3 most common cause(s)
Why are your ears ringing?
Ringing in the ear, also called tinnitus, is a common problem. Sometimes the ringing in your ear sounds more like buzzing, hissing, or a high-pitched whine. It usually isn’t any louder than background noise. But in some cases, it may be so loud that it makes it difficult to hear and concentrate.
Tinnitus can affect one or both ears. It may be a constant problem or it may come and go. Many people who have tinnitus say that if they think about it, the sound is always there. They just don’t notice it when they’re focused on other things.
The most common causes of tinnitus are hearing loss and loud noises. The sound is from damage to the nerves in the ear that help you hear. This is why many people with hearing loss also experience tinnitus.
Some people are more likely than others to develop tinnitus. These include cigarette smokers and people who have cardiovascular disease. Men are more likely to get it than women.
If the ear ringing does not go away, you should make an appointment with an otolaryngologist (also known as an ENT—ear, nose, and throat doctor).
Depending on the cause, ringing in the ear may be treated with hearing aids, behavioral therapy, medication, or surgery.
Causes
1. Hearing loss
Symptoms
- Ringing in the ears that’s worse when it’s quiet
- Difficulty hearing
- Difficult participating in conversations
- Difficulty hearing in loud environments
- Dizziness
Hearing loss is the most common cause of ringing in the ears. The hearing loss may be very noticeable. Or it may be so mild that you don’t even realize you have a problem.
It’s not unusual to experience some hearing loss as you age. The most common causes of hearing loss are regular exposure to loud noise and age-related hearing loss. Other causes include abnormal bone growths or tumors, or damage to the inner ear or eardrum.
It’s not clear why people with hearing loss also experience tinnitus. However, in a study published in The Lancet, researchers theorized that hearing loss causes the brain to create a ringing noise to “replace” sounds patients are unable to hear. This may be why many people with hearing loss say that their tinnitus is worse when they’re in a quiet environment.
If you have tinnitus and hearing loss, your doctor may recommend “sound masking” to minimize the ringing. This means using a fan or white noise machine in quiet places (like your bedroom when you’re trying to sleep).
You may also need hearing aids to minimize the effects of hearing loss, which in turn increases the input of sound. This increase in sound input can reduce the intensity of the tinnitus.
Other treatments include behavioral therapy, which helps you train yourself to tune out the ringing.
Pro Tip
Ringing in the ears truly can come in all shapes and sizes. The ringing can be high pitched or a low sound. It can be a roaring or like a single note on the piano. —Dr. David Lee
2. Exposure to loud noise
Symptoms
- Ringing in the ears
- Difficulty hearing
- Dizziness
Hearing a very loud noise can cause ringing that lasts for a short while. The loud noise may be brief (like a gunshot) or occur over a longer period of time, such as at a concert. This kind of ringing usually goes away on its own.
If you’re regularly exposed to loud noise, however, you may develop hearing loss with tinnitus, since it often accompanies hearing loss.
Noise above 70 decibels (dB), which is similar to a washing machine or dryer, for an extended period of time may start to damage your hearing, according to the Centers for Disease Control and Prevention. Loud noise above 120 dB, which is like standing near a siren, can cause immediate harm to your ears.
Prolonged or repeated loud noise exposure should be avoided if possible.
3. Meniere’s disease
Symptoms
- Ringing in the ears
- A feeling of fullness or pressure in the ear
- Dizziness
- Episodes of vertigo (dizziness that feels like you’re spinning)
- Hearing loss that comes and goes (and may become permanent)
Meniere's disease is a disorder of the inner ear. It usually only affects one ear. Anyone can develop Meniere’s disease, but it’s most common in young and middle-aged adults. It’s not known what causes it.
Meniere’s disease is a chronic condition. There’s no cure, but it can be treated with medications called diuretics and physical therapy and exercises to improve your balance. Your doctor may also recommend wearing a hearing aid. If these treatments don’t help, surgery may be necessary.
4. Earwax blockage
Symptoms
- Ringing in the ears
- Dizziness
- Occasional cough
- Ear canal pain
- A feeling of fullness or pressure in the ear
Your body naturally makes earwax to protect your ear from infection. It usually dries up and falls out of your ear on its own. But in some cases it can build up and create a blockage in your ear.
