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Hormone therapy associated with hearing loss in postmenopausal women
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In postmenopausal women, the use of oral hormone therapy is associated with a higher risk for hearing loss, with risk increasing with a longer duration of use, according to findings published in Menopause.
“Postmenopausal HT has been proposed to slow the development of age-related hearing loss, but previous studies have been small,” Sharon G. Curhan, MD, MSc, from Brigham and Women’s Hospital in Boston, and colleagues wrote. “Cross-sectional findings suggested that postmenopausal women who did not take HT had poorer hearing thresholds than those who used HT or premenopausal women, and postmenopausal women who used estrogen therapy had better hearing than those who received estrogen plus progestogen therapy or no HT. ... Clarification of the relations between hormones and hearing could provide insight into underlying mechanisms and contribute to informed decision-making regarding HT.”
In a prospective study, Curhan and colleagues analyzed data from 80,972 women participating in the Nurses’ Health Study II who were aged 27 to 44 years at baseline and followed between 1991 and 2013. Participants completed questionnaires at baseline and every 2 years. Researchers used Cox proportional hazard regression models to examine independent associations between menopausal status and postmenopausal HT and risk for hearing loss.
After 1,410,928 person-years of follow-up, 18,558 cases of hearing loss were reported. Researchers did not observe an overall association between menopausal status, whether natural or surgical, and risk for hearing loss, but older age at menopause was associated with higher risk. After adjustment for age, race, BMI, physical activity, smoking status, comorbidities and diet, the RR for hearing loss among women who underwent natural menopause at age 50 years was 10% higher vs. those aged 50 years or younger (RR = 1.1; 95% CI, 1.03-1.17).
The use of oral HT was also associated with higher risk for hearing loss, with the risk increasing with longer duration of therapy (P for trend < .001). Postmenopausal women who used HT for 1 to 1.9 years had a 10% higher RR vs. women who never used any HT (RR = 1.1; 95% CI, 1-1.21); risk was 15% higher for women using HT for 5 to 9 years (RR = 1.15; 95% CI, 1.06-1.24); risk was 21% higher for women using HT for at least 10 years (RR = 1.21; 95% CI, 1.07-1.37).
The researchers noted that the assessment of hearing loss was based on self-report and that the study was limited to predominantly white women.
“Current considerations for HT include timing, dose, type and duration, along with risks and benefits,” the researchers wrote. “Our findings suggest that hearing may also be a consideration for women treated with HT.” – by Regina Schaffer
Disclosure: Curhan and one other researcher report consulting for Decibel Therapeutics.
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