Tinnitus might not be one of the first symptoms people associate with perimenopause, but it is the focus of clinical audiologist and tinnitus specialist Kelly Henderson’s work.

Kelly supports and educates women who are struggling with tinnitus during the perimenopausal phase.

Alexander Clementine founder Alex Perry spoke with Kelly about tinnitus, unexpected changes involving the ears, hearing in noisy environments, auditory fatigue, when to seek professional help and how tinnitus can affect everyday life.

Key takeaways

Kelly Henderson discusses tinnitus as an often-overlooked part of the perimenopause conversation; women may also experience difficulty listening in noisy environments, dizziness, itchy ears or a feeling of fullness in the ears; new or worsening tinnitus should be professionally assessed rather than automatically attributed to menopause; tinnitus can affect work, daily life and sleep; support is individualised and can include CBT, breathing techniques and attention to stress; and Kelly’s central advice is to seek support early and “be kind to yourself.”

What menopause and hearing symptoms does Kelly think are being overlooked?

Kelly believes some menopause symptoms involving hearing and the ears do not receive enough attention.

Speaking specifically about tinnitus, she says women can still be told simply to live with it.

“It needs to be taken … a lot more seriously.”

Kelly says some women experience tinnitus for the first time during perimenopause, while others who already have tinnitus notice a change in it.

Her wider message is that women should know these experiences are worth discussing and seeking help for.

What unusual ear symptoms does Kelly see during perimenopause?

Tinnitus is the most obvious one from Kelly’s work.

But:

“It’s not as unusual as we think it is.”

She also mentions dizziness and lightheadedness.

Another symptom she hears about in clinic is:

“Itchy ears.”

Kelly says:

“Lots of women I’ve seen in clinic do say they have itchy ears.”

She also discusses a feeling of fullness in the ears.

Kelly describes this as something that may feel similar to having a blockage or wax in the ear.

Importantly, she does not believe every ear symptom should simply be assumed to be menopause-related.

“We can’t attribute everything to menopause.”

If symptoms persist, Kelly says further investigation may be needed.

What hearing changes can women notice?

One experience Kelly discusses is difficulty listening when there is a lot of background noise.

She gives examples including meetings and open-plan offices.

“They might struggle to listen when there’s lots of background noise.”

Kelly describes women trying to listen and understand conversation while simultaneously dealing with work, family responsibilities and other symptoms.

She uses the term auditory fatigue to describe some of this listening strain.

After spending the day concentrating on conversations and meetings, Kelly says some women come home already feeling mentally stretched.

Tinnitus can then add another sound for the brain to focus on.

For Kelly, this can make listening and understanding conversation feel increasingly difficult.

What is tinnitus?

Kelly defines tinnitus as:

“The perception of ringing, buzzing, hissing, whistling sounds not coming from anything around you.”

She says the sound is perceived internally rather than being produced by something in the surrounding environment.

Kelly also makes an important recommendation about new or changing tinnitus:

“The GP needs to be aware of new tinnitus, and worsening of tinnitus.”

What can contribute to tinnitus in midlife?

Kelly does not think tinnitus should automatically be attributed to one cause.

“You can’t pin it down to one thing.”

She talks about looking at an individual’s wider circumstances, symptoms and lifestyle.

Among the factors she discusses are sleep, stress and anxiety, alongside other health and lifestyle factors.

“There are lots of different things that can contribute to tinnitus.”

That means Kelly’s approach begins with understanding the individual rather than assuming that somebody’s tinnitus has one simple explanation.

How does Kelly approach tinnitus support?

Kelly describes tinnitus support as individualised.

She talks about cognitive behavioural therapy (CBT), breathing techniques and looking at factors that may increase somebody’s stress.

Kelly describes CBT in this context as:

“Changing your thought patterns.”

She explains that somebody may begin to repeatedly notice their tinnitus and develop increasingly negative thoughts around it.

Her approach is not to replace those thoughts with unrealistic positivity.

Instead, she talks about moving towards:

“More balanced and realistic”

thoughts about tinnitus.

Kelly is also clear that tinnitus therapy is a process.

“Nothing is gonna change overnight. It’s a process. It’s step by step.”

And:

“We can’t switch it off, but we can change our reaction to it.”

How can tinnitus affect everyday life?

Kelly has experienced tinnitus herself since she was a teenager and says hers became worse as she reached perimenopause.

She also sees people whose tinnitus has a much greater effect on their lives.

“It can affect their working life, their daily life.”

It can also:

“Affect their sleep.”

One difficulty is that tinnitus is invisible.

“People can’t see it.”

Kelly says people may simply put up with the sound without telling others what they are experiencing.

Some wait until they feel they can no longer tolerate it before seeking help.

Her preference is for people to seek support earlier.

“Even if it affects you just a little bit, then just get some help with that.”

When should someone seek professional advice about tinnitus or hearing changes?

Kelly’s answer is clear:

“As soon as they experience anything like that, they should go and see a professional.”

She recommends seeing an audiologist, who can examine the ears and perform a hearing test.

Depending on what is found, she says somebody may also need further assessment or referral.

The important point for Kelly is not to ignore a new change.

She also believes there can be a gap between menopause and audiology conversations.

In her view, a GP working within a short appointment may not necessarily make a connection between a woman's wider perimenopausal experience and ringing in her ears.

Kelly says:

“That’s where we need to bridge that gap.”

How can partners support someone experiencing tinnitus?

Kelly’s advice begins with awareness and patience.

“Acknowledge what they’re going through.”

She also says:

“Don’t be patronising.”

If somebody has not understood what has been said, Kelly advises against dismissing it.

Instead:

“Just gently repeat it or rephrase it.”

She also suggests creating:

“A calming environment.”

After somebody has spent a busy day working and listening, Kelly sees value in giving them an environment where they can sit down and relax.

Her wider message is:

“You need to be supportive of it, and have a conversation.”

What can help someone struggling to listen at work?

Kelly gives several practical examples from the workplace.

If somebody works in an open-plan office, she suggests considering where they sit.

Positioning themselves away from constant movement and background noise may create an easier listening environment.

She also discusses noise-cancelling headphones, regular breaks and spending a few minutes somewhere peaceful.

For meetings, Kelly prefers environments that make listening easier.

“Small room, soft furnishings, sounds are absorbed… it just makes for a better listening environment.”

She also recommends speaking to a manager about what somebody is experiencing.

What is Kelly’s biggest piece of advice?

Kelly finishes with:

“Be kind to yourself.”

She encourages women to get the support they need and not expect everything to change immediately.

“Don’t rush it.”

Kelly believes women can be particularly hard on themselves while simultaneously managing work, family and responsibilities for other people.

She encourages seeking support at home, at work and for the tinnitus itself.

Her final message is:

“Take a step back, take a deep breath, and think, right, I’m just gonna look after myself.”

About Kelly Henderson

Kelly Henderson is a clinical audiologist and tinnitus specialist.

Her work includes educating and supporting women experiencing tinnitus during the perimenopausal phase, alongside assessing hearing and other ear-related concerns.

This conversation forms part of Alexander Clementine’s Expert Conversations, exploring menopause and women’s health through the perspectives of specialists working in different areas.