– Biological underpinnings of hearing loss can occur in the cochlea or central auditory system
– New ABR physiology measures can help diagnose temporal processing problems
– Hormones can affect hearing, positively or negatively
– Clinical research on hormone replacement therapy (HRT) reveals that estrogen can be positive, progestin may be negative; and aldosterone may be positive
– Animal model studies (mice) show the same trends for the sex hormones and with aldosterone
– Proactive intervention with aldosterone hormone therapy can slow down the progression of age-related hearing loss in mice
– Neurobiological studies provides some of the biological mechanisms by which aldosterone exerts its biotherapeutic actions
– Animal model pharmacological studies give strong evidence that antioxidants can attenuate ototoxicity due to noise overexposure

Learning Objectives:
1. Biological mechanisms of hearing loss can occur in the cochlea (peripheral auditory system) or parts of the brain used for hearing (central auditory system).
2. ABRs can be used as a physiological biomarker to detect the onset of age-related hearing loss – presbycusis in middle age.
3. Sex hormones can modulate the progression of presbycusis, positively or negatively.
4. Aldosterone, the main hormone that regulates sodium and potassium in the body, is linked to good hearing in old age.
5. Administering aldosterone to aging mice can slow down presbycusis.
6. Pharmacological administration of antioxidants can reduce the damaging effects of loud noise.