What is tinnitus?

Tinnitus affects over seven million UK adults (1), presenting as ringing, buzzing, humming, throbbing, or even music. It can occur in one or both ears, either intermittently or constantly. For some, it follows exposure to loud noise and fades; for others, it persists and impacts daily life.

Tinnitus can stem from loud noises, ear infections, or certain medications. It may also signal conditions like hearing loss, hypertension, or temporomandibular joint issues (TMJ). Tinnitus itself is not a condition but a symptom of another health issue.

What causes tinnitus?

It is recognised that hormonal changes may play a role in developing tinnitus in women. Hormone receptors in your ear cells and auditory pathway influence hearing. Changes in blood flow and composition to the inner ear (the cochlea) can affect the electrochemical signals generated by hair cells, altering auditory signals.

Oestrogen impacts the development and maintenance of auditory pathways. A drop in oestrogen during menopause may contribute to tinnitus. This suggests that oestrogen may play a protective role against the development of tinnitus. 

There's a possible link between reproductive hormones and tinnitus during menopause, although more research is needed. This hypothesis is supported by the common occurrence of tinnitus during pregnancy, another period of significant hormonal changes.

A study found that lower oestrogen levels may reduce hearing sensitivity in postmenopausal women, (2) whilst a study of premenopausal women observed that those with irregular menstrual cycles had higher odds of experiencing tinnitus compared to those with regular cycles. (3) Further significant correlations have been found between tinnitus and menstrual cycle disorders such as secondary dysmenorrhea (PMS) and menorrhagia (heavy or prolonged bleeding) in a recent study, further supporting the view that reproductive hormones play a role in this symptom. (4)

HRT & tinnitus

Hormone replacement therapy (HRT), which is often used to alleviate menopausal symptoms, has been linked to an increased risk of tinnitus in a Korean study where the overall prevalence of tinnitus was 22.2% among postmenopausal women.  Tinnitus severity was significantly higher in women using HRT and significantly lower in women who breast fed their children. They concluded that ‘a longer duration of HRT use was associated with developing tinnitus in Korean postmenopausal women.’ (5)

However, two more recent studies of HRT use found that it 1) is helpful in the treatment of perimenopausal chronic tinnitus, especially in moderate to severe perimenopausal patients, and is recommended for clinical use. (6)  2) Hormone replacement therapy decreases the risk of tinnitus in menopausal women: a nationwide study (7)

Additionally, research shows that antidepressants and blood pressure medications for menopause may raise tinnitus risk.  (1)

In summary

Researchers are investigating the link between tinnitus and menopause, considering hormonal imbalance and age-related hearing loss as common causes in midlife women. Other factors include medications, loud noise exposure, and ear bone changes.  

Management for Menopause Tinnitus

Avoiding possible irritants. These include nicotine, caffeine, and loud noises, among others.

Managing stress: Excess stress can worsen tinnitus. Try deep breathing, yoga, tai chi, biofeedback, or other stress management techniques.  

Reducing alcohol consumption. Alcohol increases blood flow to the ears by dilating blood vessels, which may exacerbate inner ear issues such as tinnitus.  

Suppressing the noise. Using low-volume radio static, a fan, simulated sounds, humidifiers, and air conditioners can reduce noise for women.

Aiming for hormone balance through dietary tweaks such as reducing sugar and refined carbohydrates, adding in quality protein and good fats with each meal and eating plenty of fibre.

Supporting with phytoestrogens, if possible, through increased soy-based foods such as edamame beans & tofu as well as specialist supplements like Red clover.

Trialling HRT if suitable & desired based on your health history and symptom severity.

References

1 Jarach CM, Lugo A, Scala M, et al. Global Prevalence and Incidence of Tinnitus: A Systematic Review and Meta-analysis. JAMA Neurol. 2022;79(9):888–900. doi:10.1001/jamaneurol.2022.2189

2 Kim SH, Kang BM, Chae HD, Kim CH. The association between serum estradiol level and hearing sensitivity in postmenopausal women. Obstet Gynecol. 2002 May;99(5 Pt 1):726-30. Doi: 10.1016/s0029-7844(02)01963-4

3 Yu, JN., Nam, G.E., Han, K. et al. Association between menstrual cycle irregularity and tinnitus: a nationwide population-based study. Sci Rep 9, 14038 (2019). https://doi.org/10.1038/s41598-019-50559-5

4 Zuriekat M, Al-Rawashdeh B, Nanah A, Nanah M, Basha AS. The link between tinnitus and menstrual cycle disorders in premenopausal women. Sci Rep. 2025 Jan 22;15(1):2821. doi: 10.1038/s41598-025-87408-7. Erratum in: Sci Rep. 2025 May 7;15(1):15893. doi: 10.1038/s41598-025-99049-x. PMID: 39843937; PMCID: PMC11754614.

5 Lee SS, Han KD, Joo YH. Association of perceived tinnitus with duration of hormone replacement therapy in Korean postmenopausal women: a cross-sectional study. BMJ Open. 2017 Jul 10;7(7):e013736. doi: 10.1136/bmjopen-2016-013736. PMID: 28698314; PMCID: PMC5541493.

6 Liu P, Wei R, Zhu Z, Li H, Guo L, Miao Y, Chen X. [Hormone replacement therapy in perimenopausal women with chronic tinnitus]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep;35(9):812-817. Chinese. doi: 10.13201/j.issn.2096-7993.2021.09.009. PMID: 34628834; PMCID: PMC10127825.

7 Chen HC, Chung CH, Chen VCF, Wang YC, Chien WC. Hormone replacement therapy decreases the risk of tinnitus in menopausal women: a nationwide study. Oncotarget. 2018 Feb 8;9(28):19807-19816. doi: 10.18632/oncotarget.24452