Huh? Hearing Loss and Menopause
Hearing Loss May Be an Indicator of Low Bone Mass!
While some hearing loss is associated with normal aging, scientists are starting to recognize that declining estrogen may contribute to central auditory processing changes in postmenopausal women reporting difficulty hearing in noisy surroundings or ringing in the ears (tinnitus) despite normal hearing on exams. Researchers still don’t have all the answers as to the connection between menopause and hearing loss, but the evidence is starting to suggest a connection with declining estrogen levels.
Recent evidence suggests a strong association between the severity of osteoporosis and the onset of sensory-neural hearing loss in postmenopausal women due to the deterioration of the bony components of the inner ear, specifically the cochlea. Sensory-neural hearing loss (SNHL) is permanent hearing loss due to a damaged cochlea. The cochlea is the sensory organ of hearing, a hollow spiral-shaped bone located in the inner ear that processes sound waves into electrical impulses that our brains can interpret as sound frequencies. If the bony cochlea loses mass from osteoporosis, that can reduce the ability of the cochlea to process sound waves.
A rapid onset of high-frequency hearing loss also reported by women after menopause may be related to declining estrogen affecting the hair cells in the cochlea. The hair cells contain estrogen receptors, and their job is to transmit high-frequency signals within the cochlea. Damage or dysfunction of the hair cells is directly related to high-frequency hearing loss.
Hormone replacement therapy is not currently recommended for the prevention of hearing loss because its effectiveness and safety have not been proven yet in research. Estrogen replacement may have a protective effect on hearing and progesterone may worsen hearing loss however studies have been inconclusive. Another hormone, aldosterone, may be effective for treating tinnitus, however, the safety and effectiveness of aldosterone therapy are still under review. Current research focuses on developing local estrogen formulations applied directly within the ear to lower the risks and side effects associated with other hormone therapies. Stay tuned!
Inner ear damage can also produce problems with dizziness and balance for many reasons besides menopause-related estrogen loss and are common complaints associated with perimenopause.
Bottom line: Hearing loss can be an early indicator of low estrogen and bone loss! Hearing loss and balance deficits are stronger predictors of a future fracture than bone mass alone. If you are perimenopause or post-menopause, and experiencing new problems with hearing loss or balance, make an appointment with your provider to determine the underlying cause, including a bone density scan to rule out osteoporosis.