COVID vaccine unrelated to sudden loss of hearing
DEAR DR. ROACH: My friend lost hearing in one of her ears after a vertigo and dizziness spell a few months ago, when she also noted tinnitus. Her hearing issues have not resolved, unfortunately. Given some anecdotal reports of issues like this happening after receiving a COVID vaccine, she is wondering whether to get the new booster or not. She wants to, but losing hearing in her other ear would be devastating. Her doctors haven't had real answers. Any thoughts on the issue or on who to contact for a more educated answer? -- K.L.R.
ANSWER: It sounds like your friend had sudden sensorineural hearing loss (SSHL), a rare condition whose cause is not understood. The hallmarks of the illness are sudden loss of hearing in one ear (takes place over 72 hours or less, but in about half the cases, the person has woken up with hearing loss); tinnitus (noise that other people can't hear, usually a ringing or buzzing sound), which is present in 90% of people with SSHL; and vertigo (a sense of movement, such as spinning, when the person is still) in about half of people.
The tinnitus is normally present on the same side as the hearing loss. I am sure your friend has had a complete evaluation by a head and neck surgeon (otolaryngologist). Early treatment (with steroids and possibly antiviral medicine) helps people regain hearing, and about two thirds of people will regain hearing, although it may not be complete. The return of hearing begins within the first three months. Unfortunately, your friend is unlikely to recover, so I understand why she is concerned about anything that might increase her risk of having this on her other side.
Fortunately, there is now strong evidence through clinical studies that the COVID-19 vaccines do not increase the risk of developing sensorineural hearing loss. After 185 million doses of the COVID-19 vaccines, there were no more cases of SSNL among vaccine recipients than would be expected among people who did not get the vaccine.
DEAR DR. ROACH: I am a 71-year-old woman in good health, but sex for me is extremely painful. Not only the start and insertion, but also once inside. I've seen ads for laser treatment; however, this is $2,000. What do you suggest? -- Anon.
ANSWER: Painful sex is a very common problem in women and, unfortunately, one that some women aren't comfortable bringing up to their doctor.
There are many, many different causes, and most of them are treatable. They can be physiological (low estrogen levels, which are nearly universal in women after undergoing menopause, can often lead to painful sex); anatomical (including endometriosis and benign tumors); neurological (such as pudendal neuralgia); and psychological (such as a history of intimate partner violence). There are many others, and I couldn't do justice to them all in 10 columns. A comprehensive evaluation is essential by an expert, such as a gynecologist who subspecializes in pelvic pain.
Laser treatment holds some promise; however, its role in chronic pain is not yet clearly defined, and I would strongly recommend an evaluation by an expert to see where the pain might be coming from prior to spending money on an unproven therapy that has the potential for complications, especially when you aren't sure what is being treated.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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