More Hearing Loss with Each Pregnancy—What’s Going On?

by Neil Bauman, Ph.D.

A lady wrote:

I am a 30 year old female who received my first hearing aid at 8 years old. I had a stapedectomy at age 17. I was told I had congenital fixation of my stapes and bilateral vestibular aqueduct syndrome and some nerve damage. I have a combination of sensorineural and conductive hearing loss. My hearing was pretty stable until pregnancy at which point we have noticed a pattern where during pregnancy it gets worse, then it gets a little better after pregnancy but does not return to the way it was before pregnancy. (There have been four pregnancies). I am wondering if there are any options for me in terms of restoring my hearing, or if I should not have any more children. Is there a possibility that birth control will also affect my hearing? At this point my hearing loss is becoming hard to handle, despite two top of the line hearing aids.

From what you have said, it appears that you have two conditions that can cause hearing loss.

First, you appear to have otosclerosis. The stapedectomy was to try to fix it. Interestingly enough, otosclerosis often first shows up at puberty (hence your need for a stapedectomy at 17), then worsens with each pregnancy (as you have found so far) and has one final crack at the cat at menopause.

Second, it appears you also have Large Vestibular Aqueduct Syndrome (LVAS). I assume by “bilateral vestibular aqueduct syndrome” you really mean large (or enlarged) vestibular aqueduct syndrome (LVAS/EVAS). With LVAS you can lose hearing from atmospheric and other pressure changes. In your case, straining during childbirth could have caused a drop in hearing. Sometimes the hearing comes back, or  partially comes back, in a couple of weeks or so. Again, this might have happened in your case as well although I have never heard of a person having both otosclerosis and LVAS.

Typically, the otosclerosis causes a conductive hearing loss, while LVAS causes a sensorineural hearing loss.

Now to answer your real questions—whether there are any options for you in terms of restoring your hearing, and whether you should have any more children or not.

Often otosclerosis can be helped by surgery (stapedectomy). Sometimes bone eventually overgrows the prosthesis so another surgery may be necessary. I’d talk it over with your ear specialist and see whether having more surgery would likely help restore the conductive component of your hearing.

As for the sensorineural component of your hearing, there is nothing medically doctors can do for you.

On the question of having more children, that is up to you of course. My viewpoint is have as many children as you want in spite of losing more hearing with each pregnancy. You already know that you can cope—not that it is easy—but you can do it.

You also asked, “Is there a possibility that birth control pills will also affect my hearing?”

Good thing you asked this question as it appears not many people seem to know the answer. Any birth control pills containing Estradiol, or any HRT (hormone replacement therapy) pills containing Estriol can definitely harm your hearing if you have otosclerosis. In my book, “Ototoxic Drugs Exposed” I have this warning for both of these drugs. It reads: “Warning—if you have otosclerosis you should not use Estradiol/Estriol if you have a worsening of your otosclerosis, or if your otosclerosis deteriorates during pregnancy as you may experience a further drop in your hearing. If you do decide to take Estradiol/Estriol and have otosclerosis, you should be under close medical supervision. Furthermore, you should weigh the long term benefits against the risks to your hearing.”

Since your hearing loss is “becoming hard to handle, despite two top of the line hearing aids” you may want to investigate whether you are eligible for cochlear implants. They will bypass both your middle ear and inner ear and their various problems. I see that as a viable option for you.