Menopause and ringing in the ears
Learn all about perimenopause, low estrogen, menopause and tinnitus
Tinnitus, the perception of ringing, buzzing or other phantom sounds in the ears, is a common yet often misunderstood condition, particularly among women approaching or experiencing menopause. While tinnitus can affect people of any age, growing evidence suggests that hormonal changes during the menopausal transition may influence how and when symptoms appear, as well as their intensity. In fact, up to 30 % of women report new or worsening tinnitus during perimenopause and menopause, highlighting that this isn’t a rare coincidence but a symptom many experience alongside other midlife changes.
Menopause is characterised by a gradual decline in oestrogen and progesterone, hormones that play a role not only in reproductive health but also in blood flow, nerve function and auditory processing. Fluctuations in these hormones may affect the inner ear and the brain’s ability to interpret sound, potentially increasing sensitivity to noise or triggering tinnitus. At the same time, stress, disrupted sleep and changes in mental wellbeing, all common during menopause, can further heighten awareness of ear-related symptoms. Understanding the connection between tinnitus and menopause is essential for improving diagnosis, management and quality of life. By exploring how hormonal changes interact with hearing health, women can feel more informed, less isolated and better equipped to seek appropriate support and treatment options.
30% of women
1 in 3 women report new or worsening tinnitus during perimenopause and menopause.
Menopause and ringing in the ears: what does it look like?
Ringing in the ears, commonly referred to as tinnitus, is a symptom some women experience during menopause, and it can present in distinctive ways.
- Menopause-related tinnitus is often described as loud, intrusive and unpredictable, differing from more stable forms of tinnitus seen at other life stages.
- Many women report a high-pitched ringing, buzzing or hissing sound that may be heard in one ear, both ears or centrally in the head. The intensity often fluctuates, sometimes worsening suddenly without an obvious trigger. Symptoms are frequently more noticeable in quiet environments, particularly at night, which can interfere with sleep.
- Menopausal tinnitus commonly worsens during periods of heightened anxiety, sleep disruption or hormonal shifts. As oestrogen levels decline or fluctuate, the brain’s auditory pathways and neural networks involved in sleep, attention and emotional regulation may become more sensitive. This heightened sensitivity can cause the brain to amplify internal sounds, making tinnitus feel more intrusive.
- Many women also experience tinnitus alongside other neurological-type symptoms, such as migraines, brain fog, poor concentration, sleep problems and mood instability. Changes in hormone levels can destabilise these interconnected systems, activating the limbic system, which governs emotional responses and stress regulation. When this system becomes overactive, emotional reactivity and sympathetic nervous system activity increase, intensifying both tinnitus and distress.
- This interaction can create a vicious cycle: tinnitus increases stress and poor sleep, which in turn heighten brain sensitivity and further amplify tinnitus. While symptoms may improve as hormones stabilise, persistent or worsening ringing, especially when accompanied by hearing loss, dizziness or pain, should always be assessed by a healthcare professional.
Perimenopause and ringing in the ears: things to know
Hormonal changes
Perimenopause symptoms
Age-related hearing changes
Medication changes
This interaction can create a vicious cycle: tinnitus increases stress and poor sleep, which in turn heighten brain sensitivity and further amplify tinnitus. While symptoms may improve as hormones stabilise, persistent or worsening ringing, especially when accompanied by hearing loss, dizziness or pain, should always be assessed by a healthcare professional.
The link between tinnitus and menopause
While there is no precise data on how many women experience tinnitus specifically during menopause, what is well established is that tinnitus becomes more prevalent with age. As a result, women around perimenopausal and menopausal age appear to be at a higher risk of developing or noticing worsening tinnitus symptoms.
- Hormonal changes - The link between tinnitus and menopause is thought to be connected to hormonal changes, particularly the decline in oestrogen. Oestrogen receptors are found throughout a woman’s body, including in the ear and the cochlea, the part of the inner ear responsible for converting sound vibrations into nerve signals.
