Sex-Associated Differences in Age-Related Sensorineural Hearing Loss: Why Are Men More Vulnerable?
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic, physiological, and epidemiological literature without systematic review methodology.
PubMed 42533485 · doi:10.5534/wjmh.260126
What was done
This narrative review synthesized epidemiological, physiological, and mechanistic evidence to evaluate sex-associated differences in age-related sensorineural hearing loss (presbycusis) across the life course.
What was found
No quantitative effect sizes or numerical values were reported in the abstract. Reported findings include: female newborns exhibit larger otoacoustic emissions than males; adult men develop earlier and steeper high-frequency threshold declines than women; postmenopausal long-term oral estrogen or estrogen-progestogen therapy is associated with increased hearing loss risk rather than uniform protection; and in older men, higher serum testosterone (but not DHEA-S) is associated with lower odds of high-frequency hearing loss.
Why it matters
It provides a multi-hit framework linking endocrine and mitochondrial biology with occupational and lifestyle risks to explain male auditory vulnerability and justify risk-stratified screening in aging men.
Limits
The review relies on a narrative rather than a systematic methodology, omitting quantitative synthesis and risk-of-bias grading. The abstract reports no numerical data. Causal roles for sex steroid signaling in human cochlear protection remain unproven, and exogenous hormone therapies are not validated clinical treatments for hearing preservation.
Cited by
- contradicts Premenopausal women tend to have better hearing sensitivity on average than men, but postmenopausally their hearing thresholds catch up to men.