 5% and 0% in menopausal and non-menopausal women, respectively [ 21 ]. The difference between these studies and the current study can be attributed to the difference in the research method as the mentioned studies as the evaluation was carried out by questions and completing the questionnaire, while in our study, assessment was done according to gustatory tests. Lim in his study stated that women are more sensitive to smell and taste than men, but not to sweet and salty tastes, and also no evidence of age-related sensory decline was found [ 32 ]. The difference between their results and ours may be explained by racial, ethnic, and geographic differences between populations, different concentrations of solutions, and different study methods. In general, women's life has three general stages: menstruation, pregnancy and menopause. Hormonal changes play an important role during these stages and are effective in changing specific salivary proteins, minerals, lipids and their derivatives. In addition, aging and its side effects such as decrease in non-stimulated saliva, xerostomia and decrease in pH of saliva can also cause problems in understanding the taste of different foods and subsequently causing problems for women after menopause[ 10 ]. Yoshida et al, stated that the menopause index causes a decrease in taste perception in people and menopausal women have this problem, but there is no change in the taste threshold and this difference can be due to the difference in the gender of women and men, but, because salivary glands and oral epithelial cells express estrogen receptors, it is possible that changes in the level of sex hormone secretion directly affect oral and dental health, and this change was attributed to the decrease in plasma estrogen level, which leads to the decrease in saliva flow and the effect on the mental state [ 33 ]. A review of the literature showed that there was an 81.4% correlation between the number of menopausal symptoms and the number of oral complaint symptoms in the studied subjects [ 34 ]. The main cause of menopausal symptoms is the complex relationship between estrogen metabolism and the autonomic nervous system, which regulates saliva secretion, and the volume of unstimulated saliva was lower in participants with menopausal symptoms in this study. The researchers found that the decrease in estrogen reduces the sensitivity to salty and sweet tastes, which leads to an increase in the consumption of products containing salt and sugar [ 35 ]. Probably due to the effect of estrogen on taste receptors in the form of increasing the number of Na + channels and increasing their excitability, which decreases with menopause and estrogen reduction. Taste preference, taste detection threshold, and reactivity to taste stimuli are affected by sex while taste behavior is affected by estrogen levels [ 36 ]. However, Delilbasi et al. stated that there was no difference in the alleviation of symptoms of oral discomfort between those who underwent hormone replacement and those who did not [ 27 ]. The cause of difference can be the small number of study groups, the non-use of non-menopausal women as a control group and the high age of the participants. Steroid hormones, especially estrogen, play an important role in the physiology of the oral cavity as estrogen receptors exist in the oral mucosa, gingiva, and salivary glands. The decrease in estrogen levels during menopause affects the maturation process of the oral epithelium and leads to a thin, atrophic epithelium. Hormone replacement therapy can reduce oral discomfort in menopausal women in most cases, and this shows the role of female sex hormones in maintaining oral tissues [ 37 ]. Following research on the relationship between pregnancy and dysgeusia, researchers found that the threshold of sense of taste in sweet tastes decreases during pregnancy and does not change significantly in salty and sour tastes [38]. As sensory threshold was constant in men, these changes in the sense of taste, especially for sweetness in women, were attributed to female sex hormones and their changes. Higher taste sensitivity before ovulation is probably attributed to high estrogen levels and the decline in taste sensitivity after ovulation is probably attributed to the combined performance and decrease in estrogen and progesterone levels. Xerostomia mouth is also one of the factors that can reduces taste sense in menopausal women. Along with dry mouth, pain receptors are also activated, which may affect the function of taste and neurons and behavioral cells. In general, dry mouth is more common in women than men in all age groups, the amount of saliva flow depends on the individuals estrogen levels. Many studies confirm a slight decrease in saliva secretion in postmenopausal women compared to women in the fertility phase [39]. Oral discomforts such as xerostomia are expressed regardless of other changes, and oral discomforts are primarily more common in menopausal women than before menopause (40). Research has shown that there is a significant negative correlation between dry mouth and taste threshold in menopausal women [41]. Studies on the pH and flow rate of saliva in menstruating and menopause have shown that in menopausal women there is a significant decrease in salivary pH and its flow rate, and it causes more problems in the mouth and teeth area [42]. This is an emphasis on dentists paying more attention to menopausal women. Saliva is necessary for oral tissues health and taste perception.The non-stimulated and stimulated flow rate of sublingual and submandibular glands decreases in menopausal women compared to non-menopausal women, and this is independent of drug interactions [43]. Studies on the examination and comparison of oral and periodontal health status in menopausal women with and without xerostomia show that after comparing the flow rate of saliva, acidic capacity and pH of stimulated saliva, no statistically significant difference was found in the saliva flow rate between the two groups, but pH was significantly more acidic in menopausal women. Also, mucosal injuries in the group with dry mouth were clearly higher than the group of healthy women [44]. This more acidic saliva with the correlation of dry mouth can cause mouth irritation and its symptoms and cause oral discomfort in women after menopause. Changes in the mouth in women after menopause can have different reasons and it is definitely not associated with hormonal changes and local and psychological factors can affect it. One of the reasons for the increase in taste disorders in different studies is people's age, people's age is one of the factors which can affect people's sense of taste and smell [ 3 ]. By conducting experiments with all 5 main tastes, the researchers came to the conclusion that age can have a direct relationship with the reduction of the sense of taste and women perceive all tastes better [45]. In a research ,it was found that men have a higher taste threshold for sour and salty tastes than women and those with dysgeusia had reduced non-stimulated saliva for all 4 tastes (3), the reason