Percepção do zumbido durante o ciclo menstrual

Abstract

The fluctuation in gonadal steroid hormone levels, which occurs during the menstrual cycle, may influence the auditory function and perception of tinnitus. However, the specific mechanisms have not been fully elucidated. This study aimed to investigate the relationship between sex hormones and tinnitus with emphasis on the menstrual cycle. In this paper two articles were developed: the first is a systematic review, titled "Sexual Hormones and Tinnitus: A Systematic Review," which aimed to review the scientific literature to verify the interference of sex hormones in tinnitus perception. The final sample consisted of 13 articles. It has been found that tinnitus may undergo changes during the menstrual cycle, being exacerbated in the premenstrual periods and at the beginning of menstruation; Had a higher prevalence in pregnant women; Was the most common hearing complaint during pregnancy and symptom present at menopause; Phytotherapics used for hormone replacement in menopausal women decreased the intensity of tinnitus; Traditional hormone replacement therapy with synthetic steroids had a significant effect in patients who already had tinnitus or triggered tinnitus and contraceptives favored the occurrence of tinnitus. The second article was developed with empirical data from a field survey, which aimed to investigate the perception of tinnitus during the menstrual cycle. Twenty-six individuals with tinnitus participated, of which 15 were female and 11 were male (control group). Initially, they underwent anamnesis, basic otorhinolaryngological and audiological evaluation. The selected volunteers were evaluated in two sessions during the menstrual cycle, in which the tinnitus evaluation tests were performed: acuphenometry, Visual Analog Scale and Tinnitus Handcap Inventory. To measure the level of estradiol, the blood was dosed in women. For men, the criterion for the division of sessions was only temporary. The analysis of the results showed that tinnitus occurred more consistently in men and presented intensity variation only in the group of women being intensified in the menstrual cycle phase with lower levels of estradiol. Considering the results of the two articles, it can be concluded that fluctuations of sex steroid hormones in women, whether during the menstrual cycle, pregnancy, menopause or in their therapeutic use, may exert an interference on tinnitus. The change in internal ear homeostasis is the underlying mechanism pointed to tinnitus changes that occur not only in the cycle but also in pregnancy and menopause; The tinnitus shows variations of its intensity during the menstrual cycle that can be related to the cyclical fluctuation of the feminine sexual hormones and the neuroprotective role of estradiol on the auditory system; The neuroprotective role of estradiol on the auditory system may be related to certain physiological hormone levels that need to be better identified.