Ear ringing and menopause: what you need to know

In the years leading up to menopause, your ovaries gradually produce less oestrogen and progesterone. Fluctuations are most dramatic during perimenopause, the first stage of menopause. Sex hormones play a crucial role in sexual development and reproduction. But they also have profound effects on the nervous system and blood flow. Scientists don't yet know if tinnitus is directly caused by menopause. But hormonal fluctuations are believed to be a major contributor. 

Research suggests that changes in oestrogen levels may alter blood flow to the inner ear. Without a healthy blood flow, the auditory system may be more vulnerable to damage, which can contribute to the development of tinnitus. During menopause, as oestrogen levels naturally decrease, the mucous membranes in the body can become dry, including those in the ears. These changes can alter the perception of sound. Tinnitus can manifest as a constant buzzing or ringing, or as a beeping, rumbling or throbbing sound. Fatigue or stress can be a trigger for tinnitus, or make it worse. Tinnitus can also cause dizziness, make you more sensitive to certain sounds or occur in combination with mild hearing loss.  

Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings.

It is common for existing tinnitus to become worse during periods of stress or fatigue. In the years leading up to menopause, cortisol levels rise among some women due to hormonal fluctuations. The stress hormone cortisol, which is also released in response to acute stress, also known as the fight-or-flight response, influences blood pressure and blood flow. This, too, can make tinnitus worse.  

Poor sleep is also a contributory factor. Hot flashes and night sweats can disturb sleep, which in turn can affect auditory perception. If you don’t get enough sleep your brain function and ability to cope with stress are reduced. This can also exacerbate tinnitus, making the ringing or buzzing sounds more prominent. Furthermore, medical conditions like high blood pressure and ear infection can worsen tinnitus. People with tinnitus may also experience a worsening of the condition if they are being treated with HRT for a long period of time, or with antidepressants. Always discuss any side effects of medication with a doctor. 

Tinnitus affects both men and women - approximately 740 million adults globally. Although more research still needs to be done on the topic, studies indicate that hormonal fluctuations may contribute to tinnitus during menopause. 

Meta-analysis has shown that the prevalence of chronic tinnitus increases with age. As you age, structures inside the ear and their functions decline. Some women find tinnitus starts or gets worse when they enter perimenopause or are menopausal. The symptoms may improve in postmenopause, when hormone levels are stable and consistently low. 

Menopausal tinnitus can be an annoying and distressing problem. For some people, tinnitus can be a chronic problem that lasts for years. There is no cure for tinnitus, but there are ways to reduce symptoms. 

• Reduce stress. Stress is a known trigger for tinnitus. Yoga, mindfulness and meditation are proven ways to lower your cortisol levels and calm your nervous system. Learning to say no, being willing to delegate and making time in your day for rest also help to reduce stress. 
• Make sleep your number one priority. Fatigue can make tinnitus symptoms more bothersome. Quality sleep helps your brain to process stimuli, increasing tinnitus tolerance. Improve your sleep hygiene, if necessary. Stick to a schedule, ensure a relaxing bedtime routine and avoid screens before bedtime.  
• Avoid noisy environments. Protect your ears from loud noises which can exacerbate tinnitus, especially if you have sensitive ears. Wear earplugs or noise-cancelling headphones in noisy environments, such as concerts or festivals.  
• Adjust your diet. Nutrients are important for general health and nerve function. Avoid caffeine, alcohol and sugar, as these substances can aggravate tinnitus symptoms. Foods that are rich in antioxidants, vitamins and minerals (fruit and vegetables) help support your health. 
• Consider cognitive behavioural therapy (CGT). Therapy can change the way you think about your tinnitus and reduce anxiety and stress. 
• Try sound therapy. Sound therapy uses calming sounds that diminish the presence of tinnitus, such as white noise or soothing music. Because the brain can only focus on one thing at a time, using sound can provide immediate relief. 
• Keep a journal. Write down the circumstances when tinnitus symptoms bother you most, or least. This will help you identify any potential triggers for your tinnitus (e.g., stress, foods, drinks or sounds). 
• Support your health with supplements. Tinnitus has been linked to Vitamin B12 and Vitamin D deficiencies. Magnesium and zinc can help with tinnitus symptoms because of their beneficial effects on the nervous system. Consult a doctor before using supplements.