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.
I know this article is 3 years old, but I just thought I’d mention it doesn’t seem like you’ve taken into account that people go through hormonal changes during pregnancy, which can cause hearing loss. Just as people with hearing loss can lose more hearing when they go through puberty. Since she lost hearing DURING pregnancy, it has nothing to do with the strain of delivery. Anything having to do with the changing of hormones (i.e. birth control) can have an effect on hearing.
Hi Adriane:
You are correct that hormonal changes can affect hearing loss. I didn’t specifically mention that, but alluded to it as otosclerosis flares up due to hormonal changes. But as you say, hormonal changes alone can affect hearing.
Regarding EVA and the strain of delivery, I am trying to determine if the risk of increased hearing loss from labor and delivery is significant enough to go the c-section route. Do you have any thoughts on this? I don’t know if this site is still monitored at all but thought I’d ask. Thanks!
Hi Brittney:
I can understand your concern. But as I see it, you are only looking at the negative of possibly losing more hearing, but I don’t see that you are concerned about the negatives of having a “C” section on both your physical and emotional health and on your baby’s physical and emotional health. Many doctors may downplay that, but those side effects are very real.
From what I have read/studied over the years, I’d say those negatives outweigh the possible loss of more hearing. If I were in your shoes, I wouldn’t go for a “C” section unless something goes wrong with a vaginal birth so it becomes an emergency situation.
When you have EVA, you should already know how much straining or other things causes hearing loss and whether the resulting hearing loss is temporary or permanent. In my experience a lot of the time you lose quite a bit of hearing and much of it, but not all, comes back in a month or so. So even if you do have considerable hearing loss from the birthing experience, you could get a lot of it back so it isn’t as bad as you fear.
And there are always hearing aids and cochlear implants if it comes to that. It’s not going to be that you are left totally deaf with not options.
Cordially,
Neil