Some people are more prone to earwax blockages, such as those who wear hearing aids. Blockages also frequently develop in people who clean their ears with a cotton swab or other foreign objects. This pushes earwax deeper into your ear, so it is unable to fall out on its own.
You may be able to clear the blockage with ear drops that soften earwax. These are available at your local pharmacy. If this doesn’t work, see your doctor. Simple medical procedures can remove the blockage by irrigating your ear canal or with special tools that won’t push the wax deeper into your ear.
5. Middle ear infection
Symptoms
- Ringing in the ears
- Ear pain
- A feeling of fullness in the ear
- Drainage of fluid from the ear
- Fever
Ear infections, called otitis media, are much more common in young children, but adults can get them, too. When fluid is trapped behind the eardrum, it can cause temporary hearing loss and tinnitus.
Ear infections may clear up on their own. If yours doesn’t, your doctor can treat it with ear drops that may contain an antibiotic. In some cases, you may also need to take oral antibiotics.
6. Side effect of medication
Symptoms
- Ear ringing that coincides with medication use
According to a study published by the American Tinnitus Association, more than 450 prescription and over-the-counter drugs can trigger tinnitus or worsen existing symptoms. These include some antibiotics, diuretics, cancer medications, and Aspirin. Whether you develop ringing in the ears may depend on the dose you take. Higher doses are more likely to cause tinnitus.
Usually, stopping the medication will solve the problem. However, you should never stop taking a medication without talking to your doctor first. Your doctor may be able to lower your dose or put you on a different medication instead.
Pro Tip
Ask your doctor if any of your medications could be contributing to your ear ringing. Especially if you are taking multiple medications or recently changed dosages or prescriptions. Common offenders include some types of antibiotics, some diuretics, and many cancer treatment medications. —Dr. Lee
Other possible causes
Some conditions may cause ringing in the ears, but it isn’t one of the main symptoms or may occur in only a few people. These include:
- Temporomandibular joint disorders (TMJ)
- Blood vessel anomalies
- Eustachian tube dysfunction
- Intracranial masses
- Head injuries
- Muscle spasms
When to call the doctor
Make an appointment with your doctor if tinnitus lasts for more than a couple weeks or is interfering with your quality of life (preventing you from sleeping, hearing conversations, etc.). Your doctor may refer you to an ENT or an audiologist (hearing specialist). They will give you a physical exam and a hearing test.
Should I go to the ER for ringing in the ear?
You should go to the ER if you have the following:
- Ringing in the ears along with a fever, headache, or changes in vision or mental status.
- Ringing in the ears that begins suddenly along with muscle or body weakness.
Dr. Rx
Additional information that can help your doctor with a diagnosis of ear ringing include: Timeframe—does the ear ringing come and go? Is it worse at night or in quiet situations? And then not noticeable during the day or in areas with high ambient noise? Location—is it in one ear or both? If both, does one ear have louder or different ringing? Sound quality—I’ll often have patients try to mimic the sound. Is it a “whooshing” that is pulsatile? Or is it a constant note? Lastly, associated symptoms—Do you have dizziness or fluctuating hearing loss? Any ear fullness or pressure? —Dr. Lee
Treatments
At-home care
- Run a white noise machine to ease the intensity of the ringing.
- Practice behavioral therapies to learn how to tune out the tinnitus.
- Wear hearing aids if your doctor has recommended them. It can reduce the tinnitus.
Other treatment options
- Your doctor may recommend an antidepressant to help you cope with the severity of the ringing. (Though certain antidepressants may trigger tinnitus.)
- Treating the underlying problem that caused the ringing (such as an ear infection) can reduce or eliminate ear ringing.
- Surgery can help some causes of ear ringing (such as Meniere’s disease).
We've gathered some OTC treatment options that might help alleviate your discomfort before you consult with a doctor.
- White Noise Machines: A steady background noise can help mask the ringing.
- Earwax Removal Kits: If your tinnitus is caused by earwax buildup, using a removal kit might provide relief.
- Hearing Protection: To prevent worsening of tinnitus through exposure to loud noises, consider using ear protection.
Preventative tips
To prevent ringing in the ears, you should:
- Wear ear protection when you’re in loud environments.
- Get routine ear screenings.
- Watch TV or listen to the radio at a lower volume.
- Quit smoking. Smoking is associated with tinnitus.
- Eat healthy and exercise to improve your cardiovascular health.
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