- Gradual loss of high-frequency hearing - During the menopausal transition, falling oestrogen levels may affect how the cochlea functions. In some women, this can contribute to a gradual loss of high-frequency hearing, a change that often becomes more pronounced with age. When the brain receives fewer sound signals at these higher frequencies, it may compensate by generating internal sounds, which are perceived as tinnitus.
- Oestrogen and progesterone - During menopause and the preceding perimenopausal phase, levels of oestrogen and progesterone fall and fluctuate significantly. Oestrogen plays an important role in how the auditory system functions, helping to regulate blood flow to the inner ear and support the nerve cells that convert sound into electrical signals for the brain. When oestrogen levels decline, these processes may become less efficient, potentially contributing to hearing changes and making phantom sounds such as ringing, buzzing or hissing more noticeable. Research suggests that a significant proportion of women experience new or worsening tinnitus around this stage of life.
- Sleep disruption - Menopause can also disrupt sleep, and there is a recognised association between insomnia and tinnitus. It is not always clear which comes first: tinnitus can make it harder to fall asleep, while poor sleep may heighten awareness of tinnitus. The contrast between a noisy daytime environment and the quiet of the bedroom often makes tinnitus more noticeable at night.
- Stress and anxiety - Finally, stress and anxiety, which may increase during menopause either directly or as a result of other menopausal symptoms, can further intensify tinnitus and make it harder to manage.
Low estrogen and tinnitus: how they interact
Low oestrogen levels may play a role in the development or worsening of tinnitus, particularly in women during perimenopause and menopause. Tinnitus itself is common, affecting around 10–25% of adults, and its prevalence increases with age. As oestrogen naturally declines during midlife, some women report new-onset tinnitus or a noticeable increase in existing symptoms.
Scientific research suggests this connection is biologically plausible. Oestrogen receptors are present in the auditory system, including the inner ear and cochlea. Oestrogen is thought to support healthy blood flow, nerve signalling and sensory hair cell function within the ear. When oestrogen levels fall, these mechanisms may become less efficient, potentially contributing to subtle hearing changes, particularly at high frequencies. Reduced auditory input at these frequencies may prompt the brain to “fill in the gaps”, resulting in the perception of phantom sounds such as ringing or buzzing.
Low oestrogen may also influence tinnitus indirectly. Hormonal changes are associated with sleep disturbance, increased stress and anxiety, all of which are known to exacerbate tinnitus perception. Poor sleep, in particular, can heighten awareness of internal sounds, especially in quiet environments.
Evidence from clinical and population studies indicates that post-menopausal women report tinnitus more frequently than pre-menopausal women, although the relationship is complex and not universal. Hormone replacement therapy (HRT) appears to affect tinnitus differently depending on the individual, reinforcing the need for personalised medical assessment.
If tinnitus develops alongside symptoms of low oestrogen, healthcare professionals may consider hormonal factors as part of a broader diagnostic and management approach.
Anxiety, sleep deprivation and low mood
Another possible connection between tinnitus and menopause relates to the presence of other common menopausal symptoms, including sleep problems, anxiety and depression. These symptoms frequently occur during the menopausal transition and can significantly influence how tinnitus is experienced.
- Sleep disturbance is particularly important. Poor or fragmented sleep can reduce a person’s ability to cope with tinnitus, making the sounds seem louder or more intrusive. When the brain is tired, its capacity to filter out or ignore internal noise is reduced, which can make tinnitus harder to manage, especially at night.
- Psychological factors such as anxiety and low mood can also intensify tinnitus. Stress and emotional strain may increase awareness of internal sounds and create a cycle in which tinnitus worsens anxiety, which in turn further amplifies tinnitus perception.
- There is also evidence suggesting that some medications used during menopause may contribute to tinnitus in certain individuals. Hormone replacement therapy (HRT), commonly prescribed to relieve menopausal symptoms, has been associated in some studies with a higher risk of tinnitus, although findings are mixed and effects appear to vary between individuals.
- In addition, medications such as antidepressants and blood pressure treatments, which are sometimes prescribed during midlife, have been reported to trigger or worsen tinnitus in some cases. For this reason, any new or worsening tinnitus should be discussed with a healthcare professional, particularly when starting or changing medication.
