Tinnitus, Headaches, Migraines, and Menopause: What’s the Connection?
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Dr. Julie Prutsman
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If you’re going through perimenopause or menopause and have noticed ringing in your ears, more frequent headaches, or changes in your migraines, you’re not alone. Some women notice tinnitus (ringing, buzzing, or humming in the ears) beginning during this stage of life, becoming more noticeable, or coming and going alongside headaches.
Could hormonal changes be playing a role?
Research is beginning to reveal a possible connection between tinnitus, migraines, and menopause. Although we don’t yet know exactly how these conditions are related, the findings offer important insights into what women may experience during this transition, and why these symptoms deserve attention.
As a clinical audiologist specializing in tinnitus, I’ve worked with women experiencing everything from occasional ringing to persistent tinnitus that affects their sleep, concentration, and quality of life. Understanding the possible connections between tinnitus, headaches, and hormonal changes can help women make informed decisions about their care.
What Does the Research Say About Tinnitus and Migraines During Menopause?
Perimenopause typically begins in a woman’s 40s and can last several years. During this time, estrogen and progesterone levels fluctuate before declining as menopause approaches. Menopause is defined as 12 consecutive months without a menstrual period and occurs at an average age of about 51.
These hormonal changes can affect many parts of the body, including sleep, mood, temperature regulation, and bone health. They may also influence headache and migraine patterns. Given how widespread these changes can be, it’s reasonable to wonder whether they might affect the ears and the way the brain processes sound.
Several studies suggest that tinnitus and migraines may be connected.
Tinnitus and Headaches: What One Study Found
A US study examined 2,485 perimenopausal and postmenopausal women and found a significant link/association between tinnitus and severe headache or migraine symptoms.
Compared to women without tinnitus, peri- and postmenopausal women with occasional, intermittent or constant tinnitus were all more likely to report severe headaches or migraine symptoms. Interestingly, the strongest association was found among women with intermittent tinnitus, who had 2.62 times the odds of reporting severe headache or migraine symptoms.
As a clinician, I find this particularly interesting because I frequently hear from women who experience intermittent tinnitus alongside significant headaches or migraines. Because this type of tinnitus comes and goes, it can sometimes be overlooked or dismissed.
These findings suggest that intermittent tinnitus is worth discussing with a healthcare professional, especially when it occurs alongside headaches or migraines.
Other Research Points to a Similar Connection
A separate, smaller study of women experiencing menopausal symptoms found that a history of headaches was significantly more common among women with tinnitus. Although the study could not establish cause and effect, its findings add to the growing evidence of a possible relationship between tinnitus and headaches.
The connection may extend beyond menopause, too. A systematic review involving more than 26,000 participants found that migraines were associated with both tinnitus and hearing loss.
Could Hormonal Changes Be Part of the Connection?
One possible explanation involves estrogen, a hormone that plays a role in many systems throughout the body. Estrogen influences the nervous system, blood vessels and inflammatory processes. Estrogen receptors are also present in the auditory system, so it’s biologically plausible that changes in estrogen could affect how the ear and brain respond to sound.
As estrogen levels fluctuate and ultimately decline during menopause, changes in blood flow, neural activity, inflammation, sleep, stress, and sensory processing could potentially influence tinnitus in some women.
But we must be careful not to oversimplify. Tinnitus is a complex condition. Hearing loss, noise exposure, medications, neurological activity, stress, sleep, migraine, cardiovascular factors, jaw or neck problems, and other variables can contribute to tinnitus or change how strongly someone perceives it.
Researchers are also investigating whether neuroinflammation (inflammation involving the nervous system) plays a role in tinnitus. However, exactly how inflammatory processes contribute to tinnitus in humans remains an active area of research.
The bottom line is that hormonal changes may be one piece of the puzzle, but they are unlikely to explain every case. Understanding your individual symptoms and health history is essential to finding the right approach to care.
What Does This Mean for You?
These studies suggest tinnitus and migraines may be related, but they don’t explain why. They do not prove that migraines cause tinnitus, that tinnitus triggers migraines, or that menopause directly causes either condition. Instead, the findings suggest these symptoms may share underlying biological processes that researchers are investigating further.
Understanding those processes could eventually help researchers identify better ways to evaluate and manage tinnitus in women experiencing hormonal changes.
