Subclinical hearing loss in women with polycystic ovary syndrome: a case-control study using extended high-frequency audiometry

OBJECTIVE: To determine whether women with polycystic ovary syndrome (PCOS) exhibit hearing loss and if so, to identify the specific frequencies involved using extended high-frequency audiometry. METHODS: This single-centre, prospective, cross-sectional case-control study included 39 women with PCOS (diagnosed according to the Rotterdam criteria) and 39 age-matched controls. All participants underwent otoscopic examination, tympanometry, conventional pure-tone audiometry (250-8,000 Hz), and extended high-frequency audiometry (up to 12,500 Hz). Speech reception thresholds (SRT) and speech discrimination (SD) scores were also tested. RESULTS: No statistically significant between-group differences were detected at 1,000-8,000 Hz. Women with PCOS demonstrated significantly elevated thresholds at 250 Hz and 500 Hz in both ears (p < 0.05), and at 11,200 Hz (right: p = 0.004; left: p < 0.001) and 12,500 Hz (left: p = 0.008). SRT was significantly higher in the PCOS group in the right and left ears. (p = 0.020 and p = 0.002 respectively). Speech discrimination scores were significantly lower in the PCOS group bilaterally (right: p = 0.036; left: p = 0.005). CONCLUSION: Women with PCOS exhibit detectable but subclinical alterations in extended high-frequency hearing and speech performance despite normal conventional audiometric thresholds. The frequency-specific pattern of threshold elevation is consistent with cochlear involvement potentially mediated by metabolic, inflammatory, and hyperandrogenic mechanisms. Extended high-frequency audiometry may serve as a sensitive tool for detecting early auditory dysfunction in women with PCOS.