All the Buzz in Perimenopause

Ear ringing and tinnitus

Is That a Bell or My Brain?

You may think this article is about the rapidly expanding global menopause industry, which is expected to grow to $28 billion (USD) by 2033 from $18 billion currently (USD). However, the only boom I'm about to talk about is the one in my ears.¹

Let’s talk today about tinnitus, otherwise known as ear ringing.²

This may be the shortest The Periprofessional article ever.

In case you’re short on time, here are the two highlights:

1. Tinnitus is poorly understood in general, let alone for the perimenopause crowd.

2. They don’t know yet if hormone therapy helps or worsens tinnitus.

The end.

Thank you, and good night!

If you’ve got more time, I have a slightly longer version.

What does tinnitus feel like?

• Noises are heard in the ear that are not coming from outside your head.

• Ringing, whooshing, buzzing, roaring, hissing, or humming, which can be constant or intermittent

• Sounds in either one or both ears

• Sounds may be accompanied by pressure or fullness feeling in the ears

• Noises heard may vary in pitch throughout the day

• Can interfere with your hearing and concentration

• Can accompany dizziness

• May hear pulsing in line with your heartbeat

Things you may find yourself saying when dealing with tinnitus

● “What’s that sound?” (that no one else hears)

● “My ears feel like I’m on a plane.”

● “I can understand why Vincent Van Gogh chopped off his ear.”

● “My left ear has ringing that comes and goes.”

● “It gets so bad at night. I can’t fall asleep.”

How does perimenopause affect tinnitus?

This is the million-dollar question: No one knows exactly why tinnitus occurs, let alone why it may develop or increase during perimenopause. I have a few theories based on the limited information we currently have and my own experiences.

However, first let's broaden the scope of this question and examine the general reasons why tinnitus can occur.

1. Exposure to loud noise

2. Ear blockages like ear wax. It’s possible to have increased ear wax production in perimenopause.

3. Blood vessel disorders

4. Some medications can increase ear noise³

5. Jaw clenching and grinding (TMJ)

6. Becoming sensitive to brain activity sounds

7. Hearing loss can cause tinnitus and tinnitus can cause hearing loss

For us in perimenopause, it may be due to fluctuating hormones affecting our auditory nerves, our blood flow, our muscles, inner ear fluid levels, or something else.

A timely update! A just-published cohort study on Dec 3, 2024 by South Korean researchers showed an increased risk of tinnitus in GERD sufferers (GERD = acid reflux). They aren’t sure yet if GERD causes tinnitus, but they seem to be linked. ⁴

Potential Treatments

There is also little known about effective treatments for tinnitus. Nothing so far has been shown to be consistently effective. Some studies show that hormone therapy can help reduce tinnitus, and some studies show that it can increase tinnitus.

I’m not saying I agree or disagree with the below treatments, but this is what I know about what is currently available.

Some suggestions include:

• Relaxation techniques

• White noise machines and music (personally, I hate this recommendation; it’s like putting gasoline on a fire)

• Tinnitus retraining therapy, which is a combination of therapy and sound therapy to reduce the signals in your brain that can cause tinnitus

• Hypnotism

• Acupuncture

• Craniosacral therapy

• Cognitive behavioral therapy

• Correcting a suspected vitamin deficiency

• Tinnitus supplements

My Experience

I’ve experienced tinnitus for a long time, but it started to worsen around 2019. Since then, it has significantly increased in intensity the deeper I get into perimenopause, to the point where my hearing is now affected.

I have what is known as reverse slope hearing loss, which is less common than the age-related hearing loss that typically affects high-pitched sounds. As a result, I struggle to hear low-pitched sounds because the tinnitus drowns them out.

Hearing aids are not very helpful for me because they are designed primarily for high-pitched sounds. Consequently, I’ve become skilled at lip reading.

Things I can’t hear:

• rain

• owls

• the dryer

• some male voices

• soft or mumbled sounds

• voices when there is background noise

• distant voices

• the refrigerator humming

• the dishwasher running

Despite how many times I say “What?” to my family, they still believe I can hear them when they continue speaking to me while walking into another room.

I've realized that the situation has become serious enough that I need to make an effort to figure it out myself.

I believe my tinnitus is most likely caused by either jaw clenching, which puts pressure on my jaw and affects the nerves in my ears and muscles in my neck, or it's due to my brain being so busy lately, making me more sensitive to the sounds produced by my own brain.

The most probable explanation seems to be the jaw clenching or TMJ issues. I discussed this with my dentist, who was quite impressed by the strength of my jaw muscles (should I flex them for you?). She recommended a night guard because my clenching has caused a small crack in one of my back teeth.

She gave me a mini neck massage, and I suggested that she offer this as an add-on treatment. I really love my dentist! She used to provide paraffin wax hand treatments prior to Covid. Who says going to the dentist can’t feel like going to a spa?

Did you know that your teeth shouldn’t touch in a properly positioned resting jaw? Also, the tip of your tongue should be on the roof of your mouth behind your front teeth and your lips should be gently touching. Tell this to my mouth!

I’m going for my annual hearing exam and appointment with my ear, nose, and throat doctor (ENT) soon. She knows I’m struggling, but there’s little she can offer for evidence-based medicine recommendations.

Tinnitus has a nice ring to it

People are often surprised by my bubbly personality when I start talking because if you were to happen upon me sitting by myself, you’d see my mean, resting face. This is just me deep in thought and clenching my jaw, which makes me look like I’m scowling. Plus, I can’t hear you approaching, so I don’t know you’re there.

One of my favorite songs is Everybody’s Talkin’ by Harry Nilsson… “Everybody’s talkin’ at me. I can’t hear a word they’re saying. Only the echoes of my mind.”

I’ve already tried some of the above suggestions with no improvement, and some even made it worse temporarily. Maybe this is why I love writing so much – I don’t need my ears to do it.

I’ll keep trying to find solutions, and I’ll update you all at some point. Hopefully, the night guard will reduce the tinnitus.

“Everybody’s talkin’ at me. I can’t hear a word they’re saying.
Only the echoes of my mind.” - Harry Nilsson

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Be well, stay cool…

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1. SOURCE: Lutton, Logan. “International Menopause Market Expected to Reach $27.63 Billion by 2033.” Managed Healthcare Executive, 25 Nov. 2024, www.managedhealthcareexecutive.com/view/international-menopause-market-expected-to-reach-27-63-billion-by-2033. Accessed 9 Dec. 2024.

2. Tinnitus is pronounced both “tin-neye-tus” or “tinn-a-tus”. I prefer tin-neye-tus. Tomato - Tom-ato.

3. https://www.goodrx.com/health-topic/ear/these-prescriptions-may-cause-ringing-in-the-ears

4. Kang SW, An MH, Ha S, Kim MG, Park TJ, Kim HK, Sheen K, Park RW, Park SS. Association between gastroesophageal reflux disease and tinnitus in a nationwide population-based cohort study. Sci Rep. 2024 Dec 3;14(1):30106. doi: 10.1038/s41598-024-81658-7. PMID: 39627428; PMCID: PMC11615245.