Can tinnitus be caused by hormonal imbalance?
How are tinnitus and hormones connected?
Oestrogen and hearing
Oestrogen influences hearing sensitivity, particularly at higher frequencies. Both rapid drops and sudden rises in oestrogen levels can cause temporary changes in how sound is processed. These hormonal shifts may disrupt the brain’s ability to interpret sound signals accurately, increasing the likelihood of tinnitus. Research has shown that some women experience cyclical changes in hearing and tinnitus severity, reflecting normal hormonal variations across the menstrual cycle.
During menopause, declining oestrogen levels have a complex relationship with hearing. While reduced oestrogen does not automatically cause hearing loss, it may increase vulnerability to hearing difficulties, sudden hearing changes and tinnitus in some women.
Oestrogen, the cochlea and hearing loss
Oestrogen receptors in the auditory pathway
Post-menopause and tinnitus: how common is it?
Tinnitus is relatively common in the general population, affecting an estimated 10–25% of adults, and its prevalence increases with age. For women, this means tinnitus is often reported more frequently after menopause, even though it is not always clear whether menopause itself is the direct cause.
- Studies suggest that post-menopausal women report tinnitus more often than pre-menopausal women, likely due to a combination of factors rather than a single trigger.
- Age-related hearing changes play a significant role, as gradual high-frequency hearing loss becomes more common in midlife and beyond. When the brain receives reduced sound input, it may compensate by generating phantom sounds, perceived as tinnitus.
- Hormonal changes may also contribute. After menopause, oestrogen levels remain consistently lower, and oestrogen is known to support blood flow, nerve signalling and sensory function in the auditory system. While low oestrogen alone does not cause tinnitus in everyone, it may increase susceptibility in some women, particularly when combined with hearing loss or other health factors.
- In addition, post-menopause is often associated with sleep problems, anxiety, stress and certain medications, all of which are known to influence tinnitus severity and awareness. These factors can make tinnitus more noticeable and harder to cope with, even if they are not the original cause.
- Overall, tinnitus is not inevitable after menopause, but it is relatively common. Persistent or bothersome symptoms should always be assessed by a healthcare professional to rule out treatable causes and discuss management options.
10-25% of adults
Up to 1 in 4 adults experience ears ringing during their life
What happens to the body during the menopausal transition?
- The menopausal transition, often called perimenopause, is the phase leading up to menopause when a woman’s hormone levels—particularly oestrogen and progesterone—begin to fluctuate and gradually decline. This stage can last several years, and in some cases up to a decade. It is commonly characterised by irregular menstrual cycles, hot flushes, sleep disruption, mood changes and increased sensitivity to stress.
- Perimenopause ends with menopause, which is clinically defined as the point at which a woman has gone 12 consecutive months without a menstrual period. After this, women enter the post-menopausal stage, when hormone levels stabilise at a lower baseline. In discussions about tinnitus, the term menopause often refers to this entire continuum—from early perimenopause through menopause and into post-menopause.
Tinnitus and hormones: a complex relationship
- Hormonal change, particularly involving oestrogen, has been linked to temporary shifts in hearing sensitivity, but its long-term effects remain unclear. Research findings are mixed: some studies suggest oestrogen may worsen hearing outcomes in certain contexts, while others indicate it could enhance auditory sensitivity in post-menopausal women. These inconsistencies highlight why tinnitus during menopause cannot be approached with a single solution.
- Individual factors—such as age at menopause, use and duration of hormone therapy, genetics and overall health—strongly influence how tinnitus develops and persists. This variability reinforces the need for personalised assessment and management.
What is often missed about menopause-related tinnitus
- Menopause-related tinnitus is frequently treated as a standalone ear issue, but this overlooks the wider picture. For many women, it reflects a broader neurological pattern driven by hormonal instability and heightened sensory sensitivity. Tinnitus often appears alongside migraines, poor sleep, anxiety and cognitive fog, suggesting shared underlying mechanisms.
