tinnitus that comes and goes

Overview

Tinnitus is the sound of ringing, buzzing, hissing, or humming in your ears when there is no outside sound making it. When these sounds come and go, it is called intermittent tinnitus. It can last a few seconds, a few minutes, or longer, and it may happen every once in a while or many times a day. For most people, it is a temporary and harmless annoyance.

Yes. Nearly everyone experiences a brief episode of tinnitus at some point in their life. Tinnitus that comes and goes is the most common pattern, especially after exposure to loud sounds, during times of stress, or when earwax shifts.

Anyone can experience tinnitus that comes and goes. It is slightly more common as you get older, and it is more likely in people who have some hearing loss, who work in noisy places, or who have had head or neck injuries.

Symptoms

Common symptoms

• Ringing, buzzing, hissing, clicking, or roaring sounds in one or both ears
• Sounds that appear suddenly and then fade away
• Sounds that become more noticeable in quiet rooms
• Episodes that last anywhere from a few seconds to a few hours
• The sound may be soft or loud, high-pitched or low-pitched

Symptoms in children

• Children may say their ears are 'making a noise' or 'humming'
• They may have trouble paying attention in school because of the sound
• They might feel anxious at bedtime or in quiet places
• They may rub or pull at their ears

Symptoms in older adults

• Tinnitus episodes often go along with age-related hearing loss
• The sound may be more noticeable when hearing is already reduced
• It can sometimes affect balance or concentration
• Older adults may mistake the sound for a mechanical or electrical noise in the room

Causes

Main causes

• Age-related hearing loss
• Exposure to loud noises, like concerts, machinery, or firearms
• Earwax that touches the eardrum
• Ear infections or fluid behind the eardrum
• High blood pressure
• Stress and anxiety
• Tight jaw muscles or jaw joint problems (TMJ)
• Certain medical conditions that affect blood flow

Risk factors

• Being over 60 years old
• Working in noisy jobs or attending loud events without hearing protection
• Having a family history of hearing loss or tinnitus
• Smoking, because it affects blood flow to the ears
• High blood pressure or heart disease
• Ongoing stress or lack of sleep

When to see a doctor

See a doctor urgently if:

• Sudden hearing loss
• Tinnitus that begins after a head injury
• Tinnitus together with dizziness that keeps you from walking
• Tinnitus with facial weakness, numbness, or difficulty speaking
• Any bleeding or pus from the ear

Book a routine appointment if:

• Tinnitus that bothers you often or affects your sleep
• Tinnitus that lasts more than a week without going away
• A pulsing sound that matches your heartbeat
• Tinnitus in only one ear that keeps coming back
• Tinnitus with hearing changes or a plugged feeling in the ear

Diagnosis

A healthcare provider will ask about your symptoms and do a physical exam. They will look inside your ears to check for earwax, infection, or other problems. They may also test your hearing.

Tests that may be done

• A hearing test (audiogram) – you listen to sounds through headphones and respond when you hear them
• A detailed ear examination with a special light
• Tests of the muscles around your ears and jaw
• Sometimes imaging tests like an MRI or CT scan if the tinnitus is only in one ear or has a pulsing quality
• Blood tests if your doctor suspects high blood pressure or another medical condition

What to expect at your appointment

The appointment is usually simple and painless. The doctor will ask you to describe the sound, how often it happens, and whether it changes with your head movements or heartbeat. You may need more than one visit, and in many cases no cause is found. That does not mean the tinnitus is imaginary — it just means the examination is clear.

Treatment

There is no single cure for tinnitus that comes and goes, but most people find it easy to manage. Treatment focuses on fixing any underlying cause, protecting your hearing, and making the sound less bothersome. For many people, the tinnitus becomes quieter or less noticeable on its own over time.

Self-care at home

• Avoid loud noises and wear ear protection at concerts or in noisy workplaces
• Play soft background music or white noise, especially when trying to sleep
• Try not to think about the sound – the more you focus on it, the louder it can seem
• Get enough sleep and manage stress, since tiredness can make tinnitus worse
• Limit caffeine and alcohol for a while to see if your symptoms improve
• Keep your ears clean, but do not use cotton swabs inside – let a pharmacist or doctor help if earwax is a problem

Medical treatments

Medical treatment depends on the cause. If earwax is the problem, it can be removed safely. If an infection or high blood pressure is present, your doctor will treat that. For people with hearing loss, hearing aids can make normal sounds clearer, which may make tinnitus less noticeable. Sound therapy and cognitive behavioral therapy (CBT) can help you feel less distressed by the sound. Some medicines can help with stress or sleep, but there is no pill that specifically cures tinnitus. Any medicine you take should be discussed with your doctor, because certain medicines can actually make tinnitus worse.

When is surgery considered?

Surgery is rarely needed for tinnitus that comes and goes. It may be considered only if a specific treatable problem is found, such as an abnormal blood vessel or a tumor pressing on the ear nerve. For the vast majority of people, surgery is not an option and not necessary.

Living with this condition

Living with intermittent tinnitus often means learning to let the sound fade into the background. You can do this by keeping your brain busy with other sounds, such as music, podcast, or a fan. Avoid total silence if sound bothers you, and try to keep a regular routine so fatigue does not make the ringing worse.

Lifestyle tips

• Use hearing protection in noisy environments
• Keep stress low with relaxation techniques like deep breathing or gentle yoga
• Set a regular sleep schedule and wind down before bed
• Limit headphones and keep the volume at a safe level
• Tackle habits that can affect your blood flow, like smoking or heavy drinking

Diet and exercise

A healthy balanced diet and regular physical activity are good for your ears and your overall health. Exercise improves blood flow, which may help reduce tinnitus for some people. It is also a natural way to ease stress. If you have high blood pressure or diabetes, managing these through diet often helps with tinnitus.

Mental health and emotional wellbeing

Tinnitus can be frustrating, especially when it keeps coming back. It can cause anxiety, trouble sleeping, and difficulty concentrating. If the sound is making you feel low or overwhelmed, it is important to talk to someone. Your mental health matters, and support is available.

Prevention

Not all cases of tinnitus can be prevented, but the most common cause – loud noise – can be avoided. Protect your ears with earplugs or earmuffs when you are around loud machinery, concerts, or sports events. Also, keep the volume down on personal listening devices. Managing blood pressure and stress can also reduce your risk.

Vaccines

Vaccines are not used to prevent tinnitus. However, keeping up with regular vaccinations, such as the flu shot or pneumococcal vaccine, may help prevent some ear infections that can lead to tinnitus.

Screening programmes

There is no routine screening for tinnitus. But if you are over 50, work in a noisy job, or have a family history of hearing loss, it is a good idea to get a hearing test every few years. Early detection of hearing loss can help prevent tinnitus from developing.

Complications

If left untreated

• Tinnitus can become more annoying if it is ignored, but it rarely becomes a serious medical emergency
• Persistent or strong tinnitus might lead to trouble sleeping or tiredness during the day
• It can cause concentration problems at work or school
• Severe tinnitus can affect mood and trigger anxiety or depression

Long-term outlook

For most people, tinnitus that comes and goes is temporary and harmless. Even when it continues over time, many people find it becomes less noticeable as they get used to it. With the right self-care and support, tinnitus usually does not get worse and often gets better. You can live a full, peaceful life even if the sounds occasional appear.

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