Medication-Associated Xerostomia and Oral Symptom Burden in Midlife Women: A Drug Safety Perspective Across the Menopausal Transition

Background/Objectives: Medication-associated xerostomia is a clinically relevant adverse effect, but its contribution to oral symptom burden in midlife women remains insufficiently characterized. This study investigated the association between xerogenic medication exposure and xerostomia burden across the menopausal transition and whether this association extended to broader oral symptoms.

Methods

This cross-sectional study included 306 Romanian women aged 45–65 years. Medication exposure was assessed in two complementary ways: a medication-list-derived definition, in which reported medicines were coded into therapeutic classes with recognized xerogenic potential (n = 54; 17.6%), regarded as the pharmacological reference measure, and participant-reported use of medication potentially associated with dry mouth (n = 39; 12.7%), which additionally reflects patient recognition of xerogenic exposure. Outcomes were a six-item xerostomia symptom score (XSS-6; 0–18) and a nine-item oral symptom score (OSS-9; 0–27), both derived from the MMBQ-44. Associations were evaluated using two-part models adjusted for age, menopausal stage, body mass index, smoking, medication burden, and psychological symptom burden, with complementary sensitivity analyses.