- Early recognition matters. If the brain remains in a hypersensitive state for too long, tinnitus can become more entrenched. Addressing hormonal, neurological and auditory factors together offers a more effective path than relying on sound therapy alone.
Pulsatile tinnitus and menopause: things to know
Tinnitus and menopause treatments in the UK
Managing tinnitus during the menopausal years often works best when you address more than the ear alone. For many women, symptoms reflect a mix of hormonal change, sleep disruption, stress-system activation, and heightened neurological sensitivity. A practical plan usually combines medical input with lifestyle strategies that support hearing, brain resilience, and overall wellbeing.
Hormone patterns can matter because fluctuating or declining oestrogen and progesterone may affect auditory processing and how strongly the brain reacts to internal noise. That said, tinnitus in menopause is rarely driven by hormones alone. Midlife hearing changes, migraine pathways, anxiety, and general health factors often interact, so a personalised approach tends to be more effective than a single “quick fix”.
Hormone Replacement Therapy (HRT)
Can HRT help tinnitus in menopause? Hormone Replacement Therapy (HRT) is widely used for troublesome menopausal symptoms such as hot flushes and night sweats. Some research has suggested HRT might be associated with a lower likelihood of tinnitus or improvements in tinnitus distress in certain groups—particularly when sleep and emotional symptoms also improve. However, findings are mixed: other studies have linked long-term HRT use with higher tinnitus reporting or greater severity in some women. This doesn’t mean HRT is “good” or “bad” for tinnitus overall; it means responses can differ depending on dose, formulation, route (oral vs transdermal), migraine history, baseline hearing status, and individual sensitivity.
Because HRT has recognised risks and benefits, decisions should be made through shared decision-making with a clinician, using the lowest effective dose for the shortest appropriate time, and reviewing symptoms regularly. If tinnitus changes after starting or adjusting HRT, it’s worth flagging early so the plan can be refined.
Non-hormonal medical options
Lifestyle strategies
Diet and inflammation
Overall, the most effective care is usually multimodal: addressing hormones when appropriate, supporting sleep and mental health, managing comorbid triggers, and adapting strategies over time as menopause progresses.
Menopause and tinnitus: BHRT as a treatment
Tinnitus is commonly reported during perimenopause and menopause, a time when hormonal fluctuations—particularly declining oestrogen—can affect the auditory system and the brain’s ability to regulate sound perception. One treatment sometimes discussed in this context is bioidentical hormone replacement therapy (BHRT).
- BHRT uses hormones that are chemically identical to those naturally produced by the body, most commonly oestradiol and progesterone. These hormones are usually derived from plant sources and prescribed in standardised, regulated formulations.
- Like conventional HRT, BHRT is primarily intended to relieve menopausal symptoms such as hot flushes, night sweats, mood changes and sleep disturbance—but it may also influence tinnitus indirectly.
- The potential link lies in how oestrogen affects the auditory pathways, blood flow to the inner ear and neurotransmitter systems involved in sound processing and emotional regulation. For some women, improving hormonal stability with BHRT may lead to better sleep, reduced anxiety and improved stress tolerance, all of which can lessen tinnitus distress. However, evidence specifically supporting BHRT as a direct treatment for tinnitus remains limited and mixed.
- It is important to note that BHRT is not a guaranteed solution for tinnitus and may not be suitable for everyone. Hormone therapy—bioidentical or otherwise—carries potential risks and benefits that depend on factors such as age, medical history, formulation, dose and route of administration.
- For women considering BHRT, tinnitus should be discussed as part of a broader symptom picture, with careful monitoring and a personalised approach guided by a qualified healthcare professional.
Natural remedies for menopause and ringing in the ears
1. Support sleep quality
2. Manage stress and nervous system reactivity
3. Optimise nutrition
4. Consider key nutrients
5. Gentle physical activity
Natural approaches work best as part of a holistic, personalised plan. If tinnitus is persistent, worsening or accompanied by hearing loss or dizziness, medical assessment is important to rule out treatable causes.
What neurological symptoms can occur during menopause?
