Author ORCID Identifier

https://orcid.org/0009-0007-8041-5255

Date Available

5-10-2025

Year of Publication

2025

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Public Health

Department/School/Program

Gerontology

Faculty

Jennifer Shinn

Faculty

John Watkins

Abstract

Estrogen and progesterone have demonstrated modulatory effects on central auditory nervous system (CANS) function. Post-menopausal females often present to audiology clinics with complaints of difficulty hearing in background noise. However, these individuals often have normal peripheral hearing sensitivity on standard audiometry. Previous studies using the auditory brainstem response (ABR) in post-menopausal females demonstrated longer response latencies compared to their premenopausal counterparts, suggesting that sound does not transmit through the CANS as efficiently. However, to date, the available literature focused on sex hormones and the CANS relies mainly on objective measures, predominantly the ABR. The ABR reflects physiologic function through the inferior colliculus with no consideration for higher auditory processing centers. To date, the research does not adequately address the concerns of clinical populations nor does conventional audiometry. The purpose of this study is to examine the relationship between central auditory function and sex hormones, estrogen and progesterone, specifically as it relates to the primary auditory complaint of difficulty hearing in the presence of noise.

This prospective, cross-sectional study addressed the purpose in three ways: electrophysiologically, behaviorally, and perceptually. Twenty premenopausal females and 14 post-menopausal females were recruited for evaluation of central auditory processing (CAP) abilities. The participants were seen for two or three visits. Their initial visit included medical history, the Speech, Spatial and Qualities of Hearing questionnaire (SSQ) and a standard audiologic assessment to verify normal peripheral hearing sensitivity. The second and third visits consisted of a behavioral CAP test battery and the auditory P300 electrophysiological assessment in quiet and in background noise. The behavioral CAP battery included the following tests: Dichotic Digits, Duration Patterns, Quick Speech-In-Noise (QuickSIN), and the Listening in Spatialized Noise – Sentences (LiSN).

The study results demonstrated that premenopausal status and higher levels of estrogen and progesterone were associated with better listening abilities in background noise and utilization of spatial cues on the QuickSIN and LiSN. Higher scores on the SSQ spatial and quality subscales were associated with better talker and spatial advantages on the LiSN. Hormone concentrations did demonstrate a statistically significant positive correlation with P300 amplitude in the quiet condition only. There were no significant correlations between hormone concentrations and P300 latency or menopausal status and any P300 metric. The SSQ was not associated with response latency, however the spatial subscale and total were associated with amplitude in a +15 dB signal-to-noise ratio condition. Results of the study suggest that sex hormones and menopausal status maybe associated with spatial listening in complex environments with background noise.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2025.62

Funding Information

This study was supported by the University of Kentucky Center for Clinical and Translational Sciences Small Grant Award in 2024 and Jennifer Shinn, PhD, Endowed Chair of Otolaryngology in 2024.

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