March 25, 2019
Hormone Therapy and Hearing Loss
Ask the Experts

Hormone Therapy and Hearing Loss

by Wellness Letter  

Q. Does menopausal hormone therapy increase the risk of hearing loss?

A. In 2017, an analysis of data from the large Nurses’ Health Study, published in the journal Menopause, did find that postmenopausal hormone therapy (estrogen or estrogen plus progestin) was associated with an increased risk of hearing loss, but there are many caveats.

First of all, the results were surprising, since it had been theorized that hormone therapy would slow the tendency of hearing to worsen after menopause, which had been attributed in part to declining hormone production. What’s more, the apparent increase in risk was small, and was seen only inwomen using hormone therapy for at least five or even 10 years. The study found that older age (after 50) at menopause also slightly increased the risk of hearing loss.

Most important, this was just an observational study and could only find an association, not establish causation. The researchers pointed out that these results would have to be confirmed by a clinical trial.

Over the years, many observational studies have linked hormone therapy to a wide range of health outcomes, good and bad. There may be something else about women with more severe menopausal symptoms or those who choose to go on hormone therapy that puts them at increased or decreased risk for various outcomes. Well-designed clinical trials eliminate such confounding factors.

Notably, early observational studies linked hormone therapy to a decreased risk of cardiovascular disease and some other chronic conditions, which was one reason why millions of women started hormone therapy. That changed in 2002, when the Women’s Health Initiative, a landmark clinical trial, did not find such benefits (except for bone health), but rather found that the hormones slightly increased the risk of strokes, blood clots, and, when taken for more than three to five years, breast cancer.

This article first appeared in the UC Berkeley Wellness Letter.

Also see Hearing Loss: Don't Suffer in Silence.