What About Hormone Replacement Therapy and Tinnitus?
If hormonal changes may contribute to tinnitus in some women, could hormone replacement therapy help? The answer is complicated because research on hormone replacement therapy (HRT) and tinnitus has produced mixed results.
What the Studies Have Found
A large study of menopausal women in Taiwan compared 13,920 women who used HRT with 41,760 women who did not. Researchers found that women using HRT had lower rates of tinnitus and concluded that HRT might have a protective association.
However, another study of 2,736 postmenopausal women in Korea found a different result. In that group, longer-term HRT use was linked to a higher rate of tinnitus. Women who had used HRT for more than 10 years had more tinnitus than women who had never used it. Because this second study looked at participants at a particular point in time, it could identify an association but could not establish that HRT caused tinnitus.
A small preliminary study also suggested that hormone therapy might improve menopause-related tinnitus in some women.
Can HRT Help Tinnitus?
Right now, we simply don’t have enough evidence to say HRT consistently helps tinnitus, or that it consistently makes tinnitus worse. The relationship may depend on several factors, including the type of hormone therapy, duration of treatment, individual health history, hearing status, and migraine history. More research is needed to understand whether and how hormone therapy affects tinnitus.
HRT can be an appropriate treatment for certain menopausal symptoms in some women. The decision to start, change, or discontinue hormone therapy should be made with a physician who understands your overall medical history. Tinnitus alone should not be the deciding factor.
Can Tinnitus Sound Therapy and Hearing Treatment Help?
Although researchers continue to investigate the relationship between tinnitus, migraines, and menopause, treatment options can help people manage tinnitus today.
In my clinical practice, I've worked with younger women who experience intermittent tinnitus alongside severe headaches, as well as postmenopausal women with more persistent symptoms. I've seen some patients experience substantial improvement with individualized sound therapy and, when appropriate, hearing aids.
The goal is not simply to cover up the tinnitus. It’s to help make the sound less intrusive and reduce the stress it causes. And the good news – it works!
How Does Sound Therapy Work?
Tinnitus often becomes more noticeable in quiet environments, when there is little external sound to compete with it. Sound therapy introduces comfortable, carefully selected sounds that can make the contrast between tinnitus and the surrounding environment less pronounced.
Over time, appropriate sound enrichment may also help some people become less reactive to their tinnitus. The goal is to make the sound easier to live with, rather than to force it to disappear.
The right approach depends on the individual. Some people benefit from environmental sounds or sound-generating devices, while others may need a more structured tinnitus-management plan.
Can Hearing Aids Help?
For people who have hearing loss alongside tinnitus, hearing aids may be particularly helpful.
Hearing aids make external sounds easier to hear, which can make tinnitus less noticeable for some people. They may also improve communication and reduce the effort involved in listening throughout the day, which is known to trigger tinnitus spikes.
Even relatively minor hearing changes are worth evaluating when tinnitus is present. An audiologist who specializes in tinnitus management is an excellent addition to your medical team whenever tinnitus is present. It may be even more important during the menopausal years to add the expertise of a tinnitus-certified audiologist to put the whole picture together.
We do know that tinnitus management can involve several approaches, including sound enrichment, hearing aids when appropriate, education, counseling, and cognitive behavioral therapy (CBT).
In fact, the 2026 Clinical Practice Guideline for Tinnitus, published by the American Academy of Otolaryngology–Head and Neck Surgery Foundation and endorsed by the American Academy of Audiology and other organizations, recommends a comprehensive approach to tinnitus care. Recommendations include audiologic evaluation, hearing aid evaluation, cognitive behavioral therapy, and sound enrichment.
These treatments are customized around an individual patient’s hearing, tinnitus, sound tolerance, lifestyle and symptoms. When done under the correct care of an audiologist who specializes in tinnitus, these treatments are incredibly effective.
Tinnitus During Perimenopause or Menopause Should Not Be Dismissed
If your tinnitus began or changed around the same time as headaches, migraines, menstrual changes, hot flashes, sleep disruption, or other symptoms of perimenopause or menopause, that information is worth discussing with your healthcare providers.
That timing doesn’t necessarily mean hormones are causing your tinnitus, but it may be an important clue worth paying attention to.
