The Medical Minute: Why are my ears ringing?

What to know about tinnitus and other hearing problems

Susan Bianco of Lancaster, left, is fitted with hearing aids by Dr. Jackie Price, an audiologist at Penn State Health Otolaryngology – Head and Neck Surgery, as she begins treatment for tinnitus, a symptom of hearing loss. Credit: Penn State Health. All Rights Reserved.

HERSHEY, Pa. — Susan Bianco, an 87-year-old from Lancaster, realized she was losing her hearing when she found herself constantly asking her husband to repeat himself. She also was struggling during phone calls and social events.

“It's very hard to hear in a crowd,” she said. “I can't understand what one person is saying if other people are talking.”

Then, Bianco started to hear something new: an annoying buzzing in her ears that gets louder when she’s tired.

Bianco is among the 13% of U.S. adults — and 27% of adults age 65 and older — who have trouble hearing, according to the Centers for Disease Control and Prevention. She’s also among the 10% with tinnitus — a ringing in the ears often linked with hearing loss. The risk of hearing loss and tinnitus increases with age and noise exposure.

“You can’t stop aging, but you can take steps to conserve your hearing and reduce your risk of developing hearing loss and tinnitus,” said Dr. Jackie Price an audiologist at Penn State Health Otolaryngology – Head and Neck Surgery.

October is National Protect Your Hearing Month. Price explains how to prevent common ear problems and when to get help.

What is tinnitus?

Tinnitus is a ringing, buzzing, hissing or whooshing sound in one or both ears. Some people say it sounds like cicadas or a freight train, Price said.

“For some people, the noise is constant and bothersome, interfering with their productivity and quality of life,” Price said.

The noise doesn’t come from an external source. It stems from a miscommunication between the brain and ears.

Other common sound-related disorders include hyperacusis, which makes everyday sounds feel too intense, and misophonia, where certain sounds trigger strong emotional reactions.

What causes tinnitus and hearing loss?

Tinnitus and other sound-related disorders are often early signs of hearing loss, Price said.

Hearing loss starts with damage to tiny hair cells inside the cochlea, a snail-shaped organ in the inner ear. These hair cells convert sound waves into signals the brain can understand. When they’re damaged, they can’t communicate with the brain properly. The result is not being able to hear as well. The messages between the brain and ears also can become distorted, creating the sounds of tinnitus.

Hearing loss and sound disorders can affect more than just the ears. They often affect sleep, concentration and relationships. They also can speed up cognitive decline, raise depression risk and increase the risk of falls.

How can hearing loss and tinnitus be prevented?

Protect your ears from loud noise: Use hearing protection when noise exceeds 85 decibels. That means wearing earplugs or earmuffs at concerts, sporting events, fireworks and when using power tools.

“I counsel people to wear hearing protection when they’re mowing grass instead of listening to music through earbuds,” Price said. “It’s like a double whammy because people have the noise from the mower, and then they crank up the music so they can hear it, and then they listen to excess noise for 45 minutes or more, sometimes twice a week.”

Choose the right earplugs or earmuffs: Buy earplugs or earmuffs with a Noise Reduction Rating of at least 22 decibels. This number, listed on the product package, indicates how much sound the product will eliminate. Insert earplugs correctly for full protection.

“Take a foam earplug between your two fingers and smoosh it down and roll it,” Price explained. “Then, when you go to put it in your ear, pull on your ear lobe with the opposite hand to open up the ear canal, insert the earplug and let it fully expand.”

Most foam earplugs are meant for one-time use to maintain a complete seal that keeps noise out.

How are hearing loss and tinnitus treated?

Hearing loss and tinnitus have no cure, but treatment can improve hearing and quality of life.

Hearing loss: Treatment depends on the cause and extent of the hearing loss. Often, hearing aids and other assistive devices are recommended.

Tinnitus: Tinnitus Retraining Therapy can help lessen the impact of tinnitus on daily life. This treatment combines counseling, which helps people cope with the sounds in their ears, with sound therapy, which uses gentle white noise to shift focus away from tinnitus.

Bianco now wears hearing aids and recently started Tinnitus Retraining Therapy. Price programmed a soft, pleasant, constant noise into Bianco’s hearing aid as part of her sound therapy. Bianco hopes the new noise can help her feel less distracted by her tinnitus.

“It sounds like it’s raining, which is a sound I don’t mind too much,” Bianco said.

When to get a hearing test

If you notice ringing in your ears, seek out a hearing evaluation, Price said.

“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,” Price said. “Testing can help you become better educated about what's going on so you can manage those changes.”