What is Pulsatile Tinnitus?

What is Pulsatile Tinnitus?

Pulsatile tinnitus is a form of tinnitus, with its own causes and potential treatments.

Tinnitus is sound heard when there is no external source. The sound itself can vary person to person, but may sound like a ringing in the ears, whooshing sound or even a rhythmic noise or a whistling sound. There are various causes of tinnitus, sometimes making it hard to pinpoint just one.

The noise may be present in one ear, or both, or it may even sound like it’s coming from inside the individual’s head. Sometimes the pitch and frequency can change as well.

How is pulsatile tinnitus different?

Pulsatile tinnitus occurs when there is a change in blood flow in the blood vessels near the ear, or even an awareness to that blood flow. These blood vessels could be the large arteries and veins near the back of the skull and base of the neck, or smaller vessels inside the ear itself.

The major difference between subjective tinnitus and objective (pulsatile) tinnitus, is that pulsatile tinnitus is sound created from a real source. This means that your doctor or hearing healthcare professional will also be able to hear the sounds as well. It also usually has a clear underlying cause, which makes it unique from regular tinnitus which can sometimes be unclear as to why it has developed.

Pulsatile tinnitus symptoms

This type of tinnitus usually matches the individual’s heartbeat, since it is related to blood flow. It’s also important to note that pulsatile tinnitus usually occurs in one ear only, which makes it an important variant among those who suffer from tinnitus.

In addition to ringing in the ears, you might also experience other symptoms if you have high pressure in the fluid around your brain (a condition called idiopathic intracranial hypertension). This symptoms could include:

  • Headaches and/or migraines
  • Hearing loss
  • Dizziness
  • Vision problems

If you have any of these additional symptoms, it’s important to speak to your doctor.

Causes of pulsatile tinnitus

There are a few different reasons for the blood flow to change and subsequently cause pulsatile tinnitus. It could also be a combination of different reasons as well. Either way, if the underlying cause of pulsatile tinnitus is fixed, the tinnitus symptoms themselves should subside.

Localized increased flow

Rather than blood flow increasing all over the body, an area of blood vessels or one single vessel could increase causing localized increased flow. This could happen from tumours in the head or neck region, which could cause abnormal vessels or push on blood vessels. However, most tumours associated with pulsatile tinnitus are benign rather than malignant.

Generalized increased blood flow

Just like a river, the faster the blood flows within the body, the more noise it will make. Generalized increase blood flow can happen from natural situations such as pregnancy or tough exercise. These activities increase the flow of blood within the body and thus make the blood louder for the individual.

Generalized increased blood flow, or increased high blood pressure, could also happen in severe anaemia or when the thyroid gland is overactive, which is known as hyperthyroidism or thyrotoxicosis.

Either way, the individual experiences pulsatile tinnitus from their blood pressure increasing. It’s like it becomes a quick-running river rather than a calm stream.

Turbulent blood flow

Issues with the body’s arteries (such as conditions that harden the arteries) can cause blood flow to become irregular and turbulent. A blockage in the arteries can also cause blood flow to become turbulent, usually obstructed from cholesterol or fats. This type of flow is much louder than regular blood flow, making it more noticeable for the individual. It’s similar to a loud, rough river, that can make a lot of noise.

How is pulsatile tinnitus treated?

Because pulsatile tinnitus is a symptom of another issue, it’s often treated by solving the underlying issue first.

Since high blood pressure and artery conditions tend to be the most common, they can be treated with certain lifestyle changes, such as:

  • Reducing sodium in your diet to help keep your arteries clear
  • Stop smoking
  • Limit your alcohol consumption
  • Regular exercise to stay healthy
  • Keep an eye on your weight, and lose weight if necessary
  • Reduce caffeine intake

If lifestyle changes or medications cannot improve the condition, surgery on the impacted artery may be an option (such as surgery on a damaged blood vessel). Otherwise, typical tinnitus treatments can also be used:

Sound therapy

One of the most common and trusted ways to manage tinnitus symptoms is by using sound therapy. This can be done a number of ways, including using tinnitus-specific hearing aids.

The idea behind sound therapy is that you can play sound, such as brown noise, white noise, music or natural sounds to help mask your tinnitus. The important part is that the external noise is played slightly below your tinnitus sounds, rather than playing it loud overtop to cover the tinnitus. By playing it slightly lower than your tinnitus, your brain can work to ignore the tinnitus sounds over time. It may not completely eliminate the sounds, but your brain will notice the tinnitus much less in time.

Sound therapy can be done using tinnitus-specific hearing aids which connect to an app on your smartphone. From there, you can choose which noises you’d like to hear and set the volume to before your tinnitus. You can wear these throughout the day for as long as you like, as long as it’s slightly quieter than your tinnitus. Regular mp3 players or iPhones can also be used, but you’ll need to wear headphones instead.

Sound therapy could also be utilized using sound generators, usually used in the bedroom when you’re trying to sleep with tinnitus. These machines can make all sorts of different noises, including daily life sounds like a fan or an air conditioner. A silent environment is the worst nightmare for someone with tinnitus. As long as you can have quiet, external noises playing, you can help retrain your brain to focus on something other than your tinnitus.

Stress management

While much is still being discovered about tinnitus, it’s known that stress and anxiety can make tinnitus symptoms more apparent. By practicing healthy stress relief and relaxation techniques, the individual can minimize their tinnitus symptoms. Other activities such as massages, acupuncture, or meditation can help reduce stress. However, it should not be done in a completely silent room as that can make tinnitus more noticeable.

Some people also claim that essential oils help their tinnitus symptoms. Although more research is needed in this area, essential oils can help reduce stress and subsequently minimize tinnitus symptoms indirectly.


The main aspect of pulsatile tinnitus is that it is a side effect of something else. Once you figure out what the main issue is, and solve it, the tinnitus symptoms will subside as well. If you think you may have tinnitus, including pulsatile tinnitus, speak with your doctor. It’s important not to self-diagnose and your doctor will be able to provide a thorough treatment plan for your symptoms specifically.

Quiet Mind is a blog dedicated to turning a critical eye to tinnitus treatments and supplements.  So many don’t work and are overhyped, we’re here to shed some light on some of the scams and successful products that claim to stop the ringing.


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