A thorough tinnitus evaluation involves more than asking whether you can hear a beep during a hearing test. It should consider your hearing, tinnitus pattern, sound tolerance, medical history, medications, headache or migraine history, sleep, stress, and other factors that could contribute to your symptoms.
If you’ve been told nothing can be done for your tinnitus, or that you simply must accept it because you are getting older or going through menopause, consider seeking another opinion from an audiologist who regularly evaluates and treats tinnitus specifically.
Tinnitus may not always disappear completely, but that doesn’t mean you have to manage it without support. The right evaluation and treatment plan can help reduce its impact on your daily life, no matter the cause.
I’ve dedicated my career to tinnitus advocacy and helping people find relief. At Sound Relief, our team provides comprehensive, personalized care at our Colorado and Arizona locations, welcoming patients from across the country. If tinnitus is affecting your life, we’d love the opportunity to help you find relief, too.
The Bottom Line
Tinnitus, headaches, migraines, and menopause may be connected in ways researchers are only beginning to understand. Hormonal changes could play a role for some women, but tinnitus is complex, and no single explanation applies to everyone.
If you've noticed changes in your tinnitus during perimenopause or menopause, pay attention to the pattern and discuss it with your healthcare providers. Understanding your hearing, medical history, migraine symptoms, sleep, and other potential contributing factors can help guide your care.
Most importantly, don't assume that tinnitus is simply something you have to live with as you get older. With an appropriate evaluation and an individualized treatment plan, there are ways to make tinnitus less intrusive and improve your quality of life.
Frequently Asked Questions About Tinnitus, Migraines, and Menopause
Can Perimenopause or Menopause Cause Tinnitus?
Hormonal changes during perimenopause and menopause may contribute to tinnitus in some women, but research has not established menopause as a direct cause of tinnitus. Tinnitus is usually multifactorial, so hearing changes, migraine, medication, stress, sleep, cardiovascular health, noise exposure, and other factors may be relevant to you.
Are Tinnitus and Migraines Connected?
Research suggests an association between migraine and tinnitus. A systematic review found associations between migraine, tinnitus, and hearing loss, while a recent study of peri- and postmenopausal women found significantly greater odds of severe headache or migraine symptoms among women reporting tinnitus. These findings suggest a connection but do not establish that one condition causes the other.
Why Does My Tinnitus Come and Go with Headaches or Migraines?
Researchers do not yet know exactly why tinnitus fluctuates with migraine symptoms in some people. Possible explanations include interactions between the pathways that process hearing and facial stimulation (trigeminal pathways), changes in sensory processing, changes in blood flow, nervous system activity, inflammation, and other biological processes. Stress and disrupted sleep may also affect both conditions. If you notice a pattern, sharing it with your healthcare providers may help guide your evaluation and treatment.
Is Intermittent Tinnitus Common During Perimenopause?
Intermittent tinnitus can occur for many reasons. In a study of 2,485 perimenopausal and postmenopausal women, intermittent tinnitus had the strongest association with severe headache or migraine symptoms among the tinnitus patterns studied. This does not mean intermittent tinnitus is caused by menopause or migraines, but it is worth discussing, particularly if you also experience headaches or other new symptoms.
Can Hormone Replacement Therapy Help Tinnitus?
It’s possible that hormone therapy may affect tinnitus in some women, but the research is conflicting at this point. Some studies have associated HRT use with a lower rate of tinnitus, while another found an association between longer-term HRT use. HRT is not an established treatment for tinnitus. Discuss the potential benefits and risks with your physician before starting, changing or stopping hormone therapy.
Can Sound Therapy or Hearing Aids Help Menopause-Related Tinnitus?
Sound therapy and hearing technology may help reduce the impact of tinnitus regardless of whether hormonal changes contributed to its onset. Treatment should be individualized based on a comprehensive audiologic and tinnitus evaluation. Sound enrichment can make tinnitus less noticeable for some people, while hearing aids may help when hearing loss is also present. Cognitive behavioral therapy (CBT) can help reduce tinnitus-related distress. Finding an audiologist who specializes in tinnitus to assess and manage your tinnitus symptoms is key to tinnitus relief.
Will Tinnitus Go Away After Menopause?
There is no reliable way to predict whether tinnitus will resolve after menopause. Some tinnitus is temporary or fluctuating, while other tinnitus becomes persistent. Because tinnitus has many possible contributors, it’s best not to assume it will disappear once hormone levels stabilize. An expert evaluation can help identify potential causes and management options.
