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Hormone Therapy May Damage Hearing

Study: Hormone Replacement Therapy With Progestin Harms Hearing; Some Skeptical
WebMD Health News
Reviewed by Louise Chang, MD

Sept. 5, 2006 - Middle-aged women who take certain types of hormone replacement therapy may suffer some hearing loss as a result, new research suggests. But not all are convinced.

Women in the study who took hormone replacement therapy that included progestin along with estrogen performed worse on hearing tests than women who did not take hormone therapy and those who took estrogen alone.

Researcher Robert D. Frisina, PhD, tells WebMD the hearing loss attributable to progestin use was in the range of 10% to 30%.

It is not clear, however, if length of time on progestin therapy impacts risk, Frisina says, or if the hearing loss reverses when treatment is stopped.

The study was published Tuesday in the Proceedings of the National Academy of Sciences.

"Our findings suggest that this is one more possible side effect that women should consider when they make their decision about whether or not to take hormone therapy with progestin," Frisina says. "That is particularly true for women who already have some hearing loss."

However Wendy Klein, MD, FACP, senior deputy director of the Institute for Women's Health at Virginia Commonwealth University, says the study was too small and had too many other limitations to provide useful information to women considering such therapy.

Smallest Doses, Shortest Time

Hormone therapy -- estrogen plus progestin for women who have not had hysterectomies, and estrogen alone for those who have -- is widely regarded as the most effective treatment for hot flashes and other symptoms related to menopause.

For women with an intact uterus, the addition of progestin in hormone replacement therapy reduces the risk of uterine cancer from estrogen.

But hormone therapy use plummeted virtually overnight in the summer of 2002 with the publication of a large, government-run study linking hormone therapy with an increased risk of heart attacks, strokes, blood clots, and breast cancer.

Experts now recommend that women take the smallest doses of hormone therapy they can for the shortest time necessary to effectively treat menopausal symptoms.

Frisina speculates that progestin may damage hearing by impairing hearing-related nerve cell receptors within the ear and brain.

He recommends that women who are considering taking progestin have a hearing test before starting treatment. They should then be tested on a regular basis every six months or so, while they are on the hormone, he says.

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