Itchy ears in menopause and perimenopause: why it happens and what helps

It starts as a tickle deep inside your ear. You rub it, wiggle a finger in, maybe reach for a cotton bud. Ten minutes later it's back. Some nights it's the first thing you notice when your head hits the pillow.

If you're in your 40s or 50s, you may have read that itchy ears are a sign of menopause, and wondered if that's really true. The honest answer is: it's possible, but not proven. The NHS lists "dry and itchy skin" as a symptom of perimenopause and menopause, and the inside of your ear is lined with skin. But very little research has looked at the ear itself.

Either way, an itchy ear is worth taking seriously. The most common causes are easy to sort out, and a few need a doctor.

Are itchy ears a sign of perimenopause?

They can be part of the picture, but on their own they don't tell you much. Itchy ears are common at every age. The usual causes are things like eczema, earwax and water in the ear, which we cover below.

Here's what we do know:

• The NHS lists "skin changes, including dry and itchy skin" among the symptoms of perimenopause and menopause.
• A 2022 review of menopause and skin problems found that itching is often seen in women after menopause, usually along with dry skin.
• A menopause toolkit published on the Women's Health Concern website lists "general skin itchiness" as a menopause symptom.

And here's what we don't know. We couldn't find a single study that has looked directly at the skin inside the ear canal during menopause. So when you read that falling oestrogen "dries out your ears", that's an educated guess, based on what happens to skin elsewhere. It may well be right. It just hasn't been tested.

Why does menopause make your ears itch?

Oestrogen helps keep skin thick, springy and moist. A review of oestrogen and ageing skin explains that after menopause, skin gets thinner and drier. It holds less collagen, the protein that gives skin its strength. The review says skin collagen may fall by as much as 30% in the first five years after menopause.

The 2022 review adds that oestrogen seems to affect how much water the skin loses. Skin that loses more water is drier, and dry skin itches.

The ear canal is lined with thin skin. So if your skin is getting drier everywhere else, it makes sense that the ear canal might too. That's the most likely link, but remember it's a theory, not a proven fact.

In perimenopause, hormones don't just fall in a straight line. The Migraine Trust describes "rapid changes" in hormone levels as you approach menopause. Nobody yet knows whether ear itching follows the dips, the swings, or neither.

The itch-scratch cycle

Once an ear starts itching, scratching can keep it going. Guy's and St Thomas' NHS leaflet on outer ear problems explains that cotton buds, scratching and poking damage the skin of the ear canal. That damage can lead to inflammation and infection, which itch even more.

Other common causes of itchy ears

Before putting it down to menopause, it's worth knowing the usual suspects. Most are easy to treat.

• Eczema or psoriasis. Guy's and St Thomas' says these skin conditions make ear canal problems more likely.
• Seborrhoeic dermatitis. This is the same condition that causes dandruff. The British Association of Dermatologists says it can affect the inside of the ear canal, the cup of the ear and behind the ears. If your scalp is flaky too, mention it to your GP.
• Earwax. A build-up can irritate the skin, or trap water behind it and cause an infection.
• Water, soap and shampoo. Getting these in your ear can irritate the skin. Hot, humid weather makes problems more likely.
• An outer ear infection (otitis externa). Itching often comes with pain, discharge, dulled hearing or flaky skin around the ear.
• HRT. The NHS lists itching as a possible side effect of both oestrogen and progestogen. If your skin started itching after you began HRT, tell your GP. Don't stop taking it without talking to them first.

How to stop itchy ears in menopause: things to try tonight

These tips come from Guy's and St Thomas', the NHS and the British Association of Dermatologists.

1. Put the cotton buds away. Don't scratch, poke or put anything in your ear, including your finger. Your ears clean themselves.
2. Moisturise the outside only. If the skin is dry or itchy, Guy's and St Thomas' suggests a little moisturiser around the bowl of the ear and the entrance to the canal. An unscented one is kinder to itchy skin. Don't push anything down into the canal.
3. Keep water out in the shower. One option is a loose ball of cotton wool coated in white soft paraffin, resting at the entrance of the ear. Don't push it in.
4. Clean the outside gently. Use a dry tissue on the outer ear only.
5. Let your ears dry naturally. After swimming, you could use a hairdryer on its lowest setting, held about 20cm away.
6. If you wear a hearing aid, wash the mould regularly in warm soapy water. Ask your provider about a vented or hypoallergenic mould if your ears are often irritated.
7. If wax is the problem, the NHS suggests 2 to 3 drops of olive or almond oil, 3 to 4 times a day for 3 to 5 days. Lie with the ear facing up for 5 to 10 minutes after each go. Skip almond oil if you're allergic to almonds. Don't use any drops if you might have a hole in your eardrum.
8. Look after your skin generally. The NHS advice on itchy skin suggests avoiding scented soaps and products, and not staying in hot baths or showers for long.

What a pharmacist or GP can offer

• A pharmacist can suggest treatments for dry or itchy ear canals. Tell them if you might have a hole in your eardrum, as some products aren't safe then.
• For an infection or inflammation, a pharmacist or GP may offer antibiotic, antifungal or steroid eardrops (NHS).
• If it keeps coming back, your GP may take a swab or refer you to an ear, nose and throat (ENT) specialist.
• If you have other menopause symptoms too, it's worth talking about them all together. HRT is the main medical treatment for menopause symptoms. The NHS says oestrogen "can help manage your symptoms" (NHS menopause treatment). The 2022 skin review notes that oestrogen treatment has been shown to reduce water loss from the skin. But no one has studied whether HRT helps itchy ears in particular, so think of that as a question for your GP, not a promise.

When to see a GP about itchy ears

Make a normal appointment if:

• the itch doesn't get better with the self-care steps above, or it keeps coming back (NHS)
• the skin in or around your ear is red, scaly, cracked or weeping
• you keep getting ear infections
• it's affecting your sleep or your day
• you also have dry, itchy skin elsewhere, or other menopause symptoms you'd like help with

And go sooner, using the box at the top of this page, if there's pain, discharge, swelling or any change in your hearing.

It can help to take a list of all your symptoms with you, even the ones that seem odd. Our symptoms checklist lets you tick them off and print a list for your GP.

Related

Itchy ears often come with itchy skin elsewhere, an itchy scalp or ringing in the ears (tinnitus), and you can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms