Women’s health articles

Tinnitus and menopause — What’s that noise in my head?

by Marcy Holmes, Women’s Health Nurse Practitioner

• Causes and triggers of tinnitus
• Theories and devices for tinnitus
• Natural tinnitus treatments

Barbra Streisand blames it for her “volatile temper.” Humorist Garrison Keillor says “it can drive you nuts.” Former model Cheryl Tiegs has it, and so did Beethoven, and Vincent Van Gogh. “It” is tinnitus (pronounced tin’-ah-tuss or ti-nye’-tuss), an annoying, unusual, and sometimes maddening ringing in the ears. Many patients over the years have come to me complaining of tinnitus and the condition can drive sufferers to distraction — and beyond.

In medical terms, tinnitus is the perception of sound with no external source present. It is a perceived sound that varies from person to person which some describe as sounding like a bell ringing, waves crashing, TV static, a dial tone, or even crickets chirping. Others say they hear humming, buzzing, whooshing, or pulsating tones. Tinnitus can occur in one ear, both ears, or seem to come from inside one’s head. It can come and go but often remains relentlessly constant. For many, tinnitus is minor and diminishes or disappears with the passage of time, but for others it becomes chronic, severe, and disabling.

Technically, tinnitus is a symptom and, as such, can have many different causes. Most cases that I have seen affect women over the age of 40. Tinnitus in women seems to pop up out of nowhere to an unsettling degree — but it often appears to correspond to hormonal changes. A few of my patients have reported unexplained sounds which started after a period of stress. Others relate it to TMJ (temporomandibular joint) issues, a new prescription or increase in medication, and some may even experience it temporarily following a viral head cold.

The American Tinnitus Association supports the need for more research to help individuals suffering with this condition. There are growing observational reports by experts connecting tinnitus to hormone cycles in women. Tinnitus has been observed after pregnancy, at menopause, or with the use of hormone therapy, for example. Hormones are not widely regarded as a cause of tinnitus, yet this phenomenon needs further study for us to be able to draw any firm conclusions. Perhaps the hormones have an impact on blood pressure and the blood vessels of the inner ear, and it’s possible that changes from menopause or taking estrogen may be one of triggers for tinnitus in women.

If you go to your practitioner with tinnitus, you’ll probably undergo testing to exclude inner ear infection, high blood pressure, a thyroid condition, and Lyme disease. Rarely, tinnitus can signify something more threatening, so it makes sense to get it checked out. It may also be wise to see an ear, nose and throat (ENT) specialist, to rule out hearing loss (most notably in the upper frequencies), noise-induced nerve damage, or more serious inner-ear abnormalities. If you feel fullness, pressure, and dizziness along with the tinnitus, then Ménière’s disease of the inner ear, in particular, is something you and your practitioner should investigate.

There are many conditions that have ringing of the ears as a side effect, so treatment can come down to identifying and treating the core condition. Then it’s likely that the associated tinnitus will go away as the condition itself heals. For example, removing ear wax impaction, treating a middle-ear infection, getting help for neck pain or TMJ issues, adjusting a medication dosage, or treating high blood pressure can resolve some cases of tinnitus.

Causes and triggers of tinnitus

Many people don’t realize that taking a new medication or changing your existing medication regimen can trigger ringing in the ears. Certain drugs are known to be ototoxic — “toxic to the ear” — even some taken over the counter, like aspirin or other anti-inflammatory drugs. If you have had a new onset of tinnitus or a marked change in your symptoms, be sure to review any recent medication changes and report the symptoms (including improvements) immediately to your prescribing physician. Sometimes the smallest change can make a big difference, and it’s important to document it.

I am also a true believer in eliminating artificial colorings and flavorings, as well as artificial sweeteners whenever tinnitus, or any type of inflammatory or neurological issue is present.

But not all tinnitus has a clear cause or identifiable trigger. This is called idiopathic tinnitus — tinnitus of unknown origin. Idiopathic tinnitus may be hereditary, and studies on genetic connections are underway at the University of Michigan, funded by the American Tinnitus Association.

Theories and devices for tinnitus

The precise mechanism or exact cause for tinnitus is a subject of debate. Most current research indicates that it’s more about abnormal impulses in the auditory areas of the brain cortex, rather than something going on in the inner ear. This has led to the development of therapeutic sound devices that are customized to each patient’s audiometric profile. These devices provide dynamic acoustic nerve stimulation that essentially interrupts, desensitizes and reorganizes these brain impulses, so the individual “habituates” to the sound and eventually doesn’t perceive the sound as unpleasant noise anymore.

By reducing the contrast between the annoying sound being experienced and a different, more pleasant sound or combination of sounds, therapeutic sound can soothe and relieve tinnitus and its associated stress. A range of sound-based methods of tinnitus management are being used and developed today — there are even some which use pleasant music in the devices! Though therapeutic sound devices can be costly and may take time to work (4–6 months is common), treatment can be very effective. I have had several patients who are very pleased with their results with this technique.

Some experts believe tinnitus stems from the neurons (nerve cells) innervating the ear, as branches of the nervous system stemming from the cervical spine and temporomandibular joint (TMJ) region. Proponents of this theory endorse treatment with noninvasive neuromuscular techniques, like chiropractic adjustment, integrative manual therapy (IMT), and osteopathic manipulative therapy (OMT). Some patients also respond well to acupuncture, including auriculotherapy, where specific points on the external ear are stimulated for chronic tinnitus management. Others have tried electrical stimulation to good effect, where a small electrical current is delivered across the skin with an “E-stim” device or TENS unit.

Tinnitus and hearing loss in women

A more drastic measure to treat tinnitus involves surgery to implant an electrical device in the body, though this option is usually reserved for patients suffering from unbearable tinnitus with profound hearing loss who have tried less invasive measures to no avail.

While tinnitus and hearing loss can occur together, they don’t necessarily go hand in hand. If you go to a practitioner for tinnitus, the first step will be to test your hearing. For some of my patients with tinnitus, it has been a relief to find out that their hearing is just fine. There are a couple of important research notes about hearing and hearing loss in women:

• Scientists have determined that a woman’s hearing can be temporarily affected when her progesterone levels are high, during the latter portion of her monthly cycles.
• It has also been documented that some hearing loss can occur in women as they get older. But studies show that women who receive progestins (synthetic forms of progesterone) as part of their hormone replacement therapy, may experience an even greater decline in hearing. In fact, scientists calculate that women taking HRT with progestins experience greater hearing loss — up to 30% more — than women who don’t take HRT or those women who take estrogen alone.

Natural tinnitus treatments

Though many people do “just learn to live with it,” there are numerous natural tinnitus treatments options available. Apart from the noninvasive acoustic devices described above, certain specific herbal remedies may help. Few scientific studies have been conclusive regarding the benefit of herbal remedies for tinnitus, but the American Tinnitus Association considers them to be worth a try. One option is Ginkgo biloba herbal supplements, which may work for some by improving circulation to the inner ear. Another herb, feverfew, may reduce inflammation. Hawthorn berry may work by reducing blood pressure or affecting circulation to the inner ear. And, if your tinnitus seems to have occurred in response to some changing hormones, you may also benefit from trying botanical hormone support, such as Herbal Equilibrium, offered with our Personal Programs.

Certain vitamins, minerals, and micronutrients such as magnesium, zinc, potassium, manganese, bioflavonoids, and vitamins A, C, and the B vitamins have also been reported as helpful when dealing with tinnitus and hearing loss. Magnesium seems to help minimize damage from noise exposure, so there may be a connection to tinnitus. You can typically find all these micronutrients in a high-quality multivitamin and mineral formula, which, with all the additional health benefits, is worth consideration for sure.

Customized homeopathic remedies may be options, as well as herbs used in Traditional Chinese Medicine (TCM), but I encourage you to find a licensed practitioner to help you with the amounts and types of herbs. Again, while there is limited peer-reviewed research, many people report excellent results. There are also many types of ear drops containing herb-infused and essential oils that can be tried, as well as ear candling, for those who wish to go that route.

Several other alternative treatments seem to work for some individuals with tinnitus, though results may vary. They include acupuncture, laser treatment, ultrasound techniques, ear-canal magnets, electromagnetic therapy, and even hypnotherapy. Since stress can certainly play a role in worsening symptoms, it is also never a bad idea to give consideration to your emotional health and well-being, and to address any recent traumatic events or unresolved emotional baggage you may carry with you. There are many options for exploring emotional health, such as Emotional Freedom Technique, the Hoffman Quadrinity Process, cognitive behavioral therapy, counseling, neuro-emotional technique, Gestalt therapy, and self-help support groups.

I have a slight degree of tinnitus: I can hear a faint cicada-like noise all the time, but only if the room is silent and I listen for it. Most of the time I cannot hear it over everything else in the environment, but I do prefer to sleep with the “white noise” of a fan in the room. Many of us don’t notice ringing in our ears until we lie down to sleep at night. Another alternative is to place a radio on the bedside table and turn the volume down very low while sleeping.

Occasionally my tinnitus becomes a louder pulse, like my heartbeat, then passes. It is also very loud and uncomfortable after attending concerts — which I now avoid. When I was young, I thought this was the case for everyone and we all just had to put it out of our minds, so I did. Over the years many of us endure a tremendous amount of noise pollution from loud machinery, construction noise, hairdryers, music, and sports, without being entirely aware of the damaging effects. Much of this could be avoided by wearing ear protection when we know we’re going to be exposed to loud sounds. Just as we wear helmets when we engage in sports that could result in head injury, we should start protecting our ears from noise damage due to occupational, recreational, or ambient sources.

I also can’t recall when my tinnitus really started. Now I know that those affected by tinnitus have their own threshold of tolerance, that the degree of loudness varies, and that it can really affect quality of life and sense of well-being. The longstanding approach toward tinnitus has been to just live with it. Fortunately, today there are many natural options to try, along with the conventional medical options available if tinnitus dramatically impairs your quality of life. Some women may find relief with natural remedies to support hormone balance, if the tinnitus appeared at a time of change.

If you are suffering from tinnitus, consider making some healthy lifestyle and diet changes — it may be one part of a combination of steps that can make all the difference to your sense of hearing and your health.

 

Our Personal Program is a great place to start

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References & further reading on tinnitus

 

Original Publication Date: 07/29/2009
Last Modified: 08/24/2009
Principal Author: Marcy Holmes, Women’s Health Nurse Practitioner