That faint ringing or buzzing in the ears is easy to dismiss, but audiologists say it can be an early clue that hearing is starting to fade. In a Medical Minute article from Penn State Health, audiologist Dr. Jackie Price described tinnitus and similar sound disorders as often being among the earliest signs of hearing loss.
"Sometimes people think they hear fine, but there are signs of change inside the ear, such as hair cell damage or hearing loss at the highest frequencies," said Dr. Jackie Price, an audiologist at Penn State Health Otolaryngology, Head and Neck Surgery.
Tinnitus is the perception of sound without an external source, so nobody else can hear it. Surveys estimate that 10 to 25% of adults live with it, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).
Noise and age catch up first
Noise is one of the most common triggers. People often first notice ringing after a loud workplace shift, a concert, or a sporting event, and the NIDCD says hearing loss driven by aging or by noise exposure is strongly associated with the condition.
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Age drives the pattern. NIDCD data on chronic tinnitus show prevalence starting to rise around age 40, peaking between 65 and 79, then easing off after 80. Men have higher rates than women, with the widest gap between the ages of 50 and 69.
When blood vessels are behind the noise
Tinnitus can also point outside the ear. High blood pressure, atherosclerosis, and malformations in blood vessels close to the ear can alter blood flow and cause tinnitus, according to the NIDCD.
In rarer cases the sound pulses rhythmically with the heartbeat. This is called pulsatile, or objective, tinnitus, and a doctor may be able to hear it through a stethoscope. Because it can reflect a vascular issue, it deserves an evaluation rather than a wait-and-see approach.
When medications are the trigger
Certain drugs can bring ringing on, especially at higher doses. The NIDCD lists non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and aspirin, along with certain antibiotics, anti-cancer drugs, anti-malaria medications, and antidepressants.
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If ringing appears after starting a new prescription or increasing a dose, the medication history is worth raising with a doctor. Do not stop a prescribed drug without medical advice.
When to see a doctor
The NIDCD recommends starting with a primary care doctor, who will check for earwax or fluid from an ear infection blocking the canal and review your medical history and medications, then refer you to an ear, nose, and throat specialist if needed.
Some situations warrant faster action. Sudden hearing loss in one or both ears, often accompanied by tinnitus, should be treated as a medical emergency, the NIDCD says, because prompt care improves the odds of recovering hearing. New ringing in only one ear, or tinnitus paired with dizziness, also warrants an appointment rather than a delay.
"You can't stop aging, but you can take steps to conserve your hearing and reduce your risk of developing hearing loss and tinnitus," Price said.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.