Sensory symptoms linked to menopause
Ear-related symptoms in menopause
Cognitive and mental changes
Migraine, menopause and tinnitus
Central sensitisation and sleep disruption
Mood, serotonin and stress responses
Effective management focuses on calming these systems through a multimodal approach: improving sleep, reducing stress, supporting mood and addressing hormonal and neurological factors together.
How does menopause disrupt sleep and make tinnitus worse?
Common sleep disorders during menopause
- Sleep problems are extremely common during menopause, affecting up to 60% of women. The most frequent conditions include:
- Insomnia, often linked to anxiety, low mood, hot flushes and night sweats
- Restless leg syndrome, where involuntary leg movements repeatedly interrupt sleep
- Obstructive sleep apnoea, an underdiagnosed condition in midlife women that causes repeated breathing interruptions and poor sleep quality
- Sleep bruxism, involving teeth grinding or clenching, which can lead to jaw pain, headaches and disrupted sleep
These conditions frequently overlap with tinnitus, creating a shared symptom burden.
The role of melatonin
The sleep–tinnitus vicious cycle
How do mood disorders amplify tinnitus during menopause?
Why serotonin balance matters
A key mechanism linking mood and tinnitus involves serotonin, a neurotransmitter essential for emotional stability and sensory filtering. Oestrogen supports serotonin production and receptor function. As oestrogen levels fall, serotonin regulation may become impaired, reducing the brain’s ability to filter out irrelevant sensory signals. This makes internal sounds, such as tinnitus, more prominent and distressing.
Low serotonin also increases activity in the limbic system, the brain’s emotional and threat-detection network. When this system is overactive, tinnitus is more likely to be perceived as alarming, which further increases stress and sensory sensitivity.
Fight-or-flight and chronic tinnitus
Supporting mood and reducing tinnitus distress
What is the best treatment for menopause-related tinnitus?
How is hormonal tinnitus treated effectively?
Menopausal tinnitus tends to fluctuate with stress levels, sleep quality, hormone changes and diet, so treatment plans need to be flexible and regularly reviewed. What helps one person may not help another, and even within the same individual, needs can evolve over time. Factors that influence tinnitus variability include:
- Hormonal shifts affecting auditory sensitivity and emotional regulation
- Neuroplasticity, where brain pathways involved in tinnitus and mood adapt over time
- Co-existing conditions such as anxiety, migraine or sleep disorders
Because of this complexity, a multimodal strategy is often the most effective. This may involve coordinated care between GPs, gynaecologists, mental health professionals and audiology centres such as Amplifon, where hearing assessments, tinnitus counselling and personalised management plans can be provided.
Why a multimodal approach works best
Tinnitus and menopausal symptoms involve multiple systems, so effective care often targets:
- Neurological function, to reduce auditory hypersensitivity
- Hormonal balance, where appropriate and clinically indicated
- Mental and emotional health, using approaches such as CBT or mindfulness
- Lifestyle factors, including sleep, nutrition and physical activity
Audiology centres like Amplifon play an important role in this framework by offering specialist tinnitus support, hearing evaluations and ongoing monitoring, helping patients adapt strategies as symptoms change.
Does menopause tinnitus go away?
Natural alternatives to HRT for tinnitus relief
Oestrogenic plants
Non-supplement strategies
Non-supplement strategies are equally important. Regular exercise, including aerobic and resistance training, can reduce hot flushes, improve sleep and stabilise mood. Stress-management practices such as mindfulness and yoga help regulate cortisol levels, which may otherwise worsen hormonal imbalance and tinnitus. Improving sleep hygiene, for example by optimising the sleep environment and reducing evening blue-light exposure, can also reduce cognitive fog and tinnitus awareness. A nutrient-rich diet, especially one containing magnesium, omega-3 fatty acids and antioxidants, supports both brain and hormonal health.
Natural approaches may be particularly suitable for women with mild to moderate symptoms or those at higher risk of HRT-related side effects, though they may not provide rapid relief for more severe cases.
Serotonin-based medications
Do serotonin-based medications help with tinnitus and menopause?
