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Hormone Replacement Therapy (HRT) and Ear Pain

by Neil Bauman, Ph.D.

A lady explained:

I have recently started taking HRT [hormone replacement therapy] (estrogen only) via a transdermal patch 50mcg, for the last 11 weeks. Since starting HRT I have had a constant pain deep inside my left ear, with intermittent nerve pain radiating behind the ear. It can happen anytime and last from 1 min to 1 hr to all day.

My doctor has examined my ear but can not find anything wrong. I decided to stop the HRT for one week. The pain subsided quite dramatically, however my menopausal symptoms got worse. My doctor suggested I start a lower dose 25mcg. With the lower dose, the pain is mild compared to what it was, (I can live with it), the pain behind the ear has gone and my menopausal symptoms are manageable.

Do you think HRT could have caused this ear problem?

I haven’t heard of ear pain specifically associated with HRT, although it is a reported side effect of Progesterone and a number of “hormone” drugs, so I wouldn’t be at all surprised if that is what is happening. (Incidentally, a number of antidepressants have ear pain as a side effect too—all the SSRIs for example.)

The fact that when you stopped the HRT the pain went away is very strong circumstantial evidence that the pain was indeed related to the HRT. Also, the fact that the pain came back when you restarted the HRT is strong corroborating evidence. The clincher is that taking a reduced dose gives you reduced pain.

Obviously, taking the lowest dose that will control most of your symptoms is a wise way to go. Alternately, you could dump the HRT completely and use alternate medicine—herbals, etc. which can help relieve your symptoms without the painful side effects.

Reader Interactions

Comments

  1. carrie says

    February 20, 2010 at 6:03 AM

    I started hrt combined and within 10 days ear drumming started,I think there is a connection although my doctor says otherwise so I have now stopped hrt to see if the ear trouble subsides.

    Reply
  2. Susan says

    June 26, 2012 at 4:45 PM

    I have been using a patch (Climara) and now I know why I have been getting a right ear pain. I did not think it was the patch but having been off it for only one day the ear pain is subsiding.

    Reply
  3. Melissa Cotter says

    August 12, 2017 at 2:27 AM

    I’ve been on hrt patches for 2 weeks now and the inside of my left ear feels fuzzy as if it’s full of cotton wool that’s also tickling it. I just worry if it could be a warning sign of something else as I know that hrt can sometimes increase the risk of having a stroke.

    Reply
    • Neil Bauman, Ph.D. says

      August 13, 2017 at 9:42 AM

      Hi Melissa:

      Are you meaning sounds seem fuzzy and you cannot understand speech as well as you used to–this could be the beginning of hearing loss and can be one of the side effects of HRT therapy.

      Cordially,

      Neil

      Reply
      • Jennifer says

        March 5, 2021 at 9:37 AM

        Hey Dr. Bauman. I had early menopause due to a necessary hysterectomy. I woke up with the estradiol patch on, and I’ve used it ever since. It’s been great, but my tinnitus has been gradually getting worse. Is it because my estrogen is high or low (lower than it was pre-hysterectomy?)

        Reply
        • Neil Bauman, Ph.D. says

          March 7, 2021 at 12:46 PM

          Hi Jennifer:

          I’m not sure that your tinnitus is a result of a change in estrogen levels at all. The Estradiol drug itself is listed as causing tinnitus in hundreds upon hundreds of women. So the patch itself may be the culprit.

          Cordially,

          Neil

          Reply
  4. Kerry says

    July 19, 2020 at 5:40 PM

    I just started hormone vaginal inserts and I have horrible left inner ear pain. I am on day 5 of a 14 day treatment and wonder if I should stop. plus, increased nervousness and anxiety with loss of appetite.

    Reply
    • Neil Bauman, Ph.D. says

      July 20, 2020 at 9:18 AM

      Hi Kerry:

      Whether you stop or not is up to you of course. The Progestins can indeed cause ear pain, not to mention hearing loss. One lady, who lost most of her hearing to HRT, summed up her situation as, “[in retrospect] my life would have been much easier if I’d just withstood the hot flashes and not medicated them away!”

      Hopefully, if you stop, your ear pain will go away in a day or so like others have reported.

      Cordially,

      Neil

      Reply
  5. Pam says

    May 2, 2021 at 3:28 PM

    Hello, I was put on medeoxyprogesterone for excessive bleeding. So far I have been taking 10mg once daily for last 30 days. Suddenly since 5 days ago I started having a buzzing sound in my ear. If I stop the medroxyprogeterone will this buzzing go away?

    Reply
    • Neil Bauman, Ph.D. says

      May 2, 2021 at 3:47 PM

      Hi Pam:

      Medroxyprogesterone can certainly cause tinnitus in some people. Hundreds have reported this fact to the FDA’s data base. Hearing loss is another side effect reported by hundreds of women.

      Do you have any hearing loss as a result of taking the Medroxyprogesterone? If so, that could be a cause of the tinnitus. If you stop the drug and your hearing returns (assuming you lost some), the tinnitus could fade away as the hearing returns.

      If the tinnitus occurs just by itself, I can’t say whether it will stop when you stop the drug or not. Don’t have any specific information on this, but there is a good chance it will go away–my gut feeling. You can always try it and see.

      Cordially,

      Neil

      Reply
  6. Anne says

    May 8, 2021 at 4:53 PM

    I started HRT in July ear ringing a couple months after as well as bad pain in middle ears. Went to Dr. they said no problem with the ears. I went off HRT completely in March due to bad tinnitus/ menopause symptoms returned. Went back on HRT a month later- ear pain back again the very next day and worsening tinnitus. Now have gone cold turkey off HRT.

    Reply
  7. MONICA says

    July 29, 2021 at 8:36 AM

    Hi there.
    I began a low dose combo patch Estradiol roughly 5 months ago. The benefits of this have been great in terms of sleep, energy and mood. About one month ago I began to have some dizzy spells, and in the last ten days have fullness in both ears and quite a lot of discomfort. Two consults (not ENT) found no blockages or infections. One consult believes TMJ might be the culprit. Wondering if cutting the patch in two might lessen the ear trouble if HRT is indeed to blame. Im 49 and in good shape.

    Reply
    • Neil Bauman, Ph.D. says

      August 2, 2021 at 7:15 AM

      Hi Monica:

      Taking HRT drugs can cause various ototoxic side effects which I believe you are now experiencing. I don’t think this is related to TMJ. I don’t see anything wrong with halving the dose to see if that makes a difference to your ears. If not, you might want to go off the Estradiol completely and see whether your ears return to normal.

      Cordially,

      Neil

      Reply

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