When Should I Have Tinnitus Evaluated?
If you develop new or bothersome tinnitus, arrange an evaluation with an audiologist. A comprehensive hearing assessment by an audiologist can identify hearing changes that might otherwise go unnoticed and help determine whether you need further medical evaluation.
Sudden hearing loss: Seek immediate medical attention, particularly if it occurs alongside tinnitus. Sudden sensorineural hearing loss is a medical emergency, and prompt treatment is important.
Tinnitus that pulses with your heartbeat: This type of tinnitus warrants medical evaluation because it can sometimes be associated with an underlying vascular or other medical condition.
Persistent tinnitus in one ear or tinnitus with unequal hearing between the ears: These symptoms should be assessed by an audiologist to determine whether further investigation is needed.
Tinnitus accompanied by new neurological symptoms: Seek urgent medical attention, especially if you experience weakness, facial drooping, difficulty speaking, or other sudden neurological changes.
References & Supporting Research
Tinnitus, Migraines, and Menopause
1. Jiang L, Cui Y, Du H. (2025).
Tinnitus constancy and self-reported severe headache or migraine symptoms in peri- and postmenopausal women: A statistical modeling and machine learning analysis.
European Journal of Medical Research, 31, Article 139.
Read the study – PubMed
A study involving 2,485 U.S. women that identified a significant association between tinnitus and severe headache or migraine symptoms, particularly among women experiencing intermittent tinnitus.
Preliminary analysis of risk factors of tinnitus related to female menopause.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 59(9), 916–921.
Read the study – PubMed
A preliminary clinical study investigating tinnitus in women with menopausal symptoms. Researchers identified a significant association between headache history and tinnitus.
3. Campello CP, et al. (2024).
Migraine associated with tinnitus and hearing loss in adults: A systematic review.
International Journal of Audiology, 63(1), 1–7.
Read the systematic review – PubMed
A systematic review of six studies involving 26,166 participants that found associations between migraine, tinnitus, and hearing loss.
Hormone Replacement Therapy and Tinnitus
Hormone replacement therapy decreases the risk of tinnitus in menopausal women: A nationwide study.
Oncotarget, 9(28), 19807–19816.
Read the study – PubMed Central
A nationwide retrospective cohort study comparing 13,920 HRT users with 41,760 nonusers. Hormone therapy use was associated with a lower incidence of tinnitus.
5. Lee SS, Han K, Joo YH. (2017).
Association of perceived tinnitus with duration of hormone replacement therapy in Korean postmenopausal women: A cross-sectional study.
BMJ Open, 7(7), e013736.
Read the study – PubMed Central
A study of 2,736 postmenopausal women that found an association between longer HRT use and increased tinnitus prevalence, highlighting the complexity of the relationship between hormone therapy and tinnitus.
A preliminary study of the treatment of chronic tinnitus in menopausal women.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 31(6), 419–422, 427.
Read the study – PubMed
A small preliminary clinical study examining hormonal treatment for menopause-related tinnitus. The findings suggested possible benefits for selected patients, although larger controlled studies are needed.
Tinnitus Treatment and Clinical Guidelines
7. Adams ME, et al. (2026).
Clinical Practice Guideline: Tinnitus Update.
Otolaryngology–Head and Neck Surgery, 175(Suppl. 1), S1–S62.
Read the clinical guideline – PubMed
An updated evidence-based clinical guideline addressing the evaluation and management of tinnitus, including audiologic assessment, hearing technology, cognitive behavioral therapy, and sound enrichment.
About the Author
Dr. Julie Prutsman, Au.D., CH-TM, is the founder and owner of Sound Relief Tinnitus & Hearing Center, an audiology practice specializing in tinnitus, decreased sound tolerance, and hearing healthcare. She has dedicated 20+ years to helping patients better understand and manage complex tinnitus and hearing concerns.
Clinical Review
This article was clinically reviewed for accuracy by Dr. Abby McMahon, Au.D., CCC-A, CH-TM, a Doctor of Audiology with Sound Relief Tinnitus & Hearing Center in Fort Collins, Colorado. Dr. McMahon has been working with patients experiencing tinnitus, hearing loss, and related hearing health concerns for the past 15 years.
