New York Science Journal 2017;10(6) http://www.sciencepub.net/newyork 17 Effect of Combined Oral Contraceptive Pills on Auditory Function Gehan Abd El-Rahman El-Zarea 1 ; Ali Abd–Eldaiem Ali 1 ; Mohamed Mohamed Frahat; Amr Mohamed Galal Arisha 1 Audiology –ENT Department, Faculty of Medicine, AL-Azhar University, Egypt 2 Obstetrics and Gynecology Department, Faculty of Medicine, AL-Azhar University, Egypt Amrgalal1985@hotmail.com Amrgalal_1985@yahoo.com Abstract Background: A lot of contraceptive methods are used by women for birth control such as oral contraceptive pills, contraceptive patch, vaginal contraceptive ring, contraceptive injection and the intra uterine device. One of these methods is oral contraceptive pills which may be combined or single. Combined oral contraceptive pills (COCP) contain estrogen and progesterone hormones, these are like pregnancy hormones preventing fertilization from taking place. The aim: Hearing loss was observed in females who are using COCP, so this study was designed to explore the nature of auditory disorders in those females and to correlate the degree and configuration of hearing loss with the type and duration of COCP. Subjects & method: This study included 30 females who were using COCP and 15 control females. Participants underwent a full history taking, basic audiological evaluation, DPOAE and neuro-otological ABR. Results: 26% of the study group (8 females) had hearing loss and 20% had tinnitus (6 females). 6 females had SNHL and 2 had conductive hearing loss. Conclusion: 26% had hearing loss and 20% had tinnitus. No correlation between the duration of using COCP with hearing loss. [Gehan Abd El-Rahman El-Zarea; Ali Abd–Eldaiem Ali; Mohamed Mohamed Frahat; Amr Mohamed Galal Arisha. Effect of Combined Oral Contraceptive Pills on Auditory Function. N Y Sci J 2017;10(6):17-21]. ISSN 1554- 0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork . 3. doi:10.7537/marsnys100617.03 . Keywords: COCP, Hearing loss, Side effect, DPOAE, Tinnitus. 1. Introduction and Rationale A lot of contraceptive methods are used by women for birth control such as oral contraceptive pills, contraceptive patch, vaginal contraceptive ring, contraceptive injection and the intra uterine device. All are effective methods of contraception that may be a good option for women. One of these methods is oral contraceptive pills which may be combined orsingle1. Combined oral contraceptive pills (COCP) taken orally, preventing fertilization from taking place. This occurs through gonadotrophin secretion inhibition by the pituitary acting on the hypothalamus. The progesterone agent present in the pills suppresses leutinizing hormone (LH) secretion and the estrogen agent is responsible for the follicular stimulating hormone (FSH) secretion suppression. 2. COCPs are currently used by more than 100 million women worldwide3. Estrogen interacts either directly or indirectly with estrogen receptors alpha (ERα) and beta (ERβ) 4. Both ERα and ERβ are present in the inner ear of humans and animals, and both subtypes seem to be active in the hearing process 5. There is no visible nuclear staining of progesterone receptors (PR's) in the striavascularis, organ of Corti or spiral ganglion in either human or rat inner ears, indicating that progesterone could not have a direct effect on the hearing modulation in the inner ear via its nuclear receptors. However, PR's have been shown in both osteoblasts and osteoclasts in the bone of humans, rats and mice. These findings lead us to conclude that there is no direct effect of progesterone on hearing6. Bittar claimed that the use of COCP may lower hearing thresholds, without altering stapedial reflex 7. On the other hand, the use of COCP does not cause significant hearing loss, however it favors tinnitus symptoms 8. Also COCP seems to have an effect on otoacoustic emissions (OAE), in a study on post- menopausal women using Hormonal Replacement Therapy (HRT) which consists of estrogen combined with progestin (progesterone) women revealed decline in OAE levels 9. Subjects, Equipments And Method: The subjects were divided into two groups: Study group (30 female subjects) this group is consisted of 30 female subjects. Control group (15 female subjects) this group consisted of 15 healthy volunteer women, who did not use contraceptive hormones or any other medications. They were selected from relatives accompanying patients. Equipment are sound treated room (locally made) according to international specifications, two channel calibrated audiometer Interacoustics, model AC40. Immittancemeter Interacoustics model GSI 39. Otoacoustic Emission Analyzer Madsen model (Celesta 503). Evoked Potential Audiometer model (Smart Intelligent Hearing System). The subjects of study and control groups were submitted to history taking, otological examination, basic audiological evaluation including pure Tone Audiometry air conduction hearing threshold level for octave frequencies between 250 to 8000 Hz and bone