could be more smoking in the male group, which reduces saliva and raises the taste threshold. Also, the difference in age and the amount of zinc in the body was effective in the amount of saliva because with increasing age, the number of taste buds decreases and systemic diseases and oral drugs increase. Etiopathology of oral problems and discomforts is multifactorial and one of them is considered to be menopause. Different discomforts such as xerostomia and burning sensation of the mouth and impaired perception of tastes are felt during this period, but a relationship between taste changes and menopause has not been correctly determined. Therefore, there is a need for more extensive research in this field. Decreased taste sensation after menopause is not only essential for enjoying the taste of food, but also directly affects food consumption and the general state of nutrition and health [46]. the frst limitation of the present study was that the results cannot be applied to a wide range of subjects due to the limited subject conditions. Other limitations included a lack of volunteers due to the coronavirus outbreak. Conclusions In this study, the taste threshold of sweet, sour and umami tastes was significantly higher in menopausal women compared to non-menopausal women in the same age range and body mass. Declarations Acknowledgment: The researchers would like to thank the participants for their patience during the conduction of the study. Thank you to the staff of Farahikhtegan, Imam Ali, Amiralmominin hospitals and Dr. Fahimeh Anbari and Dr.hoda jahandar for their advice. Authors’ contributions: jalilvand: Conducting the experiments, performing measurements, and contacting the patients. Alaee & ekhtiari Study design. Kharazi Fard: Statistical analysis. Jafari: Writing the manuscript. The authors read and approved the final manuscript. Funding: In the process of conducting this study, no funding was received, and there are no institutional open-access funds to cover APC. Availability of data and materials: The data supporting this study’s fndings are available from the corresponding author (Arezoo Alaee) upon your request. Ethics approval and consent to participate The study’s protocol followed the Declaration of Helsinki and was approved by the ethics committee of the Islamic Azad University Faculty of Dentistry, Tehran, Iran (IR.IAU.DENTAL.REC.1400.052).on 2022 . After explaining the steps to the patients, all eligible volunteers were asked to complete and sign the informed consent form to participate in the study. Consent for publication: Not applicable. Competing interests :The authors declare they have no conficts of interest in the matter of the study Author details : 1.ekhtiari: Assistant professor in gynecology.Boali hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, 2. Kharazifard: Epidemiologist,Associate professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran, 3 jalilvand:Dentist ,Tehran,iran,4jafari: Dentist,Tehran,iran .5 alaee: Associate professor ,Department of Oral Medicine, Member of the dental material research center, School of Dentistry, Islamic Azad University - Tehran Medical Branch, Tehran, Iran References Kalantari, P., Kalantari, M., Hashemipour, M. A. Evaluation of gustatory and olfactory function among premenopausal and postmenopausal women and men. Journal of Oral Health and Oral Epidemiology , 2017; 6(2): 76-84. Bloise R, Davis MP. Dysgeusia. J Palliat Med. 2016 Apr;19(4):462-3. doi: 10.1089/jpm.2016.0017. Epub 2016 Mar 7. PMID: 26949986. Shintani T, Naito M, Obayashi N, Ando T, Kawaguchi H, Yanamoto S,et al.Resting saliva volume as a risk factor for hypogeusia: A retrospective study. Physiol Behav. 2023 Aug 1;267:114224. doi: 10.1016/j.physbeh.2023.114224. 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Comparison of unstimulated salivary flow rate and oral symptoms between premenopausal and postmenopausal women. the Journal of qazvin university of medical sciences 2015;19(2) (79):39-45.Available from: https://sid.ir/paper/49366/en Viana JWM, Torres RP, Bezerra TF, Nobre FW. beneficial and adverse effects of caffeine consumption on human body: a comprehensive review. InterSciencePlace. 2021;16(2). Ogunbodede EO, Fatusi OA, Akintomide A, Kolawole K, Ajayi A. Oral health status in a population of Nigerian diabetics. J Contemp Dent Pract. 2005 Nov 15;6(4):75-84. PMID: 16299609. Alaee A, Azizi A, Valaie N, Moieni S. The Correlation between Cigarette Smoking and Salivary Flow Rate. J Res Dent Maxillofac Sci 2017; 2 (3) :5-9 URL: http://jrdms.dentaliau.ac.ir/article-1-163-en.html Kale YS, Vibhute N, Belgaumi U, Kadashetti V, Bommanavar S, Kamate W. Effect of using tobacco on taste perception. J Family Med Prim Care. 2019 Aug 28;8(8):2699-2702. doi: 10.4103/jfmpc.jfmpc_457_19. PMID: 31548959; PMCID: PMC6753787. Neumann L, Schauren BC, Adami FS. Taste sensitivity of adults and elderly persons. Revista Brasileira de Geriatria e Gerontologia. 2016;19(5):797-808. Delilbasi C, Cehiz T, Akal UK, Yilmaz T. Evaluation of gustatory function in postmenopausal women. Br Dent J. 2003 Apr 26;194(8):447-9; discussion 441. doi: 10.1038/sj.bdj.4810030. PMID: 12778099. Divya Harika P, Garlapati K, Badam RK, Gone P, Aiman A, Rajani H, et al. Taste Changes and Salivary Flow Rate Disparities in Premenopausal and Postmenopausal Women: Exploring the Zinc Connection. Cureus. 2024 Jun 17;16(6):e62538. doi: 10.7759/cureus.62538. PMID: 39022522; PMCID: PMC11254317. Hashemipour M, Sinaie N, Mehrabizadeh H, Borna R. Prevalence of oral manifestation in premenopausal and postmenopausal females referring to Kerman School of Dentistry. Journal of Isfahan Dental School, Autumn 2010. 2010:185-94. Saluja P, Shetty V, Dave A, Arora M, Hans V, Madan A. Comparative Evaluation of the Effect of Menstruation, Pregnancy and Menopause on Salivary Flow Rate, pH and Gustatory Function. J Clin Diagn Res. 2014 Oct;8(10):ZC81-5. doi: 10.7860/JCDR/2014/9935.5071. Epub 2014 Oct 20. PMID: 25478455; PMCID: PMC4253273. S Yasuda M, Ito K, Nohno K, Takamatsu K, Ogawa M, Funayama S, et al. Association between Multiple Oral Complaints and Menopausal Symptoms: An Observational Study. Journal of Women’s Health and Development 5 (2022): 001-014. Lim SXL, Höchenberger R, Busch NA, Bergmann M, Ohla K. Associations between Taste and Smell Sensitivity, Preference and Quality of Life in Healthy Aging-The NutriAct Family Study Examinations (NFSE) Cohort. Nutrients. 2022 Mar 8;14(6):1141. doi: 10.3390/nu14061141. PMID: 35334798; PMCID: PMC8950182.. Yoshida N, Sugimoto K, Suzuki S, Kudo H. Change in oral health status associated with menopause in Japanese dental hygienists. Int J Dent Hyg. 2018 Feb;16(1):157-164. doi: 10.1111/idh.12282. Epub 2017 May 3. PMID: 28467021. Taga T, Ito K, Takamatsu K, Ogawa M, Funayama S, Inoue M. Menopausal symptoms are associated with oral sensory complaints in perimenopausal women: an observational study. BMC Womens Health. 2021 Jun 30;21(1):262. doi: 10.1186/s12905-021-01401-6. PMID: 34193118; PMCID: PMC8243452. Skoczek-Rubińska A, Chmurzynska A, Muzsik-Kazimierska A, Bajerska J. The Association between Fat Taste Sensitivity, Eating Habits, and Metabolic Health in Menopausal Women. Nutrients. 