hearing that comes and goes

Overview

Hearing that comes and goes means your hearing level changes over time. Some days you may hear clearly; other days, sounds may seem muffled, distant, or faint. This waxing and waning hearing loss can affect one ear or both ears, and it often lasts for a short while before improving.

Fluctuating hearing is fairly common. Many people experience it at some point in their lives, especially after colds, during allergy seasons, or after flying or diving.

It can affect people of all ages, but it is especially common in children who are prone to middle ear infections and in older adults with earwax buildup or age-related hearing changes.

Symptoms

Common symptoms

• Sounds seem muffled or quieter at times
• A feeling of fullness, pressure, or popping in the ear
• Tinnitus (ringing, buzzing, or hissing in the ear)
• Dizziness or balance problems
• Difficulty following conversations, especially in background noise

Symptoms in children

• Speech may seem delayed or unclear
• Tugging at ears or being more irritable than usual
• Seems not to respond when called by name
• Turns up the TV volume or sits closer to the screen

Symptoms in older adults

• Needs more effort to follow conversations
• Mixes up similar-sounding words
• Hearing changes are more noticeable when tired or in noisy rooms
• May have a history of earwax problems or repeated ear infections

Causes

Main causes

• Earwax buildup that moves and blocks the ear canal
• Eustachian tube dysfunction — the tube that equalizes pressure in the ear does not open properly
• Middle ear fluid from colds, sinus infections, or allergies
• Meniere's disease, a disorder that affects the inner ear and can cause fluctuating hearing, dizziness, and ringing
• Noise-induced hearing changes, especially after exposure to loud sounds

Risk factors

• Frequent colds or allergies
• Flying, scuba diving, or high-altitude travel
• Repeated exposure to loud music or machinery
• Age-related changes in the inner ear
• Smoking or exposure to secondhand smoke

When to see a doctor

See a doctor urgently if:

• Hearing loss that comes with dizziness or ringing and does not improve within a day
• Ear pain or any discharge along with hearing changes
• Hearing loss that follows a head injury or sudden pressure change

Book a routine appointment if:

• You notice changes in your hearing that happen now and then over several weeks
• You have a feeling of fullness or pressure that lasts more than a few days
• You find yourself asking people to repeat more often

Diagnosis

A healthcare professional will ask about your symptoms, look into your ears with a light, and may do simple hearing tests. They will look for clues such as earwax, fluid, or damage to the ear structures.

Tests that may be done

• Otoscopy — examining the ear canal and eardrum with a special light
• Tympanometry — a quick test that measures how well the eardrum moves from pressure changes
• Pure-tone audiometry — a hearing test where you listen to tones through headphones and signal when you hear them
• Tuning fork tests — simple tests that help tell whether hearing loss is due to sound transmission or nerve damage

What to expect at your appointment

Most ear and hearing checks are painless and take about 30 minutes. You usually do not need to prepare, but it helps to write down when your hearing changes and what you were doing at the time. If you have sudden hearing loss, go to the emergency department first and see a specialist afterwards.

Treatment

Treatment depends on the underlying cause. Many cases of fluctuating hearing are short-lived and can be managed with simple home steps. If there is an infection, fluid, wax, or another condition, it will be treated first.

Self-care at home

• Keep your ears dry and avoid putting cotton buds, fingers, or other objects inside
• Ask your pharmacist about safe earwax softening drops, such as olive oil or over-the-counter remedies
• Use steam from a warm shower to help relieve pressure after a cold
• Take regular breaks from loud environments and use ear protection if needed
• Manage allergy symptoms with guidance from your pharmacist

Medical treatments

A doctor may treat the cause directly, for example by clearing earwax, treating an ear infection, or offering ways to improve eustachian tube function. In some cases, a hearing aid or other assistive listening device may be recommended, especially if the hearing loss becomes persistent. Only a qualified healthcare professional can decide what is right for you.

When is surgery considered?

Surgery is rarely needed for fluctuating hearing. It may be considered if fluid in the middle ear persists for months and affects hearing, or if there is a specific structural problem. Any surgical option will always be discussed thoroughly with an ear specialist.

Living with this condition

Keep a simple diary of when your hearing changes, how long it lasts, and any other symptoms such as dizziness or ringing. This helps your doctor spot patterns. Let people know you may need them to face you and speak clearly.

Lifestyle tips

• Use ear protectors at concerts, shooting ranges, and with loud tools
• Limit the time you spend in very noisy places
• Avoid using cotton buds or sharp items in your ears
• Stay active and wash your hands regularly to reduce colds and ear infections

Diet and exercise

A balanced diet and regular physical activity support general health, including blood flow to the ears. If dizziness accompanies your hearing changes, avoid sudden head movements, drink enough water, and talk to your doctor about safe exercise.

Mental health and emotional wellbeing

Not hearing clearly can be tiring and frustrating. You may feel left out or anxious in social settings, and that is completely normal. It may help to share your feelings with someone you trust or to see a counselor if you feel stressed.

Prevention

Not all causes can be prevented, but you can reduce the risk of earwax impaction, noise damage, and ear infections with simple habits.

Vaccines

There is no vaccine specifically for fluctuating hearing, but staying up to date with recommended vaccines, such as flu and COVID-19, may reduce infections that can affect the ears.

Screening programmes

Ask your doctor or pharmacist whether local hearing screening is available, especially if you are over 60, work in a noisy environment, or have noticed changes in your hearing.

Complications

If left untreated

• Persistent hearing loss that may become less reversible
• Balance problems, which can increase the risk of falls
• Difficulty in school, at work, or in daily conversations
• Social withdrawal and lower quality of life

Long-term outlook

With the right care, most cases of intermittent hearing improve or can be managed very well. Even if some hearing loss becomes permanent, hearing aids and clear communication strategies can help you stay fully connected to the world around you.

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