Common Causes, Symptoms, Treatments for Pulsatile Tinnitus

25 September 2019 Assisted Living

If you constantly hear a whooshing or thumping sound that beats in a steady stucco in either one or both of your ears, you may have a more rare form of tinnitus called pulsatile tinnitus.

Like people with regular tinnitus, you hear sounds that no one else does, and it can be maddening. Your doctor can hear it if they listen with a stethoscope. But what is pulsatile tinnitus? What are the causes, symptoms, and treatments? Find out below.

Defining Pulsatile Tinnitus

Simply put, the cause of pulsatile tinnitus is blood circulating in or near your ears. This is why you can hear it, but no one else can unless they have a stethoscope. Unlike regular tinnitus where your ears put up and amplify a sound, this type of tinnitus amplifies the sound of blood circulating through your arteries.

This is why you hear a steady pulse when you have this type of tinnitus. It can get louder if your blood starts circulating faster, and it can go back to typical levels once your blood circulation returns to normal speed. You may hear it called vascular, rhythmic, or pulse-synchronous tinnitus.

Interestingly enough, there are two main types of tinnitus that people can have, and you either have one or the other. These two types are:

  • Subjective- Subjective tinnitus is the more common of the two types. Only the person that experiences it can hear the noise. This can be a temporary or a chronic condition. For example, this can show up after you've been around loud noises, like at a concert.
  • Objective- Objective tinnitus is on the other end of the spectrum. A doctor can listen with a stethoscope and hear a pulse if you have objective tinnitus. This type can also be chronic or temporary, depending on the root cause.

Symptoms of Pulsatile Tinnitus

There are several symptoms that you can experience with this disorder, and they vary from person to person. You may not experience more than one, or you might have many. However, the core symptoms many people experience at least once include:

  • Dizziness
  • Headaches
  • Hearing Loss
  • Lightheadedness
  • Heart Palpitations
  • Vision Problems

The biggest symptom is hearing a sound with a steady beat that seems to be perfectly in sync with your pulse. It can be in both ears, but it's also common to only hear it in one ear for a lot of people. Most people with pulsatile tinnitus report that the sound is distracting and loud, and it can even reach unbearable levels.

Causes of Pulsatile Tinnitus

One of the good things about this type of tinnitus is that doctors can usually pinpoint exactly what the root cause is. In turn, they can work on helping with the specific trigger, and this can help you successfully manage this condition. Potential causes include:

1. High Blood Pressure

When you have high blood pressure, it means that the pressure inside your arteries is higher than it should be to be healthy. Blood pressure is the force the blood exerts against your artery walls as it flows through. You may have heard it referred to as hypertension. It can actually lead to changes in how your blood flows through your body. In turn, it can be louder when the blood rushes through your body because it's applying more direct pressure on the arterial walls. Your pulsatile tinnitus can get louder the higher your blood pressure gets.

2. Atherosclerosis

A second probable cause of this type of tinnitus is more common in older people. Atherosclerosis is a condition where plaque builds up in your arteries, and this makes it more difficult for the blood to flow through because it narrows the artery. Your blood has to work harder to go through your body, and you can hear a louder rushing sound as the blood forces itself by the plaque buildup. This is the most common cause of having this type of tinnitus in only one ear because it's usually one side of your body that has the plaque buildup.

3. Irregular Blood Vessels

Developing irregular blood vessels is another very common problem for people around the world. When your blood circulates through kinked or damaged vessels in the brain around or near your ear, it can create both noise and pressure. Other common blood vessel problems that can result in pulsatile tinnitus include a kinked or narrow neck artery, or you could have a kinked or narrowed vein in your neck (jugular) that can cause the noise.

4. Overactive Thyroid

The thyroid gland acting up can cause a host of issues throughout your body, and this includes your blood flow. Having an overactive thyroid can encourage your body to push blood through your veins and arteries at a much quicker pace, and this makes the pressure against the walls increase. In turn, you get a much louder and more pronounced sound. This sound is usually in both ears.

5. Neck or Head Tumors

Although this is a slightly less likely cause, developing a neck or head tumor can cause this type of tinnitus. The reason behind this is that the tumor can start to press on your veins or arteries, and this creates a narrow space where your blood has to force itself through. As the tumor gets larger and puts more pressure on your artery or vein, the tinnitus can get louder. It can go away if you have your physician remove the tumor.

6. Arterial and Vein Connection Problems

Maybe you have problems with the connective tissues between your arteries and veins. If so, this can cause narrowed arteries and veins, and your blood has to work harder to pass through it. The resulting pressure can cause you to hear the pounding in your ears or ear, depending on the side the connection problems are on. You usually only hear it in one ear if this is the cause.