Serotonin is central to regulating mood, anxiety and sensory filtering. As oestrogen levels decline, serotonin pathways may become dysregulated, contributing to emotional distress and increased tinnitus sensitivity. Medications that support serotonin balance, such as certain antidepressants, can help by reducing emotional and sensory overreactivity and easing anxiety or depression, which are closely linked to tinnitus severity.
Low doses of serotonin-modulating antidepressants have shown benefit in both tinnitus and migraine management, reflecting shared neurological mechanisms.
Food and lifestyle changes to manage menopause and tinnitus
Which foods worsen menopausal tinnitus?
Which foods may improve menopausal tinnitus?
Key strategies
Key strategies include:
- Increasing anti-inflammatory foods such as omega-3-rich fish, seeds, cruciferous vegetables, berries and whole grains
- Avoiding trigger foods high in glutamate, histamine, tyramine or additives, including aged cheeses, processed meats and foods containing MSG
- Moderating caffeine, salt and alcohol intake, as these can affect fluid balance, blood vessels and nerve sensitivity
This dietary pattern may also improve hot flushes, mood swings and sleep by supporting stress-hormone and neurotransmitter regulation. Supplements such as magnesium, vitamin D, riboflavin (B2) and coenzyme Q10 may offer additional support for reducing inflammation and sensory sensitivity.
How to optimise sleep for tinnitus
How to optimise sleep for tinnitus and hormonal balance
- Sleep disruption is very common during menopause and can significantly worsen tinnitus. Poor sleep increases brain inflammation, stress and cognitive difficulties.
- Helpful strategies include maintaining regular sleep routines, reducing screen use before bedtime, managing night sweats with cooling techniques, and using relaxation or mindfulness practices to improve sleep quality.
How to reduce stress that fuels menopause tinnitus
How to reduce stress that fuels tinnitus in menopause
Chronic stress amplifies tinnitus by activating the limbic system and pain pathways. Stress-reduction techniques can lower emotional distress and reduce auditory sensitivity. Effective approaches include:
- Cognitive behavioural therapy (CBT) to reduce tinnitus-related anxiety
- Mindfulness practices to calm the nervous system
- Gentle physical activity, such as yoga or low-impact exercise, to stabilise mood and blood pressure
- Breathing techniques to regulate stress responses during tinnitus flare-ups
Combining these strategies creates a holistic framework that supports nervous system balance, reduces neuroinflammation and promotes both auditory and emotional wellbeing during the menopausal transition.
Menopause, ears ringing and more symptoms
Ringing in the ears is one of several unexpected symptoms that many women report during perimenopause and menopause. Often described as tinnitus, this persistent buzzing, hissing or whistling sound can appear suddenly or worsen alongside other changes such as hot flushes, anxiety and sleep disruption. For some women, ear ringing does not occur in isolation but is accompanied by dizziness, balance issues and jaw discomfort, adding to the overall sense of physical unease during this life stage.
One condition frequently mentioned in connection with menopausal ear symptoms is temporomandibular joint disorder (TMJ). Hormonal fluctuations, increased muscle tension and stress — all common during menopause — may aggravate jaw clenching or teeth grinding, which in turn can affect the auditory system and trigger or intensify tinnitus. Dizziness and a feeling of pressure or fullness in the ears are also commonly reported, sometimes making it difficult to distinguish between inner ear issues, hormonal causes or musculoskeletal factors. Across online forums and support groups, many women share strikingly similar experiences.
Forum discussions often highlight frustration at symptoms being dismissed or treated separately, rather than viewed as part of a broader menopausal picture. While these personal accounts are not a substitute for medical advice, they underline the need for greater awareness, holistic assessment and reassurance for women navigating menopause-related ear symptoms.
FAQs about menopause and ears ringing
Can menopause cause tinnitus?
Is tinnitus a symptom of low oestrogen?
Can tinnitus be a symptom of perimenopause?
Will HRT help tinnitus?
Does perimenopause-related tinnitus go away?
How can hormonal tinnitus be managed?
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