Tinnitus, a ringing, buzzing, humming or throbbing sound, can coincide with, or get worse with, changing hormone levels
• Tinnitus is a symptom that can come and go or linger and have a debilitating effect
• Women are more likely to experience stress and anxiety associated with tinnitus than men
• Hormones can play a role in managing, preventing and treating tinnitus
Content advisory: this article contains themes of suicide and mental health.
Tinnitus is often a troublesome symptom that affects more than seven million adults in the UK (one in seven people) [1]. It might be noticed as a ringing sound, but it can also be buzzing, humming, throbbing, or even sound like music or singing. You might experience it in just one ear, or both, and the sounds may come and go or be present all the time. For some people, it can be a passing symptom (for instance after you’ve spent the evening at a loud concert) but for others, it can last longer and significantly impact their life.
What causes tinnitus and who gets it?
Tinnitus is a complex symptom involving many different parts of the auditory pathways and can be caused by a combination of genetic and environmental factors. It can be exacerbated by psychological events such as mood disorders, depression and stress.
Men and women tend to be equally affected (some studies have shown higher prevalence in men, others vice versa) but the consequences seem to be greater for women. For instance, women with constant tinnitus experience more stress, anxiety and sensitivity to noise than men, and those with severed tinnitus have an increased risk of suicide attempts [2].
Although tinnitus can occur at any age, it’s more common in older people and occurs more frequently in those who have hearing loss. However, you can have normal hearing and still experience tinnitus.
RELATED: Hearing loss, perimenopause and menopause
Tinnitus can also be caused by the ear condition Ménière’s disease, diabetes, thyroid disorders or multiple sclerosis, and it can be a side effect of some chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin.
How do hormones affect tinnitus?
Some women find tinnitus starts or gets worse when they enter perimenopause or are menopausal. It’s not known exactly why this is - there hasn’t been much research on hearing, tinnitus, menopause and HRT.
You have hormones receptors in the cells in your ears and along the auditory pathway. Some studies show that low hormone 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.
One study of premenopausal women found that the odds of experiencing tinnitus increased in those who had irregular menstrual cycles, compared to those with regular cycles [3]. Another study has found that lower level of serum oestradiol (oestrogen) may impede hearing sensitivity in postmenopausal women [4].
How can I treat tinnitus?
If you are experiencing perimenopausal or menopausal symptoms, HRT is the first-line treatment. The right dose and type of HRT, often with testosterone, can often improve tinnitus. It may also help to prevent it - one study of menopausal women aged 45-75 found a significantly lower percentage of HRT users developed tinnitus in comparison with nonusers [5].
RELATED: Perimenopause, menopause and HRT
Reducing stress levels and relaxing can help to improve tinnitus. 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.
