The surprising link between menopause and tinnitus
Classic symptoms most often associated with hormonal changes during perimenopause and menopause are hot flashes, mood swings and night sweats.
Surprisingly, those hormonal changes are also linked to hearing loss and tinnitus, the perception of ringing, buzzing or roaring sounds no one else can hear and that have no external source.
UCI Health otolaryngologist Dr. Hamid Djalilian estimates that “up to 30% of women experience new or worsening tinnitus during menopause.”
Fluctuating and declining estrogen levels are the culprit, altering how the brain and auditory systems process sound.
By midlife, one in five people — men and women — experience some level of tinnitus but it’s usually just mild background noise, Djalilian says.
The ringing is generally caused by minor wear and tear in the auditory canal. Many people may notice it only when the room is silent, but it doesn't bother them.
The reason tinnitus can intensify during menopause isn't because your ears suddenly get worse, but rather that the brain starts magnifying that sound, he explains.
When estrogen wanes
“Estrogen helps regulate blood flow in the inner ear, supports the hair cells that convert sound into signals and stabilizes brain networks that filter out background noise. When estrogen levels swing or drop, these systems can become destabilized, leading to heightened auditory sensitivity and loud tinnitus.”
Faint, harmless sounds are amplified by a migraine-like process, where hormonal shifts, inflammation and changes in the nervous system cause a hypersensitivity to sensory stimuli, he adds.
The problem with treating menopause-related tinnitus is hormonal fluctuations make the condition unstable.
"When tinnitus is unstable, it triggers a fight or flight response and hijacks the brain," Djalilian says.
That’s why the first step in treatment is to ensure that the nervous system is functioning properly. Doctors can then use standard habituation strategies to train the brain to push tinnitus into the background.
Help for menopause-related tinnitus
"People who have not experienced tinnitus often have no idea how severe it can be," Djalilian says. "During menopause, the emotional burden can be even heavier because the same hormonal changes driving tinnitus also heighten stress reactivity and mood swings."
Unfortunately, there is no single solution for menopause-related tinnitus.
Because the condition involves multiple brain regions, a comprehensive approach is needed to address brain sensitivity, hormone balance and lifestyle factors.
Treatment options may include:
- Prescription medication support
- Hormone therapy
- Nutraceuticals
- Lifestyle changes
- Sleep optimization
- Cognitive behavioral therapy
The good news, he says, is that menopause-related tinnitus reflects a broader brain sensitivity that is treatable.
"It’s not just the tinnitus that improves, but brain health in general. Sleep gets deeper, sensory hypersensitivity decreases, mood lifts and overall well-being rises with it."
Learn more about UCI Health Hearing and Ear Disorder Services ›
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