The Menopause–Hearing–Dementia Link No One Told You About | Dialed In Health

Does menopause cause hearing loss — and can untreated hearing loss really raise your risk of dementia? According to audiologist Dr. Mandy Rounseville-Norgaard, the answer to both is yes, and almost no one is connecting the dots. Dr. Mandy has worn hearing aids since she was three years old, and she has spent decades as an audiologist watching the same pattern play out: people notice something is off for years, the brain quietly works overtime to compensate, and the average person waits about 20 years from the first sign of hearing loss to the day they finally get tested. In this episode of Dialed In Health, host Melissa Goodwin sits down with Dr. Mandy at Audiology Associates in Sioux Falls, South Dakota (she also practices in Miramar Beach, Florida) to answer the hearing questions people actually search for — especially the ones women in perimenopause and menopause have never been told. There are estrogen receptors throughout your inner ear and auditory pathways. Estrogen helps protect the hair cells that let you hear, which is part of why women tend to hold onto better hearing than men into their 40s. When estrogen drops in perimenopause and menopause, that protection fades and hearing can decline, often showing up first as tinnitus (ringing in the ears) or trouble understanding speech in background noise. Dr. Mandy also explains why she tells women to talk to their provider before assuming hormone therapy is the fix. Then there is the dementia connection. Hearing loss does not cause dementia — but the Lancet Commission lists untreated hearing loss as one of the leading modifiable risk factors for it, and the Johns Hopkins ACHIEVE study found that treating hearing loss with properly fitted hearing aids slowed cognitive decline in higher-risk adults. The mechanism is simple: the brain is a muscle, and when it stops getting a clear signal, it stops being stimulated — and social isolation makes it worse. What you'll learn: • Why you can have real hering loss and not know it — the loss is so gradual your brain adapts • The first signs worth checking: asking people to repeat themselves in noise, ringing/tinnitus, feeling drained at night from the effort of listening • The age to get a baseline hearing test (your 50s, when age-related loss tends to start in women) • What menopause and dropping estrogen actually do to your hearing • The real link between untreated hearing loss and dementia — and whether hearing aids reduce the risk • Why people wait 20 years: stigma, denial, and cost • Costco, Amazon, and over-the-counter "hearing aids" vs. medical-grade prescriptive devices — and why an amplifier is not a hearing aid • What speech mapping (real-ear measurement) and your audiogram actually are, and why fit is everything • The AirPods rule for your kids: if you can hear it, it's too loud • What a first appointment really looks like, and why adapting to hearing aids can take two weeks to a year Chapters: 0:00 The audiologist who has worn hearing aids since age 3 0:48 The menopause and hearing connection no one warns women about 2:37 Dr. Mandy's story: diagnosed as a toddler 5:08 Why she became an audiologist 7:35 Does hearing keep getting worse? Ears vs. the brain 8:25 Why people wait 20 years: stigma, denial, cost 11:55 The first signs of hearing loss you would actually notice 13:53 What you risk by waiting 14:44 Hearing loss and dementia, explained 18:02 Costco, Amazon, and OTC vs. medical-grade 21:00 Speech mapping and what "best practice" means 22:09 Perimenopause, estrogen, and your hearing 24:33 Myth-busters 30:07 What your first hearing appointment looks like 31:31 The AirPods rule for your kids 32:08 The one thing Dr. Mandy wants you to know 32:55 How to reach Audiology Associates About the guest: Dr. Mandy Rounseville-Norgaard, AuD, is an audiologist and the owner of Audiology Associates in Sioux Falls, SD and Miramar Beach, Fl. She has worn hearing aids since age 3 and has practiced across school, ENT, and VA settings before opening her own clinic in 2018. Sioux Falls: https://www.siouxfallsaudiologyassoci... Miramar Beach: https://miramarbeachaudiologyassociat... About Dialed In Health: Health and wellness is confusing — a new trend every week and half of it is just good marketing. Every episode, host Melissa Goodwin brings on the providers and practitioners who actually do the work and asks the questions you'd ask if you were sitting across from them, so you can find the right people and make better decisions. New episodes weekly. Resources & links: Dialed In Health Provider Directory: dialedin.health/the-directory Subscribe for new episodes every week, and follow Dialed In Health on Apple Podcasts and Spotify so you never miss one. This episode is educational and informational only and is not medical advice or a substitute for evaluation, diagnosis, or treatment by a licensed provider. Talk to your provider about your hearing, your hormones, or any treatment.