Aloufi Nada, Heinrich Antje, Marshall Kay, Kluk Karolina
Manchester Centre for Audiology and Deafness, Manchester Academic Health Science Centre, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.
College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia.
Front Hum Neurosci. 2023 Apr 21;17:1077409. doi: 10.3389/fnhum.2023.1077409. eCollection 2023.
First, to discuss sex differences in auditory function between women and men, and whether cyclic fluctuations in levels of female sex hormones (i.e., estradiol and progesterone) affect auditory function in pre-menopausal and post-menopausal women. Second, to systematically review the literature concerning the discussed patterns in order to give an overview of the methodologies used in research. Last, to identify the gap in knowledge and to make recommendations for future work.
Population, Exposure, Control, Outcome and Study design (PECOS) criteria were used in developing the review questions. The review protocol follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was pre-registered in the Prospective Register of Systematic Reviews (PROSPERO; CRD42020201480). Data Sources: EMBASE, PubMed, MEDLINE (Ovid), PsycINFO, ComDisDome, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, and scanning reference lists of relevant studies, and internet resources (i.e., Mendeley) were used. Only studies published between 1999 and 2022, in English, or in English translation, were included. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS).
Sex differences: Women had more sensitive hearing (measured at the level of peripheral and central auditory system) than men. Cyclic fluctuations: Auditory function in women fluctuated during the menstrual cycle, while no such fluctuations in men over the same time period were reported. Hearing sensitivity improved in women during the late follicular phase, and decrease during the luteal phase, implying an effect of female sex hormones, although the specific effects of estradiol and progesterone fluctuations on the central auditory system remain unclear. Hearing sensitivity in women declined rapidly at the onset of menopause.
The review has shown the following. Consistent sex differences exist in auditory function across the auditory pathway with pre-menopausal women often showing better function than age-matched men. Moreover, pre-menopausal women show fluctuations in hearing function across the menstrual cycle with a better function during the peak of estradiol or when the ratio of estradiol to progesterone is high. Third, menopause marks the onset of hearing loss in women, characterized by a rapid decline in hearing sensitivity and a more pronounced loss than in age-matched men. Finally, the systematic review highlights the need for well-designed and -controlled studies to evaluate the influence of estradiol and progesterone on hearing by consistently including control groups (e.g., age-matched man), using objective tests to measure hormonal levels (e.g., in saliva or blood), and by testing participants at different points across the menstrual cycle.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201480, identifier CRD42020201480.
第一，探讨男性和女性听觉功能的性别差异，以及女性性激素（即雌二醇和孕酮）水平的周期性波动是否会影响绝经前和绝经后女性的听觉功能。第二，系统回顾有关上述模式的文献，以概述研究所采用的方法。第三，找出知识空白并为未来的研究工作提出建议。
在制定回顾问题时采用了人群、暴露因素、对照、结局和研究设计（PECOS）标准。该回顾方案遵循系统评价与Meta分析的首选报告项目（PRISMA）指南，并已在系统评价前瞻性注册库（PROSPERO；CRD42020201480）中预先注册。数据来源：使用了EMBASE、PubMed、MEDLINE（Ovid）、PsycINFO、ComDisDome、CINAHL、Web of Science、通过Cochrane图书馆获取的Cochrane对照试验中央注册库（CENTRAL），并查阅了相关研究的参考文献列表以及互联网资源（如Mendeley）。仅纳入1999年至2022年间发表的英文或英文翻译的研究。使用纽卡斯尔-渥太华量表（NOS）评估证据质量。
性别差异：女性的听力更敏感（在外周和中枢听觉系统水平进行测量）。周期性波动：女性的听觉功能在月经周期中会波动，而同期男性未报告有此类波动。女性在卵泡晚期听力敏感性提高，在黄体期下降，这意味着女性性激素有影响，尽管雌二醇和孕酮波动对中枢听觉系统的具体影响仍不清楚。女性在绝经开始时听力敏感性迅速下降。
该综述表明以下几点。整个听觉通路的听觉功能存在一致的性别差异，绝经前女性的功能通常比年龄匹配的男性更好。此外，绝经前女性的听力功能在月经周期中会波动，在雌二醇峰值或雌二醇与孕酮比值较高时功能更好。第三，绝经标志着女性听力损失的开始，其特征是听力敏感性迅速下降，且比年龄匹配的男性损失更明显。最后，该系统综述强调需要精心设计和严格控制的研究，通过始终纳入对照组（如年龄匹配的男性）、使用客观测试来测量激素水平（如唾液或血液中的水平）以及在月经周期的不同时间点对参与者进行测试，来评估雌二醇和孕酮对听力的影响。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201480，标识符CRD42020201480 。