2021 Dec 16;13(12):4506. doi: 10.3390/nu13124506. PMID: 34960056; PMCID: PMC8706892. Jafari A, Alaee A, Ghods K. The etiologies and considerations of dysgeusia: A review of literature. J Oral Biosci. 2021 Dec;63(4):319-326. doi: 10.1016/j.job.2021.08.006. Epub 2021 Sep 3. PMID: 34487857. Gupta A, Pallagatti S, Gupta D, Aggarwal A, Singh R. Unstimulated Salivary Estrogen in Postmenopausal Women With and Without Oral Dryness: A Prospective Study. The Open Dentistry Journal. 2022;16(1). Sadeghi N, Farazdaghi H, Parandoosh P, Dehghani P, Khatibi M. Relationship between pregnancy and sense of taste. Romanian Journal of. 2021;125(2):312-317. https://doi.org/10.55453/rjmm.2022.125.2.21 · Ciesielska A, Kusiak A, Ossowska A, Grzybowska ME. Changes in the Oral Cavity in Menopausal Women-A Narrative Review. Int J Environ Res Public Health. 2021 Dec 27;19(1):253. doi: 10.3390/ijerph19010253. PMID: 35010513; PMCID: PMC8750983. Hosseinimehvar B, Alaee A, Azizi A, Shafizadeh N. Risk of Hyposalivation in Menopausal Patients. J Res Dent Maxillofac Sci 2017; 2 (3) :16-21 URL: http://jrdms.dentaliau.ac.ir/article-1-162-en.html Kaur K, Kaur P, Singh B, Singh K, Kaur K, Narang RS. Gustatory functional level and oral dryness: impact of menopause on women health. Journal of Advanced Medical and Dental Sciences Research. 2018;6(5):25-9. Pushparathna SB, Preejitha V, Brundha M. Estimation of salivary pH and flow rate in menstruating and menopausal women. Drug Invention Today. 2020;13(2).p:357 Newadkar UR. Mouth on fire: Oral discomfort in postmenopausal women may be surprising.J Midlife Health. 2015 Oct-Dec;6(4):184-6. doi: 10.4103/0976-7800.172351. PMID: 26903760; PMCID: PMC4743282. Ruchi, G., Madhu, R., Pratik, C., Shaleen, K., Prince, S., & Rishi, T. (2022). Evaluation and comparison of oral & periodontal health status in post-menopausal females with and without xerostomia: An observational study. International Journal of Health Sciences, 6(S2), 8241²8249. https://doi.org/10.53730/ijhs.v6nS2.7095 Barragán R, Coltell O, Portolés O, Asensio EM, Sorlí JV, Ortega-Azorín C, et al. Bitter, sweet, salty, sour and umami taste perception decreases with age: Sex-specific analysis, modulation by genetic variants and taste-preference associations in 18 to 80 year-old subjects. Nutrients. 2018;10(10):1539. Bromley S, Doty R. Olfaction in dentistry. Oral Diseases. 2010;16(3):221-32. https://doi.org/10.1111/j.1601-0825.2009.01616.x Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4926228","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":354040763,"identity":"33e6bfaa-a9f8-4b35-980c-9faddd6c6c4e","order_by":0,"name":"Afsaneh Ekhtiari","email":"","orcid":"","institution":"Islamic Azad University","correspondingAuthor":false,"prefix":"","firstName":"Afsaneh","middleName":"","lastName":"Ekhtiari","suffix":""},{"id":354040764,"identity":"fd44da72-87ac-45fa-bf3f-a651b5ce1ad2","order_by":1,"name":"Mohammad Javad Kharazi fard","email":"","orcid":"","institution":"Tehran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"Javad Kharazi","lastName":"fard","suffix":""},{"id":354040765,"identity":"5c672591-6961-4580-8e82-1a662d06144a","order_by":2,"name":"Pouya Jalilvand","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Pouya","middleName":"","lastName":"Jalilvand","suffix":""},{"id":354040766,"identity":"a4d6656d-a2f8-4c06-b80a-a6fb34083b44","order_by":3,"name":"Aryan Jafari","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Aryan","middleName":"","lastName":"Jafari","suffix":""},{"id":354040767,"identity":"bfe6e52d-590e-469b-a71a-2d29f19cc121","order_by":4,"name":"arezoo alaee","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYDADPhDxgYEhgXgtbEDMOINkLcw8xGjhn3348IcPFQzybOyHDz62bbPL42dvYPzwMQe3FolzaQmGM84wGLbxpCUb57YlF0v2HGCWnLkNjzVneAySedsYGNsYcsykc9uYEzfcSGBj5sWjRf4M/4fDQC32bfzvv/+2bKsnrMXgDA9jM1BLYptEDhszY9thwloMz7AZM844I5HcJvHMWLLn3PHEmT0Hm/H6Re4M82NgiNnY9vMnP/zwo6w6sZ+9+eCHj/i8DwESEIqRDUw2EFSPBP6QongUjIJRMApGCgAAuzpNZGRVl4gAAAAASUVORK5CYII=","orcid":"","institution":"Tehran University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"arezoo","middleName":"","lastName":"alaee","suffix":""}],"badges":[],"createdAt":"2024-08-16 16:22:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4926228/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4926228/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":64904340,"identity":"4e673b24-043e-4e11-b593-d4df19fdf83a","added_by":"auto","created_at":"2024-09-20 08:39:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":508157,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4926228/v1/8a03894f-3b55-4721-9477-da9c19a9d287.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eComparison of taste threshold in postmenopausal and non-menopausal women and men\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eDysgeusia is the most common taste disorder, which is defined as a qualitative disorder of the sense of taste [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This problem not only reduces the pleasure of eating, but also increases the risk of malnutrition due to loss of appetite and excessive consumption of salt and sugar [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Taste changes may play a role in lowering morale and reducing social interactions [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs previously reported, the prevalence of taste disorders increases with age. About 40% of the patients suffering dysgeusia are over 65 years old, and 30% of postmenopausal women complain of an unpleasant taste in the oral cavity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMenopause influenced sucrose palatability and resulted in a reduced perception of sucrose taste consequently altering eating habits to prefer sweater food.. Studies also demonstrated sex differences between tastes and found females to prefer sweeter foods, which is likely mediated by gonadal hormones [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe stimulated and unstimulated salivary flow from the sublingual and submandibular salivary glands decreases in postmenopausal women, compared to premenopausal women [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Smoking, tobacco, some systemic diseases such as diabetes, pregnancy, chemotherapy, radiotherapy and menopause affect the sense of taste [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMale menopause or andropause is a stage of men's life in the middle age that usually happens between the ages of 40 and 55 years and the changes experienced in it affect their physical, mental and emotional health [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Decrease in muscle mass, irritability and depression, sleep disturbance, hot flashes especially in the head and chest area, prostate inflammation, and physical dysfunction, are among the complications caused by andropause [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].Due to the simultaneous occurrence of andropause symptoms in men with women's menopause, paying attention to andropause is of particular importance due to its effects on other aspects of couples' lives and the relationship it has with the quality of life of individuals [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs there is no standard assessment method for taste disorders, the heterogeneity in study methods prevents the decisive conclusion of the most appropriate method of assesing taste disorders. Examination results may reflect the patient's experience [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. There are contradictions in this field and it is necessary to carry out more research [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, the researcher decided to conduct the present study on menopausal and non-menopausal women and men referring to the Faculty of Dentistry and affiliated hospitals. Tehran Islamic Azad University of Medical Sciences in 2021.