Can Astragalus (Huangqi) Protect Hearing in Women With Estrogen Deficiency Undergoing Chemo? A Rat Study Offers Clues
If you’re a woman going through menopause, have had an ovariectomy (ovary removal), or live with ovarian failure, you might not know this: estrogen deficiency can make your ears more vulnerable to damage from ototoxic (ear-harming) drugs like Cisplatin—a common chemotherapy medication. Now, a 2021 study from Zhejiang Chinese Medical University sheds light on how Astragalus (Huangqi), a staple in traditional Chinese medicine (TCM), could shield hearing in these high-risk cases.
The Problem: Estrogen Deficiency + Chemo = Hearing Risk
Estrogen plays a key role in maintaining auditory health, but when levels drop (e.g., during menopause), the ears become less resilient. For women on Cisplatin—used to treat cancers like lung, ovarian, and bladder cancer—this combination can worsen hearing loss. Previous research has shown conflicting results on estrogen therapy’s ability to fix this, and hormone replacement comes with its own risks.
Enter Astragalus: A TCM herb with a long history of reducing chemotherapy side effects (like fatigue and immune damage) in cancer patients, per a 2006 meta-analysis in Journal of Clinical Oncology. Could it also protect hearing?
The Study: How Astragalus Stacks Up Against Estrogen
Xu-Jun Hu, a researcher at Zhejiang Chinese Medical University’s College of Medical Technology, led a study with 48 female Sprague-Dawley rats to find out. The rats were split into four groups:
- Sham: No ovariectomy or Cisplatin (control group).
- OVX: Ovariectomized (estrogen-deficient) + Cisplatin.
- OVX+H: Ovariectomized + Cisplatin + daily Astragalus extract injections.
- OVX+E: Ovariectomized + Cisplatin + daily Estradiol (estrogen) therapy.
After 3 weeks of therapy, all OVX groups got 4 days of Cisplatin. Researchers then measured hearing using two tests:
- DPOAE (Distortion Product Otoacoustic Emissions): Checks how well the inner ear (cochlea) responds to sound (higher “signal-to-noise ratio” = better cochlear function).
- ABR (Auditory Brainstem Responses): Measures how sound travels from the ear to the brainstem (lower “hearing threshold” = better central auditory function).
The Results: Astragalus Helps—Similar to Estrogen
The OVX group (no therapy) had significantly worse hearing than the Sham group: lower DPOAE signals and higher ABR thresholds across 2–8 kHz (the range for human speech). But both Astragalus and Estradiol made a difference:
- Astragalus (OVX+H): Improved DPOAE at 2 kHz and 8 kHz (key speech frequencies) compared to OVX alone. ABR thresholds were also lower (better brainstem function) at most frequencies.
- Estradiol (OVX+E): Helped even more broadly—better DPOAE at all tested frequencies and lower ABR thresholds across the board.
Crucially, Astragalus performed similarly to estrogen in protecting both the inner ear and the auditory nerve pathway. And since Astragalus typically has milder side effects than hormone therapy, it could be a gentler option for women who can’t take estrogen.
What This Means for Humans (and What’s Next)
While this study was in rats, the findings align with real-world use: In China, Astragalus is often paired with platinum-based chemo (like Cisplatin) to ease side effects. But it’s rarely used alone—and the study only tested single-agent Astragalus. More research is needed to see if combining Astragalus with other herbs (as is common in TCM) boosts its hearing-protective effects.
For women with estrogen deficiency (e.g., menopause, ovariectomy) undergoing Cisplatin treatment, this study suggests Astragalus may help preserve hearing. But as with any supplement, always talk to your oncologist or TCM practitioner before adding it to your regimen—herbs can interact with medications.
The Bottom Line
Estrogen deficiency doesn’t have to mean losing your hearing to chemo. This study adds to growing evidence that Astragalus, a well-studied TCM herb, could be a valuable tool in protecting auditory health. While human trials are needed to confirm these results, it’s a promising step for women seeking safer ways to navigate cancer treatment.
This research was published in Chinese Medical Journal in 2021. The full study is available via doi.org/10.1097/CM9.0000000000000028.
References (key studies cited):
- McCulloch M, et al. J Clin Oncol 2006 (Astragalus + chemo for lung cancer).
- Hu XJ, et al. Acta Otolaryngol 2017 (Cisplatin’s effects on estrogen-deficient rats).
- Price K, et al. Hear Res 2009 (hormone therapy and hearing in mice).
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