Have you noticed any changes in your hearing now that you’re in perimenopause or menopause? If so, it’s not your imagination. Hearing problems can develop during this transitional time of life, so don’t panic. Let’s explore what may be happening.

What are hearing problems?

Hearing problems can occur in several forms, ranging from mild hearing loss to near or total deafness, ringing in the ears (tinnitus), and hypersensitivity to sound. Hearing loss is common, especially among older adults, and can be caused by a variety of factors:

• Loud noise, which is one of the most common causes. Exposure to loud sounds over time, which may be related to one’s work (construction, factory work, music) can impact hearing, especially if preventive measures were not taken or were insufficient.
• Disease, including diabetes, high blood pressure, ear infections caused by bacteria or viruses, stroke, brain injury, hypothyroidism, rheumatoid arthritis, adrenal fatigue/high cortisol, lupus, insulin resistance/type 2 diabetes.
• Genetic variations, such as otosclerosis.
• Wax accumulation in the ears.
• Use of certain medications, including some used to treat cancer or heart disease, antibiotics, and aspirin at high doses.
• Damaged eardrum.
• Menopause.

Read about menopause and tinnitus

How are hearing problems associated with menopause?

Declining estrogen levels appear to be associated with some hearing problems in menopause. One reason appears to be the impact of low estrogen on the estrogen receptors that exist in ear cells and in auditory pathways, although exactly what is involved is unclear.

According to a study led by Dr. Sharon Curhan, MD, at Brigham and Women’s Hospital, which involved more than 47,000 female nurses, women who took hormone therapy for five to ten years had an increased risk of hearing loss when compared with women not taking hormone therapy. The authors also found that women who entered menopause at an older age had a greater risk of hearing loss.

Curhan’s research indicates that low estrogen levels can affect hearing by altering blood flow to the cochlea, which is the hollow tube located in the inner ear. In another study of 1,830 postmenopausal women, those who had lower estradiol were more likely to experience hearing loss.

Another possible contributor to hearing problems in menopause is the decline in progesterone. This hormone reduces receptor cells for estrogen, which in turn reduces blood flow to the ear.

Hearing loss is just one type of hearing problem women in menopause may experience. Another is hyperacusis, or noise hypersensitivity. People with hyperacusis cannot tolerate normal environmental sounds because their body doesn’t process sounds normally. Estrogen has an effect on the neurotransmitters serotonin, glutamine, and GABA, which play a role in hearing. Therefore when estrogen levels decline, hearing can be impacted. Extreme emotional exhaustion and adrenal fatigue can result in sound sensitivity as well. 

Read about menopause and itchy ears

How to manage hearing problems naturally

You can take steps to manage your hearing problems.

• Lifestyle choices can have an impact on managing hearing problems. According to Dr. Curhan, “people who ate diets that most closely resembled the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) patterns had a substantially lower risk of hearing loss.” 
• Check your medications. You may find you are taking more over-the-counter medications such as ibuprofen or acetaminophen to help with aches and pains in menopause. However, use of these OTC drugs may be associated with hearing loss, according to research. Prescription drugs associated with hearing loss include some chemotherapy drugs (e.g., cisplatin, carboplatin), aminoglycosides (e.g., gentamicin, streptomycin, neomycin), loop diuretics (e.g., furosemide, bumetanide, torsemide), long-term hormone replacement therapy, quinine, chloroquine, and hydroxychloroquine.
• Avoid loud sounds when possible and wear ear plugs when necessary. 
• Have your hearing checked by an audiologist. You may need hearing aids or other types of hearing assistance. 
• For some women, auditory function can be affected by caffeine, alcohol, salt, gluten, monosodium glutamate, food dyes, and smoking and are best avoided. 
• Natural supplements that can support hearing health include vitamin D, resveratrol, magnesium, and B vitamins. 

When to consult your doctor

If you are experiencing persistent hearing problems and they are disrupting your daily activities or causing you stress, consult your doctor. Various health issues that frequently appear in perimenopause and menopause are associated with hearing loss and other hearing problems. These conditions include hypothyroidism, insulin resistance and type 2 diabetes, adrenal fatigue/high cortisol, and autoimmune conditions such as rheumatoid arthritis and lupus. Your doctor should check you for these or other medical conditions that may be affecting your hearing.

Bottom line

Hearing problems may develop in perimenopause and menopause and be associated with hormone changes as well as health conditions frequently seen during this transitional time of life. You may want to consult with your physician if hearing issues persist.