\u003c/p\u003e"},{"header":"Subject and Methods","content":"\u003cp\u003eThis descriptive-analytical study was approved by the ethics committee of the Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University (IR.IAU.DENTAL.REC.1400.052).\u003c/p\u003e\n\u003cp\u003eStudy subjects voluntarily participated in this study, the objectives of this research were explained to all the people participating in the research, and they were assured that the results of the research will be confidential and after obtaining consent, written consent was obtained from all the volunteers.\u003c/p\u003e\n\u003cp\u003eThe 113 study subjects which where referred to the Faculty of Dentistry of Tehran Islamic Azad University of Medical Sciences, aging between 45\u0026ndash;55 years, good oral hygiene (PI\u0026thinsp;\u0026le;\u0026thinsp;2), a maximum BMI of 30 kg/m2, were divided into three groups;\u003c/p\u003e\n\u003cp\u003eGroup A (test group): including 38 female post-menopausal\u003c/p\u003e\n\u003cp\u003eGroup B (first control group): including 39 female premenopausal\u003c/p\u003e\n\u003cp\u003eGroup C (second control group): including 36 male subjects\u003c/p\u003e\n\u003cp\u003eAll the people studied in the three groups had no systemic disease and did not consume any chemical or herbal medicine continuously. A BMI equal to 30 kg/m2 was considered as the boundary between normal weight and obesity [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003ePatients with poor oral hygiene (PI\u0026thinsp;\u0026gt;\u0026thinsp;2)[\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e], systemic diseases, especially those affecting taste sense, such as anemia, diabetes mellitus, oral neurological sensory disorders, Sjogren\u0026apos;s syndrome, xerostomia, using removable prostheses or orthodontic appliances, candidiasis, people with a history of radiotherapy and cancer, pregnancy, zinc deficiency, cerebral infarction, chronic sinusitis, history of gastrectomy, history of chronic otitis, suffering from Covid-19 [\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e], obesity [\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e], chemotherapy [\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e], consumers of antibiotics, neurological drugs, cardiac drugs, endocrine or psychoactive medications and antihistamines, anti-neoplastic, bronchodilators, anti-inflammatories, smoking cessation drugs, antifungals and antivirals were excluded from the study [18, 21[.\u003c/p\u003e\n\u003cp\u003eIn dentate people, the Turesky et al. modification of Quigley-Hein plaque index was used as an index to determine the amount of plaque on the buccal and lingual surfaces. After using the disclosing tablets, the teeth were evaluated and recorded according to the the criteria provided by Turesky et al. (1970). Plaque index (PI) was calculated by dividing the sum of all scores to the number of examined surfaces. PI\u0026thinsp;\u0026le;\u0026thinsp;2 was considered a good oral hygiene and PI\u0026thinsp;\u0026gt;\u0026thinsp;2 was considered as a poor oral hygiene [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]. Based on the score obtained from the plaque index, study groups were matched in terms of oral hygiene status.\u003c/p\u003e\n\u003cp\u003eContraindications to caffeine consumption including patients with severe anxiety, cardiovascular diseases or symptomatic cardiac arrhythmia, gastric ulcer or gastroesophageal reflux disease, hepatic and renal failure disorders, seizures, and pregnancy were also excluded [\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eXerostomic patients were excluded from the study. The following questions were asked to diagnose xerostomia;\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e1. Is your saliva too little, too much, or you don\u0026apos;t pay attention to it at all?\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e2. Do you need to drink liquids to help swallow dry foods?\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e3. Do you feel dry in your mouth while eating?\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eA very little response to first question and positive response to question 2 or 3 were considered as patients experiencing some degree of xerostomia [\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eSolutions preparation\u003c/h3\u003e\n\u003cp\u003eThe solutions were prepared at the Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Tehran Islamic Azad University of Medical Sciences. During the study, the solutions were kept at refrigerator temperature (3\u0026deg; Celcius). For this purpose, sodium chloride powder, sucrose, citric acid, caffeine and monosodium glutamate (Merck, Darmstadt, Germany) for pharmaceutical purposes were used.the desired concentrations were prepared after performing the relevant calculations by dissolving the calculated values in pure water in\u003c/p\u003e\n\u003cp\u003e(Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eTable1: different concentrations of each 5 substances in study\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1726640191.png\"\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003eAlso, a sample containing pure water was provided to people for rinsing their mouths between testing different concentrations of various solutions. The solutions were prepared in separate containers with a volume of 500 cc and were kept in the refrigerator for up to one week. Before use, the solutions were brought to room temperature (22\u0026ndash;25\u0026deg;C) in Bain-Marie.\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003eFor conducting the experiment, disposable dental mirror, gloves, 5 ml syringe, abaisse-langue, five concentrations of citric acid, sodium chloride, sucrose, caffeine, and monosodium glutamate solutions, which were packed and coded by a pharmacologist in closed and labeled containers and stored at refrigerator temperature.