Hormone Replacement Therapy is Associated With Reduced Rates of Otologic Surgery in Postmenopausal Women

Area of Science:

• Otolaryngology
• Endocrinology
• Epidemiology

Background:

• Otitis media is a common condition in postmenopausal women.
• Surgical intervention for otitis media can be invasive and carries risks.
• The role of hormone replacement therapy (HRT) in otologic health is not well understood.

Purpose of the Study:

• To investigate the association between HRT use and the incidence of otologic surgery in postmenopausal women diagnosed with otitis media.
• To quantify the risk reduction for specific otologic procedures among HRT users.

Main Methods:

• A retrospective cohort study utilizing the TriNetX Global Collaborative Network.
• Inclusion criteria: Postmenopausal women (≥55 years) with otitis media and no prior ear surgery.
• 1:1 propensity score matching created two cohorts: HRT users (n=23,614) and nonusers (n=23,614).

Main Results:

• HRT use was associated with a significant reduction in the odds of all evaluated otologic procedures.
• The composite incidence of ear surgery was 1.3% in the HRT group versus 2.8% in the non-HRT group (OR: 0.467, P <0.001).
• Specific procedures like tympanostomy, myringotomy, tympanoplasty, and mastoidectomy also showed significantly reduced odds in the HRT group.

Conclusions:

• HRT use demonstrated a 50%-55% reduction in the odds of undergoing ear surgery over a 5-year period in postmenopausal women with otitis media.
• This study provides novel evidence for a potential protective role of HRT in preventing surgical intervention for otologic conditions.
• Further research is recommended to elucidate the mechanisms and clinical implications of this observed association.