A growing number of experts believe one common menopause medication could stop tinnitus in its tracks among midlife women.
The condition – a constant ringing or buzzing in the ears, even when no external sound is present – affects an estimated 7.6million Britons.
For most, it is a nuisance. But for 1.5million with severe symptoms, it is a debilitating problem with no known cure.
Yet evidence suggests it’s even more likely to occur in women going through the menopause, with survey results finding it may impact up to one in five.
Research, however, now suggests that hormone replacement therapy (HRT) could help prevent tinnitus from becoming permanent.
While evidence is still emerging, leading audiologists and menopause specialists believe this is because HRT helps to replace declining levels of hormones such as oestrogen.
A sudden drop in oestrogen, a female sex hormone, can limit blood flow to the inner ear tube – known as the cochlear – potentially sending nerve signals inside haywire.
This can affect how sound is perceived and may be to blame for the ringing sensation.
Hormone replacement therapy may prevent tinnitus from becoming permanent, research says
Equally, other experts suggest that because tinnitus can be worsened by poor sleep, HRT may be beneficial because it can significantly improve sleep quality in menopausal women.
HRT can also improve mood and reduce anxiety, both of which are also known to influence the severity of tinnitus.
Pippa Campbell, a women’s hormone expert from London, told the Daily Mail that HRT ‘has been shown to result in fewer tinnitus cases in women’.
‘Oestrogen helps the brain and ears process sound, so when levels drop or fluctuate, that system can become more reactive,’ she added.
‘Stress, poor sleep and inflammation often turn up the volume.
‘Lower oestrogen can raise cortisol and make the brain more sensitive to sound.
‘Caffeine, alcohol and blood sugar dips often make it worse, so increasing oestrogen levels can combat this.’
Hannah Samuels, an audiologist at Boots Hearingcare, also told the Daily Mail that early reports ‘suggest HRT may ease tinnitus symptoms for some women’.
She added: ‘But everyone’s response is different.
‘If you’re thinking about HRT, it’s best to speak to your GP or menopause specialist about what’s right for you, especially if you’ve noticed changes to your hearing.
‘Oestrogen, in particular, helps to support healthy hearing, so fluctuations can sometimes make tinnitus more noticeable.’
Meanwhile, Infiniti Healthcare, a specialist women’s health clinic in Cardiff, advises that in ‘the case of hormone imbalance’, due to menopause, ‘the correct dose and type of HRT would be an option’.
Research has also suggested that the right dose and type of HRT – often with testosterone – can improve tinnitus symptoms.
One 2018 study involving more than 50,000 menopausal women aged between 45 and 75 found those who used HRT were up to three times less likely to develop tinnitus than those who didn’t.
‘HRT may have provided potential benefits on the management and prevention of tinnitus among menopausal women,’ the doctors from Taiwan said.
Another small preliminary study by Taiwanese medics who ran a specialist tinnitus clinic found menopausal and post-menopausal women ‘responded exceptionally well to HRT’.
Writing in the journal Clinical Otolaryngology, they said nine of the 13 women assessed saw a ‘significant’ improvement in tinnitus symptoms after using HRT for at least a month, with five seeing an ‘almost complete disappearance of tinnitus’.
Other limited research, however, has suggested that using HRT for long stretches could increase the risk of developing tinnitus after menopause
Paul Harrison, audiologist and founder of Hearing Aid UK, said: ‘Evidence suggests that the use of certain medications during menopause may contribute to tinnitus.
‘HRT, for instance, which is often used to alleviate menopausal symptoms, has been linked to an increased risk.’
Ms Campbell added: ‘While it is promising, research on HRT and tinnitus is early still and remains mixed.
‘So it’s very individual and best guided by a practitioner.’
For now, some lifestyle measures have been shown to help ease tinnitus.
A 2024 study found a third of patients who practised mindfulness for two months reported reduced symptoms, while another showed people who exercised more than two-and-a-half hours a week saw improvements.
Experts say that, sometimes, the symptom can disappear on its own. But this is not the case for everyone.
Indeed, previous studies suggest that once tinnitus persists for more than a month there is an 80 to 90 per cent chance that it will become permanent.
‘Simple strategies can help,’ Ms Samuels told the Daily Mail.
‘For instance, using gentle background sound or white noise to make tinnitus less noticeable, especially at night.
‘Professional earwax removal or hearing aids with tinnitus-masking features can also offer relief.’
Ms Campbell added: ‘I focus on calming the nervous system and supporting cell energy. Magnesium and taurine plus B vitamins help regulate neurotransmitters.
‘Antioxidants like NAC and alpha-lipoic acid support the mitochondria in auditory cells.’
Salt, alcohol, caffeine and foods high in natural plant chemicals called salicylates – such as coffee, avocados and blueberries – have also been shown to potentially make symptoms worse.
Researchers estimate there will be 1.2billion menopausal women worldwide by 2030, as life expectancy increases.
Official figures also show HRT use has also exploded in England in recent years.
Latest NHS data recorded 13million HRT prescriptions in 2023/24, a 47 per cent increase from the previous year.