\u003c/p\u003e\n\u003cp\u003eThe test time for the participants was between 9 and 10 AM and all the participants were recommended to avoid from eating, drinking and brushing their teeth two hours before the start of the test [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]. In this research, the whole mouth method was used. Participants were asked to rinse their mouths with distilled water [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e]. Then, sitting in an upright position, at first 3 cc of the most diluted solution (solution number one for each taste) was given to the person to hold it in the mouth for thirty seconds and then pour it out. If the person expressed the desired taste correctly, his taste threshold for this taste was considered to be the first concentration, but if the person could not recognize the correct taste or recognized the taste incorrectly, the person was given solution number two, which had a higher concentration, and this continues until the correct taste is detected. The taste recognition by each person at any concentration was recorded as taste perception with correct recognition. In the intervals related to the use of different concentrations of a taste, 5 cc of distilled water was given to the person to rinse his/her mouth for 30 seconds to remove the effect of the previous solution [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical analysis:\u003c/h2\u003e\n \u003cp\u003eThe data were recorded after removing confounding items and judged through SPSS version 17 software. Kruskal-Wallis test was used to compare the perception level of different tastes in the three study groups according to the rank nature of the concentration variable. In addition, values less than 0.05 were considered statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe distribution of the studied subjects according to the threshold of taste perception in different flavors is given in descriptive( Tables\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e-\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eThis research is based on 113 people, including 38 menopausal women (test group) with an average age of 51.5 years, 39 non-menopausal women (control group one) with an average age of 47.5 years, and 36 men (control group two) with an average age of 49.8 years, all of whom have The conditions were fulfilled.\u003c/p\u003e\n\u003cp\u003eA total of 26 people were excluded from the study due to problems such as dry mouth, use of prostheses, medication, poor oral hygiene, or contracting corona virus during the past month. None of the people in the three groups used cigarettes or alcohol. They had no history of radiotherapy and chemotherapy and were not suffering from diseases. In addition, the people of the three groups were considered almost the same in terms of socio-economic status, in terms of the fact that they were clients of the department of oral and maxillofacial diseases and hospitals affiliated to Azad University.\u003c/p\u003e\n\u003cp\u003eThere was no significant difference between non-menopausal women and men in the distribution of the study subjects according to the taste threshold perception in different types of sweets (p\u0026thinsp;=\u0026thinsp;0.911), but between menopausal women and non-menopausal women, as well as the group Men had a significant difference and postmenopausal women had a higher taste threshold than both groups (p\u0026thinsp;=\u0026thinsp;0.000) and (p\u0026thinsp;=\u0026thinsp;0.002)(Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable2\u003c/strong\u003e:\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eFrequency of minimum concentration of sweet taste\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1726640372.png\"\u003e\u003c/div\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e*Test group: menopausal women\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e**Control group 1: non-menopausal women\u003c/p\u003e\n\u003cp\u003e***Control group 2: control group two\u003c/p\u003e\n\u003cp\u003eIn the taste of sourness, there was no significant difference between non-menopausal women and men (p\u0026thinsp;=\u0026thinsp;0.058), also there was no significant difference between menopausal women and men (p\u0026thinsp;=\u0026thinsp;1), but there was a significant difference between menopausal women and non-menopausal women. and menopausal women had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.033) (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable3:\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003eFrequency of minimum concentration of perceived salty taste\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1726640371.png\"\u003e\u003c/div\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e*Test group: menopausal women\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e**Control group 1: non-menopausal women\u003c/p\u003e\n\u003cp\u003e***Control group 2: control group two\u003c/p\u003e\n\u003cp\u003eThere was no significant difference between menopausal women and men in different types of umami taste (p\u0026thinsp;=\u0026thinsp;1), but there was a significant difference between menopausal women and non-menopausal women, and menopausal women had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.005) Also, there was a significant difference between men and non-menopausal women, and men had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.007). (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable4\u003c/strong\u003e:\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eFrequency of minimum concentration of umami taste\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1726640370.png\"\u003e\u003c/p\u003e\n\u003cp\u003e*Test group: menopausal women\u003c/p\u003e\n\u003cp\u003e**Control group 1: non-menopausal women\u003c/p\u003e\n\u003cp\u003e***Control group 2: control group two\u003c/p\u003e\n\u003cp\u003eThere was no significant difference in the distribution of study subjects according to the taste threshold in different concentrations of saltiness and bitterness flavors in all three studied groups (p-= 0.195) (p\u0026thinsp;=\u0026thinsp;0.091) (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e,\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable5\u003c/strong\u003e:\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eFrequency of minimum concentration of sourness taste\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1726640446.png\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cp\u003e*Test group:\u0026nbsp;menopausal women\u003c/p\u003e\n \u003cp\u003e**Control group 1:\u0026nbsp;non-menopausal women*\u003c/p\u003e\n \u003cp\u003e**Control group 2: control group two\u003c/p\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cstrong\u003eTable6\u003c/strong\u003e:\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eFrequency of minimum concentration of\u0026nbsp;bitter taste\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/div\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cimg 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\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003cp\u003e*Test group:\u0026nbsp;menopausal women\u003c/p\u003e\n \u003cp\u003e**Control group 1:\u0026nbsp;non-menopausal women\u003c/p\u003e\n \u003cp\u003e***Control group 2: control group two\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eThere was no significant difference in the distribution of the studied subjects in terms of height and weight between the two groups of women(p\u0026thinsp;=\u0026thinsp;0.0820),but there was a significant difference between men and both groups ,and men had more height and weight(p\u0026thinsp;=\u0026thinsp;0.000).there was no statistically significant difference in the distribution of the study subjects according to BMI between all three study groups.