Do menopause hormone changes cause tinnitus, and what can you do?

Tinnitus, or ringing in the ears, is a ‘phantom’ sound that only you can hear. Many women experience tinnitus during perimenopause or after menopause – for some it’s an annoyance, for others it’s hugely debilitating, and can have a serious impact on their quality of life.

There’s evidence that reduced oestrogen levels play a part in menopausal tinnitus, but scientists don’t yet fully understand the relationship.  

If low oestrogen is contributing to your tinnitus, there’s a possibility it may improve once you reach menopause.

Although there’s no cure for most types of tinnitus, there are several treatments that may help, including sound therapies, counselling, using a hearing aid or having excess ear wax removed.

If you’re experiencing other menopause symptoms along with your tinnitus, you might want to try The Better Gut probiotics. These specially selected strains of friendly bacteria can help with everything from hot flashes to anxiety, brain fog to digestive issues.

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What is tinnitus and what are the symptoms?

Tinnitus is the name for an unusual type of sound: one that you can hear, but which isn’t produced by an outside source. Although tinnitus is often described as a ringing in your ears, different people experience different kinds of sounds, including:

• high-pitched ringing
• whooshing
• hissing
• buzzing
• humming
• pulsating

You may hear these noises in both ears or just one, or they could sound more like they’re in your head.

During perimenopause, some women experience a physical tingling feeling in their ears, as well as tinnitus.

Tinnitus can come and go and may be worse at certain times. It can be more noticeable when it’s quiet and there’s no background noise.

The exact causes of tinnitus are not very well understood and can vary, but they often include damage from loud noise.

Pulsatile tinnitus

Pulsatile tinnitus is a rhythmic sound heard in your ears or your head that’s in time with your heartbeat. It generally involves changes in your auditory pathways that increase your awareness of the blood flow in the vessels near your ear.

Unlike with other forms of tinnitus, there are tests that can tell you the cause of pulsatile tinnitus. If you have these symptoms, talk to your doctor.

Does low oestrogen cause tinnitus?

As you enter perimenopause, your levels of reproductive hormones like oestrogen and progesterone fluctuate, dropping as you head towards menopause.

These changes can contribute to a whole range of menopausal symptoms, and some women find that they develop tinnitus, or that it gets worse, during this time. Low oestrogen in particular may play an important part in this.

Although the role of oestrogen in hearing is not fully understood, it’s known to influence the functioning of your auditory system and may help protect against a loss of hearing sensitivity.

There are oestrogen receptors in many areas of your auditory pathways, including in special cells called ‘hair cells’ that turn sound impulses into electrical signals to your brain. Damage to these hair cells is thought to be one of the main causes of tinnitus. 

Large-scale observational studies have found that women with irregular menstrual cycles – who may be experiencing increased fluctuations in oestrogen levels – are more likely to have tinnitus.

Other research, involving women who have reached menopause, suggests that those with lower oestrogen levels have a greater risk of hearing loss, which is often associated with tinnitus.

Another reason tinnitus might be more common in women during perimenopause is that other menopause symptoms may increase your chances of developing it or make it worse. Stress, anxiety and poor sleep can all be the result of tinnitus but studies suggest they can contribute to it too.

Hormone replacement therapy and tinnitus

Hormone replacement therapy (HRT) is a prescription treatment – usually a tablet, skin patch or gel – that replaces reproductive hormones like oestrogen that are lost during the menopause transition.

HRT can be an effective way of improving a range of menopause symptoms, including hot flashes, anxiety and sleep problems.

There’s some evidence that it can also help with tinnitus, but it’s not completely clear cut and there has been conflicting research.

One large observational study found that menopausal women who used HRT were three times less likely to develop tinnitus than those who didn’t use it.

And in a small preliminary study, perimenopausal women with tinnitus saw rapid and significant improvements after using HRT, with more than a third saying their symptoms had almost completely disappeared.

However, other large-scale studies suggest that using HRT for longer periods could actually increase your risk of developing tinnitus after menopause – which highlights how much scientists still have to learn about the relationship between hormones and tinnitus. 

If you already have tinnitus and it’s significantly impacting your life, you may want to talk to your doctor about HRT.  

Tinnitus treatments to help stop ringing ears

There’s currently no specific cure for most types of tinnitus, but there are a number of approaches that may help reduce your symptoms – either for some instant relief or longer term improvements.

• Background sound/tinnitus masking: If you have tinnitus, you may find that it’s more noticeable in a quiet environment. For some people, adding background noise like music or a fan can counteract this. Some people use sound generators – portable machines that create white noise or other ambient sounds. These can be particularly helpful at night when you’re trying to get to sleep.
• Tinnitus retraining therapy (TRT): TRT is a combination of counselling and sound therapy aimed at reducing the signals in your brain that may cause tinnitus. Although some research suggests TRT can have significant benefits, others have shown less convincing results. TRT is also a private treatment so can be expensive.
• Cognitive behavioural therapy (CBT): The talking therapy CBT helps you to reframe your negative thoughts around tinnitus. There’s good evidence that it can improve your quality of life, especially in the short term. It can also help with related symptoms of depression.
• Hearing aids: If you have hearing loss as well as tinnitus, hearing aids can be very effective at reducing the intensity of your tinnitus and how stressful you find it – particularly if you have symptoms in just one ear.
• Ear wax removal: A build-up of ear wax can sometimes make your tinnitus worse, and removing the wax generally helps. You may be able to get rid of wax yourself by using softening drops or olive oil. Don’t try to use cotton buds, which can injure your ears. There are also private services that use special equipment to dislodge the wax.
• Relaxation techniques: Although they can’t reduce the level of your tinnitus, relaxation techniques such as deep breathing exercises or yoga may help to reduce the stress that comes with it.

Does menopause tinnitus go away?

As oestrogen fluctuates during perimenopause, it can actually reach lower levels than after menopause. If low oestrogen is contributing to your tinnitus at this time, your symptoms may decrease once you reach menopause and your oestrogen levels stabilise.

However, the causes, severity and duration of tinnitus can vary hugely and while some women could see improvements, others may not. In that case, finding ways to manage your symptoms, like those we’ve looked at above, can be a huge help.

Summary

Tinnitus is a ringing in your ears, or other phantom sound. Some women experience it during the menopause transition.

Studies suggest this may be partly due to reduced levels of hormones like oestrogen, which is involved in the functioning of your auditory pathways and may help protect against hearing loss.

However, the exact role oestrogen plays in menopausal tinnitus is not yet clear and although hormone replacement therapy may help, some research suggests it could also increase risk in certain situations.

Using background sounds to mask tinnitus can provide quick relief for some people, while therapies like tinnitus retraining therapy and cognitive behavioural therapy may improve symptoms in the longer term.

If your tinnitus is accompanied by hearing loss, hearing aids have been shown to help. And if it’s caused by excess ear wax, removing it may get rid of your symptoms.

If you have other menopause symptoms along with your tinnitus, you might want to try The Better Gut probiotics.

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• inflammation and immune health

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