SUDDEN SENSORINEURAL DEAFNESS AND HORMONE REPLACEMENT THERAPY

Whilst the oral contraceptive pill (OC) has been implicated on a numbe r of occasions as a cause of sensorineural hearing loss, there are no published reports linking hormone replacement therapy (HRT) to otologi cal symptoms. A case of sensorineural loss with tinnitus following com mencement of HRT is described, followed by a discussion outlining the fundamental differences between the OC and HRT, thus explaining why a vascular aetiology is unlikely. It is hypothesized that otological sym ptoms in such cases may be due to the effect of oestrogens on electrol yte balance disturbing inner ear function and also a direct effect on the auditory pathways mediated in part by alterations in neurotransmit ter receptor concentrations.