(p\u0026thinsp;=\u0026thinsp;0.440)(Table \u003cspan class=\"InternalRef\"\u003e7\u003c/span\u003e) \u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab7\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSample distribution based on body mass index(BMI)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"5\"\u003e\n \u003cp\u003e95% Confidence Interval for Mean\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"4\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpper Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLower Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStd. Error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;Std. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTest group\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/0026\u0026thinsp;\u0026plusmn;\u0026thinsp;0/00024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl1 group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/0025\u0026thinsp;\u0026plusmn;\u0026thinsp;0/00025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl group1\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/0026\u0026thinsp;\u0026plusmn;\u0026thinsp;0/00023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/0025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0/00002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0/0026\u0026thinsp;\u0026plusmn;\u0026thinsp;0/00024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\"\u003e*Test group: menopausal women\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\"\u003e**Control group 1: non-menopausal women\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\"\u003e***Control group 2: control group two\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n\u003c/table\u003e\n"},{"header":"Discussion","content":"\u003cp\u003eThe study showed that in menopausal women, the threshold of taste sense in all tested tastes was lower than in non-menopausal women, and there was a significant difference in sweet, sour and umami tastes compared to non-menopausal women in the same age range. This difference was greatest in the sweet taste. Among the three studied groups, there was no significant difference in the taste threshold of salty and bitter tastes. Generally, men also had a higher taste threshold than non-menopausal women. In the low concentrations, most errors occurred in perception of umami taste as none of the three groups could recognize umami in the first concentration.\u003c/p\u003e \u003cp\u003eThe results of the current study are completely consistent with the studies of Dlilbasi et al. and Khasbage et al.In the study of these researchers, menopausal women also had an increase in the threshold of taste sense in all tastes, and this change was more noticeable in the sweet taste[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The similarity between the results of our study and the aforementioned studies may be associated with the use of similar samples, the use of the whole mouth method, and the use of solutions similar to our study.\u003c/p\u003e \u003cp\u003ePedada divya et al, revealed that a significantly higher percentage of postmenopausal women could not identify sucrose taste at different concentrations compared to premenopausal women that is similar with our results. A statistically significant number of postmenopausal women also couldn't identify the bitter taste at concentration (43.3%,) compared to premenopausal women. No significant difference in taste perception of salt and sour was observed between both groups at all tested concentrations which is different with the present study. In both groups, mean taste perception rankings were similar, with salt being most perceived, followed by sour bitter, and at least with sucrose. Salivary flow rates and zinc levels did not significantly differ between two groups[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn a study, Hashemipour et al, stated that the perception of the sweet taste is significantly higher in menopausal women than in non-menopausal women. Non-menopausal is less [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The justification of the similarity in the results can be attributed to the study on the samples in the same age range and similar social conditions of the patients referred to the dental faculty. Lack of change in the sour taste can be due to the use of patients' experiences instead of experimenting with different types of tastes.\u003c/p\u003e \u003cp\u003eIn the study of Kalantari et al.,6% of menopausal women and 4% of elderly men were unable to recognize sweet taste even in high concentrations [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], that the results of this study were consistent with our study.\u003c/p\u003e \u003cp\u003eIn the study of Saluja et al. the intensity of taste perception towards sucrose and sweet taste was lower compared to other tastes and menopausal women reported a change in the diet and a greater desire for sweeter foods [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Using whole mouth method and the use of concentration serial to test the solutions and remove similar confounding variables were the reasons for the similarity in the results.\u003c/p\u003e \u003cp\u003eIn the study of Yasuda et al., umami taste caused the most confusion in taste recognition [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], which can be due to the unknown nature of this taste and the inability to distinguish it from other tastes, as observed in our research.\u003c/p\u003e \u003cp\u003eA study by Shirzaei et al., showed that taste disorders prevalence was 5% and 0% in menopausal and non-menopausal women, respectively [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The difference between these studies and the current study can be attributed to the difference in the research method as the mentioned studies as the evaluation was carried out by questions and completing the questionnaire, while in our study, assessment was done according to gustatory tests.\u003c/p\u003e \u003cp\u003eLim in his study stated that women are more sensitive to smell and taste than men, but not to sweet and salty tastes, and also no evidence of age-related sensory decline was found [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The difference between their results and ours may be explained by racial, ethnic, and geographic differences between populations, different concentrations of solutions, and different study methods.