J Am Acad Audiol 2019; 30(06): 493-501
DOI: 10.3766/jaaa.17123
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hormones and Hearing: Central Auditory Processing in Women

Skylar Trott
*   University of Kentucky College of Medicine, Lexington, KY
Trey Cline
†   Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, KY
Jeffrey Weihing
‡   Department of Audiology, University of Louisville, Louisville, KY
Deidra Beshear
§   Divisions of Women’s Health, Department of Internal Medicine, University of Kentucky, Lexington, KY
Matthew Bush
†   Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, KY
Jennifer Shinn
†   Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, KY
› Author Affiliations
Further Information

Publication History

06 February 2018

13 March 2018

Publication Date:
25 May 2020 (online)



Estrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.


The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.

Research Design:

A prospective, group comparison study.

Study Sample:

Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.

Data Collection and Analysis:

Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.


Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test–Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.


Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.


  • Bilger RC, Nuetzel JM, Rabinowitz WM, Rzeczkowski C. 1984; Standardization of a test of speech perception in noise. J Speech Hear Res 27: 32-48
  • Cameron S, Dillon H. 2007; Development of the listening in spatialized noise-sentences test (LISN-S). Ear Hear 28: 196-211
  • Caruso S, Cianci A, Grasso D, Agnello C, Galvani F, Maiolino L, Serra A. 2000; Auditory brainstem response in postmenopausal women treated with hormone replacement therapy: a pilot study. Menopause 7: 178-183
  • Caruso S, Maiolino L, Agnello C, Garozzo A, Di Mari L, Serra A. 2003; Effects of patch or gel estrogen therapies on auditory brainstem response in surgically postmenopausal women: a prospective, randomized study. Fertil Steril 79: 556-561
  • Coleman JR, Campbell D, Cooper WA, Welsh MG, Moyer J. 1994; Auditory brainstem responses after ovariectomy and estrogen replacement in rat. Hear Res 80: 209-215
  • Curhan SG, Eliassen AH, Eavey RD, Wang M, Lin BM, Curhan GC. 2017; Menopause and postmenopausal hormone therapy and risk of hearing loss. Menopause 24: 1049-1056
  • Elkind-Hirsch KE, Stoner WR, Stach BA, Jerger JF. 1992; a Estrogen influences auditory brainstem responses during the normal menstrual cycle. Hear Res 60: 143-148
  • Elkind-Hirsch KE, Stoner WR, Stach BA, Jerger JF. 1992; b Cyclic steroid replacement alters auditory brainstem responses in young women with premature ovarian failure. Hear Res 64: 93-98
  • Gates GA, Cobb JL, D’Agostino RB, Wolf PA. 1993; The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg 119: 156-161
  • Golub MS, Germann SL, Hogrefe CE. 2004; Endocrine disruption and cognitive function in adolescent female rhesus monkeys. Neurotoxicol Teratol 26: 799-809
  • Hederstierna C, Hultcrantz M, Collins A, Rosenhall U. 2007; Hearing in women at menopause. Prevalence of hearing loss, audiometric configuration and relation to hormone replacement therapy. Acta Otolaryngol 127: 149-55
  • Hultcrantz M, Sylvén L. 1997; Turner’s syndrome and hearing disorders in women aged 16–34. Hear Res 103: 69-74
  • Hultcrantz M, Simonoska R, Stenberg AE. 2006; Estrogen and hearing: a summary of recent investigations. Acta Otolaryngol 126: 10-14
  • Jerger J, Hall J. 1980; Effects of age and sex on auditory brainstem response. Arch Otolaryngol 106: 387-391
  • Jewett DL, Romano MN, Williston JS. 1970; Human auditory evoked potentials: possible brain stem components detected on the scalp. Science 167: 1517-1518
  • Khaliq F, Tandon OP, Goel N. 2003; Auditory evoked responses in postmenopausal women on hormone replacement therapy. Indian J Physiol Pharmacol 47: 393-399
  • Kilicdag EB, Yavuz H, Bagis T, Tarim E, Erkan AN, Kazanci F. 2004; Effects of estrogen therapy on hearing in postmenopausal women. Am J Obstet Gynecol 190: 77-82
  • Kim JY, Lee SB, Lee CH, Kim HM. 2016; Hearing loss in postmenopausal women with low bone mineral density. Auris Nasus Larynx 43: 155-60
  • Laugel GR, Dengerink HA, Wright JW. 1987; Ovarian steroid and vasoconstrictor effects on cochlear blood flow. Hear Res 31: 245-251
  • Lin FR, Niparko JK, Ferrucci L. 2011; Hearing loss prevalence in the United States. Arch Intern Med 171: 1851-1852
  • Maney DL, Cho E, Goode CT. 2006; Estrogen-dependent selectivity of genomic responses to birdsong. Eur J Neurosci 23: 1523-1529
  • Mulrow CD, Aguilar C, Endicott JE, Tuley MR, Velez R, Charlip WS, Rhodes MC, Hill JA, DeNino LA. 1990; a Quality-of-life changes and hearing impairment. A randomized trial. Ann Intern Med 113: 188-194
  • Mulrow CD, Aguilar C, Endicott JE, Velez R, Tuley MR, Charlip WS, Hill J. 1990; b Association between hearing impairment and the quality of life of elderly individuals. J Am Geriatr Soc 38: 45-50
  • Musiek FE. 1983; Assessment of central auditory dysfunction: the dichotic digit test revisited. Ear Hear 4: 79-83
  • Musiek FE, Baran JA, Pinheiro ML. 1990; Duration pattern recognition in normal subjects and participants with cerebral and cochlear lesions. Audiology 29: 304-13
  • Pinaud R, Tremere LA. 2012; Control of central auditory processing by a brain-generated oestrogen. Nat Rev Neurosci 13: 521-527
  • Serra A, Maiolino L, Agnello C, Messina A, Caruso S. 2003; Auditory brain stem response throughout the menstrual cycle. Ann Otol Rhinol Laryngol 112: 549-553
  • Shinn J, Long A, Rayle C, Bush M. 2016; Primary auditory symptoms in participants with normal peripheral hearing sensitivity: redefining hearing loss. Hearing, Balance Commun 14: 44-49
  • Stenberg AE, Wang H, Fish 3rd J, Schrott-Fischer A, Sahlin L, Hultcrantz M. 2001; Estrogen receptors in the normal adult and developing human inner ear and in Turner’s syndrome. Hear Res 157: 87-92
  • Stenberg AE, Wang H, Sahlin L, Hultcrantz M. 1999; Mapping of estrogen receptors alpha and beta in the inner ear of mouse and rat. Hear Res 136: 29-34
  • Svedbrant J, Bark R, Hultcrantz M, Hederstierna C. 2015; Hearing decline in menopausal women—a 10-year follow-up. Acta Otolaryngol 135: 807-813
  • Wharton JA, Church GT. 1990; Influence of menopause on the auditory brainstem response. Audiology 29: 196-201