Diagnosing Pulsatile Tinnitus

The good news is that pulsatile tinnitus can get effective treatment if it's due to an underlying cause. Your doctor will treat the root cause, and you should see a reduction in the noise level from this condition. Your doctor will most likely refer you to an ear specialist called an otolaryngologist. This specialist will give you a hearing test, and they may choose to look in your ears. Another portion of the exam includes looking at your jaw and into your eyes to see if there are any signs of increased pressure in your brain. A few other diagnostic tests include:

  • Blood testing.
  • Brainstem Auditory Evoked Response (BAER) test. This test times the electrical waves sent from your brain when they make a clicking sound in your ear.
  • This is very similar to the BAER test. However, it uses an electrode that the specialist will put either on or in your eardrum.
  • MRI or CT scan of your blood vessels and brain to look for narrowing.

If they find you have an underlying cause, they'll design a plan that works on treating that cause. If it's not from an underlying cause, there are other treatment methods available that can help reduce the noise level. It usually won't go away completely, but it can lower enough to give you relief from the constant pulsing noise.

Treating Pulsatile Tinnitus

Interestingly enough, having this type of tinnitus is many people's first clue that they have something else going on with their health. They find that they have this condition after they have a diagnosis of something else. Your individual treatment plan will depend entirely on what causes it, and it can range from medications to surgery to repair your blocked blood vessels. Once they treat the underlying condition, the noise stops. Common treatment options include:


If you have high blood pressure, going on medication can help to reduce your blood pressure levels. Once they drop, you should notice a marked reduction in the noise, or it may completely stop as long as you keep your blood pressure under control.


Another easy thing you can do to help with your health overall and encourage great circulation is exercise. It doesn't have to be high-impact either. Something as simple as walking for 20 to 30 minutes a day or swimming every day can help without adding too much excess stress on your body.

Low-Sodium Diet

Eating a diet that has a lot of salt can wreak havoc on your arteries and health. You want to switch to a low sodium diet and really watch your salt intake. The reasoning behind this is that salt causes your body to retain fluids, and this makes your body work harder to pump blood. In turn, your blood pressure rises.

Stop Smoking

Cigarette smoke has a negative impact on more than just your lungs. It also has an impact on your circulatory system, and it can cause problems with your blood pressure. Stopping smoking has an immediate positive impact on your body as a whole, and this simply improves over time.

Stress Reduction

Every time you have a high amount of stress, your body releases a stress hormone that causes your body to go into overdrive and work harder. This is where the sounds get louder. Learning ways to manage stress, like meditation, yoga, or simply taking a walk or a 10-minute break can help you reduce your stress levels.

Tinnitus Retraining

If your tinnitus isn't from an underlying source, undergoing tinnitus retraining is an option. If you choose this, you'll wear a device that plays music at a certain frequency level that helps you tune out or ignore the sound of your pulsatile tinnitus. This can take a while to get used to.

Sound Generators

A wearable sound generator looks and fits into your ear like a traditional hearing aid. When you have them in, you get a low-level and constant background noise. Again, this can help you block out the pulsing sound until you simply don't notice it anymore.

White Noise

There are such things as white noise machines, and they work to make your pulsing noise less noticeable overall. They're especially beneficial when you're trying to lie down and go to bed. Another option is to turn a fan on and let it run in your room or have the television on low. If you don't want to buy a machine, there are apps that generate white noise.


If your pulsatile tinnitus comes from something specific to your vein or artery, having surgery to clean it out is an option. Your surgeon can insert a flexible mesh tube or stent directly into your artery or vein to help hold it open and improve your overall blood flow. They can also go in and scrape any plaque out to that may be building up on your arterial walls.

Cognitive Behavioral Therapy

If none of these options work for you, cognitive behavioral therapy is another alternative. This is a unique form of talk therapy that helps you retrain your brain. You'll learn how to think about your tinnitus differently, and this can help you change your emotional reaction to it. Eventually, you won't react to the sound at all, and you'll be able to ignore it.

Pulsatile Tinnitus Outlook

Since this is generally a more annoying condition than it is anything else, your outlook depends entirely on your cause. Lifestyle changes like adding exercise, cutting out bad habits, and eating a healthier diet can help control or reduce the noise levels naturally.

If natural ways don't work well for you, medications, therapy, and surgery are other avenues you may want to explore depending on your level of severity. Generally, most people can safely live with this condition and learn to ignore it as time goes on.

Contact Bethany Homes Today!

If you have a loved one that is experiencing pulsatile tinnitus, you may want to know more. You can reach out and get in touch with our staff. We're happy to help you in any way we can!