Wednesday, February 25, 2004

More Bad News for Estrogen Users: It causes hearing loss:

The research team used three tests to compare the hearing of 32 women between the ages of 60 and 86 who had had HRT with 32 women of similar age who had not.

Among the women who had not received HRT, the researchers took into account normal age-related hearing loss when giving and evaluating the tests.

Two of the tests evaluated how the ear processes sound, and the other test evaluated how the brain processes sound, Frisina says.

Hearing loss among the women in the HRT group was most noticeable when background noise made understanding sentences difficult, such as in a crowd or at a party.

Women on HRT did poorly on all three tests, but it was on the test that evaluated how the brain processes hearing that women receiving HRT did the worst. Women in this group on average were 30 percent less effective in prioritizing and organizing sound, the researchers found.

Frisina speculates the hearing loss was caused either by the high dose of HRT given or the combination of estrogen and progesterone. "HRT apparently hurts the auditory system rather than helping it," he says.


The study was performed on a very small sample of women, and the results are being framed in terms of "percent increase" so it's hard to say how much real significance these findings have. To top it all off, the paper was presented at a conference rather than published, so it's impossible to scrutinize it. But the Health Daily Reporter at least got a second opinion:

Dr. Sandra L. McFadden, an associate professor at the Center for Hearing and Deafness at the State University of New York at Buffalo, says she "questions the validity of the study."

Despite the efforts to carefully match the two groups of women, "there may be important differences among the women comprising the two groups that account for the results, rather than the influence of HRT," she says.

McFadden adds that based on her experimental studies of hormonal treatment in chinchillas, "estrogen treatment has no effect on basic hearing sensitivity, but it can influence susceptibility to noise-induced hearing loss."

"Before I would be willing to put much stock in this study's findings, I would want to see them replicated," she says.


And good grief, if those hormones don't cause asthma, too:

In this new study, researchers found current use of estrogen alone was associated with a 2.29 times greater risk of asthma. Women who used estrogen plus progestin had a similar increased rate of newly diagnosed asthma.

Unfortunately, the abstract doesn't shed any light on the subject. (My issue of JAMA hasn't arrived yet.) It only presents the data in terms of relative risk rather than giving the actual numbers. Hard to say if this is a clinically significant finding. My guess is no, or they would have presented the data in a more straightforward manner.

One thing for sure, just as twenty years ago we were treated to papers of marginal quality touting the benefits of hormone therapy, today we're getting the opposite. It's so easy to make marginal data support a popular opinion. Hormones good, or hormones bad. Just depends on the prevailing bias.

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