Picture of nerve cellsGetting through menopause is a lot easier for many women who decide to take hormone replacement therapy, or HRT. However, that helpful medication may not be so helpful for your hearing.

While this is still being studied, enough research has shown that there is a connection between hormone use and hearing levels after menopause — and the connection makes it all the more important for women who want to take HRT to speak with their doctors and an audiologist about the potential effects on hearing.

Estrogen and Your Hearing

Estrogen has been found to be linked to hearing levels and sound processing. It actually helps carry signals to your brain and does so in a lightning-fast manner. For a long time, estrogen was thought to play a role in falling hearing levels in postmenopausal women, with less estrogen equaling a greater risk of having hearing loss.

Estrogen was thought to be protective of hearing because men, who obviously have lower levels of estrogen than women, tend to have more age-related hearing loss. At least one study found that HRT could have a beneficial effect on hearing because the women taking HRT in that study had better results on hearing tests. There was also a population that was estrogen-deficient due to a disease, and the people in that group showed signs of age-related hearing loss much earlier than populations that did not have that disease.

However, now there’s more evidence that HRT may hurt hearing in postmenopausal women, possibly because of the composition of the medication. In 2006, a study in the Proceedings of the National Academy of Sciences found that women who took HRT containing progestin had hearing losses that were up to 30 percent worse than the hearing losses found in women taking HRT with no progestin. (The HRT in the study contained either estrogen or a combination of estrogen and progestin.) The 2006 study mentioned a 2004 study that had found HRT might be harmful, but the 2006 study was the first time that a potential culprit in the HRT had been identified. The 2006 study also showed that HRT with estrogen alone appeared to offer no protective benefit.

Now a 2017 study has also found that HRT could be harmful to post-menopausal women’s hearing. This study found slightly different results than the others, but the results still have serious implications for women thinking of taking HRT. The 2017 study found that levels of hearing loss in postmenopausal women were linked to both the age at menopause and the duration of the HRT treatment, as well as simply being on HRT to begin with. This study showed that HRT with estrogen and combined estrogen/progestogen (progestins are synthetic progestogens) both affected hearing loss, and neither had an apparent protective effect.

For women who want to take HRT to soothe menopause symptoms that have been interfering with their daily lives, these study results are a sign that getting a baseline audiogram (and even a full hearing evaluation) is essential if they decide to start HRT. Women also need to discuss the risk factors with their doctors to see if one particular course might be better than another.