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Hearing loss and tinnitus in the perimenopause and menopause

Hearing loss

Hearing loss affects almost 1 in 6 people however, women are at a lower risk than men. Between the ages of 20 and 69, men are almost twice as likely to develop hearing loss for the frequency of sounds in everyday speech. This sex difference is thought to be due to estrogen protecting the inner ear in some way. This could explain why the majority of women who do suffer from hearing loss experience this around the time of (and after) their menopause.

Here are some ways to help prevent hearing loss:

Get your hearing checked regularly

If you think you may have a problem with your hearing, get it checked out sooner rather than later so something can be done about it. You might also want to consider having annual hearing checks if you work in noisy environments.

Lower your exposure to loud background noise

If you have to raise your voice to be heard in a noisy place, or can’t hear other people talking, that’s generally a sign that the background noise could potentially be damaging your hearing. Anything over 85dB is classed as harmful. For comparison, normal conversation is 60dB, a motorbike is 90 dB and a plane taking off is 120dB.

A common way that people expose their ears to harmful levels of noise is by listening to music or podcasts through headphones. To help avoid damaging your hearing in this way you could use noise-cancelling headphones, avoid listening to music at more than 60% of the maximum volume – some devices have settings you can use to limit the volume automatically – and try not to use headphones for more than an hour at a time. Protect your hearing during loud events and activities by not being close to the loudspeakers, try and take a break from the noise every 15 minutes, and consider wearing earplugs that reduce the volume but don’t muffle it.

If you’re exposed to loud noises through your work, speak to your human resources (HR) department or occupational health manager. Your employer is obliged to make changes to reduce your exposure to loud noise.

Look after your health

  • Manage your blood pressure and heart health
  • Stop smoking and vaping, and limit drinking
  • Exercise and reduce stress
  • Eat foods high in vitamin B12, magnesium, potassium, and iron

Know your family history of hearing

Some age-related hearing loss is genetic, so ask your older relatives about their hearing to see if there are any patterns.

Be aware of drugs that cause hearing loss

Drugs that can cause damage to the inner ear, which can cause hearing loss, balance problems or tinnitus, are called ototoxic.

There are over 100 prescription and over-the-counter drugs that are linked with hearing loss, including some common ones like aspirin or anti-inflammatory painkillers. Usually, there is only a risk to your hearing if you’re taking very large doses, or very strong drugs, such as those used to treat cancer.

For more information about hearing loss visit RNID or Hearing Link.


Tinnitus is often a troublesome symptom that affects 10-15% of the population at any one time. And for 1-2% of people, it significantly impacts their lives. It might be noticed as a ringing sound but it can also be buzzing, humming, throbbing, or even sound like music or singing. It could be just one ear, or both, and the sounds may come and go or be present all the time. Some women find tinnitus starts or gets worse when they enter perimenopause or are menopausal.

Tinnitus is a complex condition involving many different parts of the auditory pathways and can be  exacerbated by psychological events such as mood disorders, depression and stress. It’s not known exactly why women can experience tinnitus as part of their symptoms of peri/menopause.

There hasn’t been much research on hearing, tinnitus, the menopause and HRT. You have estrogen receptors in the cells in your ear and along the auditory pathway, but it’s still not clear what estrogen, testosterone or progesterone’s exact roles are for hearing. Some studies show that low estrogen levels can impair hearing. Experts have hypothesised that alterations in blood flow to the inner ear tube (the cochlear) and changes to the composition of the blood affect the regulation of the electrochemical impulses generated by the hair cells in the cochlear, which in turn alters the auditory signals.

Existing hearing loss can also be a cause of tinnitus, as can other factors such as Ménière’s disease or conditions such as diabetes, thyroid disorders, multiple sclerosis or anxiety or depression. Tinnitus can be a side effect of some chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin.

The right dose and type of HRT can often improve tinnitus, as can reducing stress levels and relaxing. Deep breathing or yoga may help with this as well as making sure you are getting enough sleep. It can often be helpful to listen soft music or sound therapy to help take your mind off it. There are other self-help techniques available from the British Tinnitus Association.

Hearing loss and tinnitus in the perimenopause and menopause

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