It’s no secret that growing older can be taxing on the body, and this is no less true during perimenopause, which occurs just before menopause, characterized by a significant drop in mature eggs in the ovaries, irregular ovulation, and plummeting levels of estrogen and the hormone progesterone. This drop in estrogen may play a role in hearing loss and help explain gender differences in hearing loss, according to data recently published by researchers at Drexel’s College of Medicine in the American Journal of Otolaryngology-Head and Neck Medicine and Surgery.
Gradual development of hearing loss, or presbycusis, is more common in older age and may be brought on by changes in the inner ear and auditory nerve, which sends signals from the ear to the brain. Genetics could also play a role.
The Drexel News Blog checked in with senior author Robert Sataloff, MD, a professor and chair of Otolaryngology – Head & Neck Surgery at Drexel’s College of Medicine to sort out what this new data means for patients with hearing loss and what treatment options are available.
Previous studies have looked at the protective effects of estrogen on hearing and central auditory processing. What is the main contribution of this work to the body of knowledge around menopause and hearing loss?
This is the first study to show that estrogen alters auditory brainstem, or ABR, response values. Consequently, it establishes the fact that a new set of normative values is needed for postmenopausal women who are not receiving estrogen replacement, and age alone is not sufficient for determination of normative values without considering gender.
How does estrogen have a protective effect on how we hear and understand sounds?
Estrogen withdrawal results in deterioration of the auditory system. That is, the natural protective effect of estrogen is withdrawn after menopause. The physiology of that fact is unknown. It appears that estrogen replacement protects against this phenomenon, but further research is needed.
Does your research speak to how far the field has come about the understanding of the role estrogen plays, or is it a reminder that much more work remains?
The preponderance of previous research indicates that estrogen and its signaling pathways are necessary for maintenance of normal hearing and that estrogen is protective. However, previous studies have not investigated the effects of estrogen deprivation on ABR responses. So, the normative values applied to women appear to be inappropriate.
Do you recommend anything for patients to prevent hearing loss, particularly as they approach middle age? How far away are we from therapeutics for age-related and noise-induced hearing loss?
There is a great deal that people can do to protect their hearing as they age. Avoidance of loud noise is one of the most obvious. Estrogen replacement should be considered when it is not contraindicated medically. There is a growing body of research on nutraceutical modulation to help decrease or eliminate oxidative stress. This has promise for both age-related hearing loss and noise-related hearing loss.
Reporters interested in talking to Sataloff should contact Greg Richter, assistant director, news and media relations, at 215-895-2614 or gdr33@drexel.edu.
