Hormones and Tinnitus: Can Menopause Lead To Ringing Ears?

Blocks that spell menopause on a yellow background

Menopause may be known for sparking hot flashes, mood swings, and metabolism changes as a woman’s reproductive years come to a close – but did you know it may also lead to hearing loss and tinnitus?

What Are Menopause And Perimenopause?

Menopause is a normal part of a woman’s reproductive cycle that takes place around age 50. This process is marked by a drastic decline in the female sex hormone estrogen and the end of menstrual periods. Menopause is considered complete after 12 consecutive months without a menstrual period.

Some of the most noticeable menopausal symptoms include hot flashes, chills, weight gain, thinning hair, dry skin, high blood pressure, and sleep problems. On top of these uncomfortable changes, most women experience mood swings. For some women going through menopause, tinnitus can be added to this list of frustrating symptoms.

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The less talked-about part of this change is called perimenopause. This transitional period leading up to menopause can last for several years. Over this period, the body produces less and less estrogen, which results in hormonal fluctuations and many of the same physical and emotional symptoms of menopause.

The common factor of both menopause and perimenopause are hormonal changes – and this can even contribute to hearing loss and tinnitus.

How Do Menopause And Perimenopause Impair Hearing? 

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Most people can expect some normal changes to their hearing ability as they age. You might expect that these natural changes are completely incidental and unrelated to menopause, but research suggests there is a direct link.  

Research has found that women and people who menstruate may experience hearing loss or changes in their hearing sensitivity – particularly at higher frequencies – as they go through hormonal changes. The exact reason for this hearing loss isn’t entirely understood, but signs point to the decreased estrogen levels, which may alter the normal blood flow to the inner ear (cochlea) and auditory pathways. Without a healthy blood flow, the auditory system may be more vulnerable to damage due to loud noise exposure, injury, or infection – all of which can contribute to the development or worsening of tinnitus. 

Tinnitus and perimenopause symptoms are also linked to hormones. Because perimenopause is marked by a reduction in estrogen as well, some women may begin to experience hormone-related hearing changes and new or worsening tinnitus before entering true menopause.

How Does Estrogen Impact Hearing?

There are estrogen receptors in the auditory structures, and current research suggests that changes in estrogen levels may alter blood flow to the cochlea, interrupt the brain’s neuroregulatory mechanisms, or cause changes to the tiny bones in the middle ear. All of these changes can have a tremendous impact on the perception of sound. More research is needed to fully understand how low estrogen can negatively affect hearing, but there is evidence that these hormones play a major role.

Research has shown that women tend to have better hearing than men – not only are men more likely to be exposed to loud noise more often (causing damage to the ear), a naturally lower estrogen level can impact men’s ability to hear higher-pitched sounds. Specifically, research shows those with higher estrogen levels have better hearing at frequencies above 2000Hz. Once these estrogen levels begin dropping, however, this hearing capacity is reduced.

It’s not only a drop in estrogen that can trigger tinnitus –  a sharp spike can cause hearing changes, too. About one in three women experience tinnitus during pregnancy – that’s more than three times as often as it is women who are not pregnant. This may be due to high blood pressure, which can cause ringing in the ears. Estrogen levels naturally fluctuate throughout the menstrual cycle, and research shows that even during these relatively minor changes, a woman’s hearing ability may change. 

Other hormonal changes during menopause and perimenopause can affect blood flow and blood pressure, which can affect the inner ear and lead to tinnitus. Other factors, such as stress, anxiety, and insomnia, due to menopausal changes can also worsen tinnitus.

Will Tinnitus and Hearing Loss Go Away After Menopause?

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Tinnitus is a complex condition that usually comes about as a response to health changes or medical conditions, and some post-menopausal women may experience an improvement in their tinnitus symptoms after hormone levels stabilize, while others may not.

Menopause is considered complete after one year, but estrogen levels remain low from then on. A study showed that after menopause, the reduced level of estrogen can continue contributing to hearing loss. This study reiterated that pre-menopausal women with higher levels of estradiol (a type of estrogen) were shown to be less likely to experience hearing loss.

Even though research shows that as they age, women generally experience less drastic hearing loss than men do, it is clear that menopause can impact hearing sensitivity and may contribute to the development of tinnitus.

What Treatments Are Available for Tinnitus and Perimenopause or Menopause?

Perimenopause and menopause are a natural and normal part of life, and many women may benefit from lifestyle changes, such as regular exercise, healthy eating, and stress reduction techniques. Some women find relief for both tinnitus and menopause through more direct treatments.

  • Menopause and perimenopause can deepen depression, stress, anxiety, and sleep problems – and so can tinnitus. In fact, tinnitus tends to be worsened by stress itself. Whether you’re managing hormonal changes, hearing loss, tinnitus, or all of the above, taking care of your mental wellness is absolutely essential. 
  • Many menopausal women find relief through cognitive behavioral therapy (CBT) – a type of talk therapy that helps you recognize and understand your emotional response to situations so you can reshape your thinking and manage stress levels. CBT is shown to be effective for women navigating menopause as well as people who are dealing with chronic tinnitus.
  • Tinnitus retraining therapy (TRT) is another effective technique to help your mind turn down tinnitus and focus on other things. Sound therapy and hearing aids may also help you find tinnitus relief. Prescribed hearing aids, in particular, may be a good choice if you are experiencing noticeable hearing loss due to menopause. 
  • Hormone replacement therapy decreases many symptoms associated with menopause and perimenopause. Hormone replacement therapy (HRT) restores some of the estrogen your body naturally loses during menopause. With an increased level of estrogen, hormone replacement therapy may help improve tinnitus symptoms. 

Some medications like antidepressants may be helpful in reducing the symptoms of both menopause and tinnitus in some women. However, these medications can have serious side effects, some of which may even be damaging to your hearing. Speak to your doctor or audiologist before pursuing medication that could be ototoxic.

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