Tinnitus, also known as ringing in the ears, would seemingly have no connection with menopause. Yet there is a connection, and we would like to help you understand that relationship and, more importantly, what you can do about it if you experience this symptom.

What is tinnitus?

Nearly 50 million Americans experience some degree of tinnitus, an audiological and neurological condition in which individuals hear ringing and other sounds that no one else can hear. The term has Latin roots meaning “tinkle,” but people with this condition may hear buzzing, clicking, whistling, swooshing, hissing, or (rarely) music. For about 20 million of these individuals, the sounds are chronic, and 2 million have debilitating noise.

Tinnitus isn’t a disease but a symptom of any one of about 200 different health issues, with hearing loss being near the top of the list. Hearing loss may be associated with aging, exposure to excessive noise (such as musicians, construction workers, or people who work with loud machinery), sinus problems, head or neck trauma, TMJ (temporomandibular joint disorder), side effect of using certain medications (e.g., nonsteroidal anti-inflammatories, some antibiotics, cancer medications, diuretics), and certain diseases, such as hypothyroidism, anemia, Lyme disease, high blood pressure, depression, fibromyalgia, and Meniere’s disease.

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Although scientists have yet to develop a cure for tinnitus, a number of treatment and management options are available.

How is tinnitus associated with menopause?

Researchers are still exploring the ways menopause and hormonal fluctuations can affect hearing. For example, there are conflicting findings concerning how hormone replacement therapy, which some women take to help with menopausal symptoms, impacts hearing.

Consider a study from Brigham and Women’s Hospital in Boston. After evaluating data from more than 47,000 women over 22 years, the investigators concluded that taking HRT for five to 10 years increased the risk of hearing loss by 15 percent when compared with women not taking HRT. This was true both for women taking estrogen alone or estrogen and progesterone. Other research has not found this to be true.

In another study of approximately 55,000 menopausal women, however, the findings were different. Women who took HRT showed reduced risk of developing tinnitus when compared with nonusers.

What scientists do know is that when estrogen levels drop, cells in the body that have estrogen receptors are affected, and auditory pathways and ear cells are among them. A woman’s hearing can become less sensitive during menopause partly because blood flow to the cochlea (in the inner ear) changes. Another reason may be that as progesterone levels decline, they reduce receptor cells for estrogen and therefore blood flow to the ear.

How can you manage tinnitus naturally?

Although there is no cure for tinnitus, you can adopt some effective management techniques.

• Relaxation. Stress can trigger tinnitus in many people, so learning effective relaxation techniques can be helpful. Among them is autogenic relaxation. This involves repeating a phrase that helps you picture a peaceful setting. Get into a comfortable position while you keep repeating this phrase to yourself. Practice slowly breathing in and out as you practice this relaxation method.
• Visualization. This is a type of relaxation in which you feel calm and peaceful. Then engage all of your senses: what do you see, what do you smell, what does the food taste like, what sounds do you hear, what can you feel with your hands or feet or on your skin?
• Meditation. Mindful meditation can be beneficial if you have tinnitus. Get into a comfortable position, begin breathing in and out slowly and gently, and allow your mind to be free of thought. Whenever you begin to focus on a sound, thought, or another distraction, simply let it pass without judgment and continue to calm your mind. It’s helpful to practice mindful meditation daily for at least 10 to 20 minutes.
• Progressive muscle relaxation. This can be a great way to start your day and to deal with tinnitus spikes whenever they occur. Lie down or stand when doing progressive muscle relaxation. Begin by tensing the muscles in your feet and toes for 5 to 10 seconds. Then slowly release those muscles for 30 seconds. Repeat this sequence for your legs, arms, hips, abdomen, lower back, shoulders, arms, hands, neck, and jaw.
• Maintain healthy eating habits. Eating a wholesome, natural foods diet is best for healthy hearing. The DASH and Mediterranean diets are both suggested.
• Ear protection. Be prepared: use ear plugs if you are going to be in an environment with loud noises, such as concerts, construction sites, or shooting ranges.
• Alcohol. Research has shown that excessive alcohol consumption can damage the auditory cortex, which helps you process sounds. In addition, alcohol is absorbed into the fluid in the inner ear, which can cause dizziness, imbalance, and tinnitus. The ringing or other sounds happen when alcohol causes the blood vessels to swell, which boosts the blood flow within the inner ear. It’s best to avoid or significantly limit alcohol consumption.

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• Medications. Use of certain medications may contribute to or cause tinnitus. They include nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen, naproxen), benzodiazepines (e.g., diazepam, lorazepam), antidepressants (e.g., amitriptyline, nortriptline, sertraline), various antibiotics, loop diuretics, beta-blockers, ACE inhibitors, hydroxychloroquine, and angiotensin receptor blockers.
• Cognitive behavioral therapy. In the Journal of the American Academy of Audiology, a research team reported that “CBT treatment for tinnitus management is the most evidence-based treatment option so far.”
• Supplements. Pycnogenol has been shown in studies to increase blood flow to the inner ear and decrease the experience of tinnitus.

when to see your doctor

If the tinnitus interferes with your ability to work, do daily routines, or otherwise disrupts your lifestyle, it’s time to make an appointment. Be sure to bring a list of any medications or supplements you are taking with you to your appointment.

bottom line

Tinnitus can develop in some women during their menopausal years. Use of hormone replacement therapy may make it worse. A variety of natural management methods are available to help with this symptom.