Assessment of Hearing Abilities in Females with Polycystic Ovarian Syndrome (PCOS) Using High-Frequency Audiometry and Ipsilateral Masked Auditory Brainstem Response (ABR)

Abstract

Background: Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age, with associated metabolic and vascular complications that may impact auditory function. Previous literature supports potential hidden hearing loss in PCOS, particularly at Extended High Frequencies (EHFA). There is a dearth of literature on Auditory Brainstem Response (ABR) in females with PCOS and ipsilateral masked ABR have not been explored in this population. Aim: The present study aimed to compare the audiological measures including conventional pure-tone audiometry, EHFA, Distortion Product Otoacoustic Emissions (DPOAE), and ABR with and without ipsilateral masking, in female participants with and without PCOS. Method: A standard group comparison research design was employed with 33 female participants aged 18 to 30 years, including 15 female participants having PCOS and 18 female participants without PCOS. Audiological evaluations included conventional audiometry, EHFA from 9000 Hz to 16000 Hz, DPOAEs from 1000 Hz to 6000 Hz and ABR recordings under unmasked 80 dB nHL clicks and masked conditions of ipsilateral broadband noise at 50-, 60-, and 70- dB SPL. Data were analyzed using non-parametric tests due to non-normal distribution. Results: No significant differences were found in conventional pure-tone thresholds except at 8000 Hz in the right ear, where PCOS participants had elevated thresholds. EHFA showed significantly higher thresholds at 12500 Hz and 14000 Hz frequencies in the female participants with PCOS compared to female participants without PCOS. DPOAE amplitudes showed no significant difference between the group. However, the SNR at 2800 Hz in the right ear in those with PCOS showed significantly reduced SNR. The ABR findings revealed that the 3rd peak amplitude in female participants with PCOS was significantly higher than the female participants without PCOS in the unmasked and masked conditions, suggesting a lack of suppression from brainstem especially in presence of noise which might be evolved from hormonal imbalance. Conclusion: The study demonstrates that females with PCOS exhibit elevated hearing thresholds in extended high frequencies and altered ABR responses under masking, indicative of possible hidden hearing loss and neural deficits. Routine audiological evaluations in PCOS should include EHFA and masked ABR to ensure early detection and management of hidden hearing loss.