\u003c/p\u003e \u003cp\u003eIn general, women's life has three general stages: menstruation, pregnancy and menopause. Hormonal changes play an important role during these stages and are effective in changing specific salivary proteins, minerals, lipids and their derivatives. In addition, aging and its side effects such as decrease in non-stimulated saliva, xerostomia and decrease in pH of saliva can also cause problems in understanding the taste of different foods and subsequently causing problems for women after menopause[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eYoshida et al, stated that the menopause index causes a decrease in taste perception in people and menopausal women have this problem, but there is no change in the taste threshold and this difference can be due to the difference in the gender of women and men, but, because salivary glands and oral epithelial cells express estrogen receptors, it is possible that changes in the level of sex hormone secretion directly affect oral and dental health, and this change was attributed to the decrease in plasma estrogen level, which leads to the decrease in saliva flow and the effect on the mental state [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA review of the literature showed that there was an 81.4% correlation between the number of menopausal symptoms and the number of oral complaint symptoms in the studied subjects [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The main cause of menopausal symptoms is the complex relationship between estrogen metabolism and the autonomic nervous system, which regulates saliva secretion, and the volume of unstimulated saliva was lower in participants with menopausal symptoms in this study. The researchers found that the decrease in estrogen reduces the sensitivity to salty and sweet tastes, which leads to an increase in the consumption of products containing salt and sugar [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Probably due to the effect of estrogen on taste receptors in the form of increasing the number of Na\u003csup\u003e+\u003c/sup\u003e channels and increasing their excitability, which decreases with menopause and estrogen reduction.\u003c/p\u003e \u003cp\u003eTaste preference, taste detection threshold, and reactivity to taste stimuli are affected by sex while taste behavior is affected by estrogen levels [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. However, Delilbasi et al. stated that there was no difference in the alleviation of symptoms of oral discomfort between those who underwent hormone replacement and those who did not [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The cause of difference can be the small number of study groups, the non-use of non-menopausal women as a control group and the high age of the participants.\u003c/p\u003e \u003cp\u003eSteroid hormones, especially estrogen, play an important role in the physiology of the oral cavity as estrogen receptors exist in the oral mucosa, gingiva, and salivary glands. The decrease in estrogen levels during menopause affects the maturation process of the oral epithelium and leads to a thin, atrophic epithelium. Hormone replacement therapy can reduce oral discomfort in menopausal women in most cases, and this shows the role of female sex hormones in maintaining oral tissues [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFollowing research on the relationship between pregnancy and dysgeusia, researchers found that the threshold of sense of taste in sweet tastes decreases during pregnancy and does not change significantly in salty and sour tastes [38]. As sensory threshold was constant in men, these changes in the sense of taste, especially for sweetness in women, were attributed to female sex hormones and their changes. Higher taste sensitivity before ovulation is probably attributed to high estrogen levels and the decline in taste sensitivity after ovulation is probably attributed to the combined performance and decrease in estrogen and progesterone levels.\u003c/p\u003e \u003cp\u003eXerostomia mouth is also one of the factors that can reduces taste sense in menopausal women. Along with dry mouth, pain receptors are also activated, which may affect the function of taste and neurons and behavioral cells. In general, dry mouth is more common in women than men in all age groups, the amount of saliva flow depends on the individuals estrogen levels. Many studies confirm a slight decrease in saliva secretion in postmenopausal women compared to women in the fertility phase [39]. Oral discomforts such as xerostomia are expressed regardless of other changes, and oral discomforts are primarily more common in menopausal women than before menopause (40). Research has shown that there is a significant negative correlation between dry mouth and taste threshold in menopausal women [41].\u003c/p\u003e \u003cp\u003eStudies on the pH and flow rate of saliva in menstruating and menopause have shown that in menopausal women there is a significant decrease in salivary pH and its flow rate, and it causes more problems in the mouth and teeth area [42]. This is an emphasis on dentists paying more attention to menopausal women. Saliva is necessary for oral tissues health and taste perception.The non-stimulated and stimulated flow rate of sublingual and submandibular glands decreases in menopausal women compared to non-menopausal women, and this is independent of drug interactions [43].\u003c/p\u003e \u003cp\u003e Studies on the examination and comparison of oral and periodontal health status in menopausal women with and without xerostomia show that after comparing the flow rate of saliva, acidic capacity and pH of stimulated saliva, no statistically significant difference was found in the saliva flow rate between the two groups, but pH was significantly more acidic in menopausal women. Also, mucosal injuries in the group with dry mouth were clearly higher than the group of healthy women [44]. This more acidic saliva with the correlation of dry mouth can cause mouth irritation and its symptoms and cause oral discomfort in women after menopause.\u003c/p\u003e \u003cp\u003e Changes in the mouth in women after menopause can have different reasons and it is definitely not associated with hormonal changes and local and psychological factors can affect it. One of the reasons for the increase in taste disorders in different studies is people's age, people's age is one of the factors which can affect people's sense of taste and smell [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. By conducting experiments with all 5 main tastes, the researchers came to the conclusion that age can have a direct relationship with the reduction of the sense of taste and women perceive all tastes better [45]. In a research ,it was found that men have a higher taste threshold for sour and salty tastes than women and those with dysgeusia had reduced non-stimulated saliva for all 4 tastes (3), the reason could be more smoking in the male group, which reduces saliva and raises the taste threshold. Also, the difference in age and the amount of zinc in the body was effective in the amount of saliva because with increasing age, the number of taste buds decreases and systemic diseases and oral drugs increase.