Menopause may be a risk factor for hearing loss, and postmenopausal hormone therapy (HT) has been proposed to slow hearing decline; however, there are no large prospective studies. We prospectively examined the independent relations between menopause and postmenopausal HT and risk of self-reported hearing loss.
Prospective cohort study among 80,972 women in the Nurses’ Health Study II, baseline age 27 to 44 years, followed from 1991 to 2013. Baseline and updated information was obtained from detailed validated biennial questionnaires. Cox proportional-hazards regression models were used to examine independent associations between menopausal status and postmenopausal HT and risk of hearing loss.
After 1,410,928 person-years of follow-up, 18,558 cases of hearing loss were reported. There was no significant overall association between menopausal status, natural or surgical, and risk of hearing loss. Older age at natural menopause was associated with higher risk. The multivariable-adjusted relative risk of hearing loss among women who underwent natural menopause at age 50+ years compared with those aged less than 50 years was 1.10 (95% confidence interval [CI] 1.03, 1.17). Among postmenopausal women, oral HT (estrogen therapy or estrogen plus progestogen therapy) was associated with higher risk of hearing loss, and longer duration of use was associated with higher risk (P trend < 0.001). Compared with women who never used HT, the multivariable-adjusted relative risk of hearing loss among women who used oral HT for 5 to 9.9 years was 1.15 (95% CI 1.06, 1.24) and for 10+ years was 1.21 (95% CI 1.07, 1.37).
Older age at menopause and longer duration of postmenopausal HT are associated with higher risk of hearing loss.
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1Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
2Harvard Medical School, Boston, MA
3Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Vanderbilt University School of Medicine, Nashville, TN
4Department of Biostatistics
5Department of Epidemiology, Harvard School of Public Health, Boston, MA
6The Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, Boston, MA
7Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Address correspondence to: Sharon G. Curhan, MD, MSc, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115. E-mail: SCurhan@partners.org
Received 6 November, 2016
Revised 24 January, 2017
Accepted 24 January, 2017
Author contributions: There were no contributors to the manuscript who do not meet the criteria for authorship.
S.G.C.—conception and design of study, acquisition, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript, statistical analysis, obtaining funding; A.H.E.—interpretation of data, critical revision of manuscript, statistical analysis; B.M.L.—interpretation of data, critical revision of manuscript; M.W.—analysis and interpretation of data, critical revision of manuscript, statistical analysis; R.D.E.—conception of study, critical revision of manuscript, obtaining funding; G.C.C.—conception and design of study, critical revision of the manuscript, statistical analysis, obtaining funding, supervision.
S.G.C. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding/support: This work was supported by grants DC 010811 and UM1 CA 176726 from the National Institutes of Health.
Financial disclosures/conflicts of interest: S.G.C. is a consultant for Decibel Therapeutics. A.H.E. has no conflict of interest. B.M.L. has no conflict of interest. M.W. has no conflict of interest. R.D.E. has no conflict of interest. G.C.C. is a consultant for Decibel Therapeutics.
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