From Pregnancy to Menopause: A Woman’s Hearing and Balance Journey

Women go through extraordinary changes over the course of their lives.

These hormonal changes most commonly occur during menstruation, pregnancy, postpartum, breastfeeding, return of menstrual cycles, use of contraception, fertility changes, perimenopause, and menopause. Most women will experience at least a few of these events which affect their hormones. However, there is one part of women’s health that is rarely included in the conversation: hearing and balance.

We tend to think of hearing as something that changes with age, while balance problems are often dismissed as something unrelated or temporary. Yet the auditory and vestibular systems, the systems involved in hearing and balance, are influenced by complex interactions between the inner ear, nervous system, circulation, and broader health.

Pregnancy: When the Body Changes, So Can the Inner Ear

For some women, pregnancy may coincide with changes in hearing, tinnitus, or balance. Others may notice that existing symptoms become more noticeable. This may be related to the inner ear’s sensitivity to changes in fluid balance and circulation. However, some women may experience dizziness during pregnancy for reasons unrelated to the inner ear, such as changes in blood pressure, blood sugar, anaemia, dehydration, or fatigue. The important message is this:

Dizziness during pregnancy should not automatically be assumed to be “just pregnancy.”

If dizziness is persistent, recurring, severe, or affecting daily life, it is worth discussing with a healthcare professional.

After Pregnancy: The Listening Load of Motherhood

The postpartum period brings a different kind of change. With a new baby to care for, broken sleep, breastfeeding, and emotional adjustments, concentration, listening and communication can become more difficult.

You may find yourself thinking:

“Why am I struggling to concentrate?”

“Why do conversations feel so exhausting?”

“Why do I keep asking people to repeat themselves?”

Sometimes the answer may simply be exhaustion. However, if hearing difficulties persist, it is worth considering whether there may be more to it.

Audiologists understand that hearing is not only about detecting sound. It is also about processing information, understanding speech, and making sense of what is happening around you. When you are already tired, stressed, and mentally overloaded, even a subtle hearing difficulty can make communication feel much harder.

The Years In Between: Protecting Your Hearing

Between pregnancy and menopause, women may move through many different stages of life, including career development, family responsibility, and other lifestyle changes. Through these changes, the constant is exposure to the everyday sounds of modern life.

Common activities may include use of headphones, attending fitness classes, loud playgrounds, traffic, and social events. Some of these activities may involve exposure to loud sounds that may contribute to hearing difficulties, regardless of age or gender. This is why hearing protection should be part of every woman’s long-term health habits. Such health habits may include the following:

Using appropriate hearing protection in loud environments.
Keeping personal listening devices at a comfortable volume.
Taking listening breaks.
Having your hearing assessed if you notice changes.
Paying attention to persistent tinnitus or sound sensitivity.

When Hormones Begin to Shift: Perimenopause

Perimenopause is the transition towards menopause, and it can begin earlier than many women expect. Fluctuating hormone levels related to perimenopause may result in changes in menstrual cycles and sleep patterns. Some women may also notice changes in their hearing or experience tinnitus or dizziness around the same time.

This connection between hormonal changes and hearing is complex and still being studied.

Hormones such as oestrogen affect many parts of the body, including the nervous and cardiovascular systems. Because the inner ear relies on these systems, hormonal changes may influence hearing, tinnitus, or balance for some women. However, there is no single explanation for every symptom. Therefore, new or ongoing symptoms should not simply be dismissed as “part of menopause.” Instead, ask yourself:

Could there be more than one reason for how I am feeling?

Menopause and Hearing: A Conversation Worth Having

By the time women reach menopause, usually between the ages of 45 and 55, hearing changes can become more common for many reasons. Some women report experiencing tinnitus or noticing changes in their hearing during this stage of life. Others may find that conversations become more difficult, particularly in restaurants, family gatherings, or other noisy environments. You may experience the following:

You may still hear sounds clearly but struggle to understand speech when there is background noise.
You may find yourself watching people’s faces more closely to follow what they are saying.
You may ask people to repeat themselves more often.
You may feel that listening takes more effort than it used to.

These are all reasons to consider having your hearing checked.

And Then There Is Balance

Hearing and balance are closely connected through the inner ear, and as women move through different hormonal stages, they may experience dizziness or changes in balance for many different reasons.

You may notice:

Feeling unsteady when walking
A sensation of spinning or vertigo
Feeling dizzy when turning your head or changing position
Feeling less stable on uneven surfaces
Increased difficulty balancing in the dark
A new fear of falling
Episodes of dizziness that keep returning

These symptoms can have many causes. The important thing is not to assume.

Balance problems deserve to be understood, not simply endured.

An audiologist with expertise in vestibular assessment can evaluate aspects of the balance system and help determine whether the inner ear may be contributing to your symptoms.

The Question We Should Be Asking More Often

Women’s health is often divided into separate conversations. Pregnancy belongs to one conversation, while menopause belongs to another. Hearing is seldom mentioned, and balance is discussed only when someone is already struggling. However, the body does not work in separate compartments. The systems that support hearing and balance are connected to the rest of the body, and women’s health changes throughout life.

When Should You Have Your Hearing or Balance Checked?

Consider speaking to an audiologist if you notice:

A change in your hearing
Difficulty understanding speech in noisy environments
Persistent or bothersome tinnitus
Sound sensitivity
Recurrent dizziness or vertigo
New or worsening balance problems
Unexplained changes in your ability to follow conversations

An assessment can help establish what is happening and whether further investigation or support is needed.

Your Health, Your Hearing, and Your Balance.

Women spend so much of their lives listening to others, that perhaps it is time to listen to themselves and their own health needs.

From the first hormonal changes of pregnancy to the transition through perimenopause and menopause, your body is constantly communicating with you. Sometimes, it may be telling you that you need more rest, and sometimes, it may be asking you to slow down.

Generally, however, a change in hearing, or onset of tinnitus, dizziness, or imbalance are worth investigating.

Your hearing and balance are part of your health story at every stage of life.

The next time you notice something feels different, do not automatically write it off as hormones, stress, ageing, or “just one of those things.” Caring for your hearing and balance is not just about protecting your ears. It is about supporting the woman you are—at every stage of your life!

You do not have to deal with this alone; we are here to help you. Our offices are conveniently located in Durbanville, Sea Point, Wynberg, Hout Bay and Noordhoek. Contact us at NB Hearing and Balance if you have any hearing and balance health concerns.