\u003c/p\u003e \u003cp\u003eEtiopathology of oral problems and discomforts is multifactorial and one of them is considered to be menopause. Different discomforts such as xerostomia and burning sensation of the mouth and impaired perception of tastes are felt during this period, but a relationship between taste changes and menopause has not been correctly determined. Therefore, there is a need for more extensive research in this field. Decreased taste sensation after menopause is not only essential for enjoying the taste of food, but also directly affects food consumption and the general state of nutrition and health [46].\u003c/p\u003e \u003cp\u003ethe frst limitation of the present study was that the results cannot be applied to a wide range of subjects due to the limited subject conditions. Other limitations included a lack of volunteers due to the coronavirus outbreak.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn this study, the taste threshold of sweet, sour and umami tastes was significantly higher in menopausal women compared to non-menopausal women in the same age range and body mass. \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researchers would like to thank the participants for their patience during the conduction of the study. Thank you to the staff of Farahikhtegan, Imam Ali, Amiralmominin hospitals and Dr. Fahimeh Anbari and Dr.hoda jahandar for their advice.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ejalilvand: Conducting the experiments, performing measurements, and contacting the patients. Alaee \u0026amp; ekhtiari Study design. Kharazi Fard: Statistical analysis. Jafari: Writing the manuscript. The authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the process of conducting this study, no funding was received, and there are no institutional open-access funds to cover APC.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting this study\u0026rsquo;s fndings are available from the corresponding author (Arezoo Alaee) upon your request.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate The study\u0026rsquo;s protocol followed the Declaration of Helsinki and was approved by the ethics committee of the Islamic Azad University Faculty of Dentistry, Tehran, Iran (IR.IAU.DENTAL.REC.1400.052).on 2022 . After explaining the steps to the patients, all eligible volunteers were asked to complete and sign the informed consent form to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e :The authors declare they have no conficts of interest in the matter of the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e :\u003c/p\u003e\n\u003cp\u003e1.ekhtiari: Assistant professor in gynecology.Boali hospital, Tehran Medical Sciences, Islamic Azad University, Tehran,\u003cspan dir=\"RTL\"\u003e2.\u003c/span\u003e Kharazifard: Epidemiologist,Associate professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran,\u003cspan dir=\"RTL\"\u003e3\u003c/span\u003e jalilvand:Dentist ,Tehran,iran,4jafari: Dentist,Tehran,iran .5 alaee: Associate professor ,Department of Oral Medicine, Member of the dental material research center, School of Dentistry, Islamic Azad University - Tehran Medical Branch, Tehran, Iran\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKalantari, P., Kalantari, M., Hashemipour, M. 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Bitter, sweet, salty, sour and umami taste perception decreases with age: Sex-specific analysis, modulation by genetic variants and taste-preference associations in 18 to 80 year-old subjects. Nutrients. 2018;10(10):1539.\u003c/li\u003e\n\u003cli\u003eBromley S, Doty R. Olfaction in dentistry. Oral Diseases. 2010;16(3):221-32. https://doi.org/10.1111/j.1601-0825.2009.01616.x\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"gustation, menopause, post menopause, Salinity, taste perception, taste thresholds, taste sense, taste disturbance","lastPublishedDoi":"10.21203/rs.3.rs-4926228/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4926228/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eOne of the problems of women after menopause is the occurrence of changes in the taste sense.it could affect on reducing the quality of life .the researcher decided to conduct the present study to express this issue\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis descriptive-analytical study was conducted on 113 people, including 38 menopausal women and 39 non-menopausal women and 36 men who were all qualified and matched in different factors was done. The taste threshold was evaluated by solutions of sucrose, citric acid, sodium chloride, caffeine and monosodium glutamate .The data were recorded after removing confounding items and judged through SPSS version 17 software and Kruskal-Wallis test.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere was no significant difference between non-menopausal women and men in the distribution of the study subjects according to the taste threshold perception in different types of sweets (p\u0026thinsp;=\u0026thinsp;0.911), but between menopausal women and non-menopausal women, as well as the group men had a significant difference and postmenopausal women had a higher taste threshold than both groups (p\u0026thinsp;=\u0026thinsp;0.000) and (p-= 0.002). In the taste of sourness, there was no significant difference between non-menopausal women and men (p\u0026thinsp;=\u0026thinsp;0.058), also there was no significant difference between menopausal women and men (p\u0026thinsp;=\u0026thinsp;1), but there was a significant difference between menopausal women and non-menopausal women. and menopausal women had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.033). There was no significant difference between menopausal women and men in different types of umami taste (p\u0026thinsp;=\u0026thinsp;1), but there was a significant difference between menopausal women and non-menopausal women, and menopausal women had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.005) Also, there was a significant difference between men and non-menopausal women, and men had a higher taste threshold than non-menopausal women (p\u0026thinsp;=\u0026thinsp;0.007). There was no significant difference in the distribution of study subjects according to the taste threshold in different concentrations of saltiness and bitterness flavors in all three studied groups (p-= 0.195) (p\u0026thinsp;=\u0026thinsp;0.091)\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIt seems that the taste threshold of sweet, sour and umami flavors was significantly higher in menopausal women compared to non-menopausal women.\u003c/p\u003e","manuscriptTitle":"Comparison of taste threshold in postmenopausal and non-menopausal women and men","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-18 06:24:53","doi":"10.21203/rs.3.rs-4926228/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"808eafb4-d39c-4539-94b7-f85e34929d93","owner":[],"postedDate":"September 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-20T08:31:42+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-18 06:24:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4926228","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4926228","identity":"rs-4926228","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}