Hearing a persistent ringing or buzzing in both ears can be unsettling and if you’re dealing with this, you’re far from alone. Tinnitus in both ears is surprisingly common, affecting millions of people worldwide. While it isn’t a condition in itself, it’s often a sign of something else happening in the body. From age-related hearing loss to exposure to loud noises or even certain medications, the causes behind it can vary widely. But how do you figure out what’s behind the noise? By understanding the common triggers and learning to spot the signs, you can take the first steps toward managing or even reducing your symptoms. This blog will guide you through the top causes and help you identify them, bringing you closer to clarity and relief.

What Is Tinnitus in Both Ears?

If you’ve ever heard a persistent ringing, buzzing, or hissing sound in both of your ears with no external source, you’ve experienced what’s called tinnitus. It’s not a condition on its own but a symptom of an underlying issue. For some, it’s a short-lived annoyance; for others, it can persist and severely impact daily life. In this section, we’ll explore what tinnitus in both ears, also called bilateral tinnitus, is and why identifying it is crucial for your health.

Key Characteristics of Tinnitus

Tinnitus is described as the perception of sound when no actual external noise is present. Here are the most common sounds people report hearing:

• Ringing: This can range from a soft whisper to a louder, constant tone.
• Buzzing: A low humming noise that may feel like electric vibrations.
• Hissing: Similar to the sound of air escaping from a tire or steam.
• Roaring: A deeper, rumbling sound, often compared to ocean waves.

Bilateral tinnitus specifically refers to tinnitus that occurs in both ears simultaneously, as opposed to unilateral tinnitus, where the sound appears in just one ear. This distinction matters because the causes and treatments can vary significantly. Around 10–25% of adults experience some form of tinnitus, with bilateral cases being among the most common presentations.

What makes tinnitus so challenging for many is its variability it can be constant, intermittent, or influenced by certain triggers like loud noises or stress. And while it’s easy to dismiss tinnitus as harmless, it’s often linked to something bigger happening in your body.

Why It’s Important to Identify Bilateral Tinnitus

Ignoring tinnitus in both ears isn’t just inconvenient it can be risky. Persistent tinnitus could be your body’s way of telling you that something isn’t quite right.

Here’s why it’s important to pinpoint bilateral tinnitus:

1. Hearing Loss: Tinnitus often goes hand in hand with hearing loss, particularly in older adults or those exposed to loud environments. The buzzing or ringing acts as a red flag that your auditory system is under strain.
2. Underlying Health Issues: Sometimes, tinnitus points to more serious concerns. For example:
   • Vascular Problems: Pulsing or rhythmic tinnitus may indicate blood flow issues, such as high blood pressure or blocked arteries.
   • Tumors: Tinnitus can occasionally signal the presence of rare conditions, such as acoustic neuromas, which are benign tumors on the nerve that connects the ear and brain.
3. Mental Health Struggles: Chronic tinnitus can lead to stress, anxiety, or even depression if ignored long enough. The constant noise can be mentally exhausting, affecting sleep patterns and overall quality of life.

Think of tinnitus as your body’s internal alarm system. While it doesn’t always point to a severe issue, assuming it’s “no big deal” could lead to missed opportunities for early detection and treatment. Paying attention to what your ears are telling you can save you from bigger problems down the road.

Common Causes of Tinnitus in Both Ears

If you’ve ever experienced tinnitus in both ears, you know how overwhelming it can be to track down the source of that persistent buzzing or ringing. The truth is, tinnitus isn’t a standalone condition it’s your body’s way of signaling that something else is going on. Whether it’s related to hearing health, medications, or an underlying medical condition, identifying the cause can help you figure out the next steps. Let’s break down some of the most common reasons behind bilateral tinnitus.

Age-Related Hearing Loss (Presbycusis)

One of the most frequent culprits behind tinnitus in both ears is age-related hearing loss, also known as presbycusis. As we grow older, the microscopic hair cells in our inner ear that detect sound can wear down or become damaged. This natural decline in auditory function is a leading cause of tinnitus.

Here’s a staggering fact: Over half of adults aged 75 and older experience some level of hearing loss. And it’s not just minor changes when those hair cells don’t function properly, the brain attempts to fill in the missing sound frequencies, often creating the perception of ringing or buzzing. It’s as if your auditory system hits “search mode,” but instead of silence, you get tinnitus.

Does this mean everyone over 60 will deal with tinnitus? Not necessarily, but the correlation between aging and ear health can’t be ignored. If you’re noticing hearing issues along with tinnitus, especially in both ears, age could play a major role.

Noise-Induced Hearing Loss

Think back to all the concerts, sporting events, or work environments you’ve experienced with loud noise. Even that time you cranked up your headphones to max volume counts. Noise-induced hearing loss happens when prolonged exposure to loud sounds damages the inner ear, and it’s another significant cause of tinnitus.

Here’s an example: Imagine a construction worker who spends decades operating loud machinery without ear protection. Over time, the hair cells in their ears get overloaded and can’t recover. This damage can result in both hearing loss and the constant ringing or static sound of tinnitus.

It’s not just career-related. In fact, over 26 million Americans aged 20 to 69 have experienced hearing loss due to noise exposure. And if you’ve ever left a concert feeling like your ears were “blasting” afterward, you’ve had a taste of temporary tinnitus from acoustic overload. For some, though, the effects stick around permanently, especially with repeated exposure.

Protecting your ears from noise is pretty simple earplugs, lowering the volume on your headphones, or taking breaks from loud environments can go a long way in minimizing damage.

Ototoxic Medications

Did you know some medications can actually cause or worsen tinnitus? These are called ototoxic drugs, and they’re more common than you think. Chemotherapy drugs, high doses of certain antibiotics, and even everyday over-the-counter medications like aspirin (in large doses) can negatively impact your hearing.

Take this as an example: A person undergoing chemotherapy might report sudden-onset tinnitus after starting treatment—the drugs targeting cancer cells can inadvertently harm the delicate inner ear structures. Similarly, someone taking high doses of ibuprofen for chronic pain might notice ringing in both ears after weeks or months of consistent use.

Here are just a few examples of ototoxic drugs linked to tinnitus:

• NSAIDs like ibuprofen or aspirin (especially in high doses)
• Certain antibiotics, including aminoglycosides
• Diuretics used for high blood pressure (like furosemide)
• Antimalarial drugs
• Some chemotherapy medications

While the ototoxic effects of these drugs can vary widely some temporary, others permanent, it’s crucial to talk with your doctor if you suspect medication is the cause of your symptoms.

Underlying Medical Conditions

Sometimes, the underlying reason for tinnitus isn’t directly related to ears or noise at all. Health issues ranging from circulatory disorders to TMJ (temporomandibular joint) dysfunction can contribute to ringing in both ears.

Here are a few conditions that are worth paying attention to:

1. Meniere’s Disease: This inner-ear disorder often causes vertigo, hearing loss, and tinnitus. It’s associated with fluid buildup in the ear, and the tinnitus often feels like a roaring low-pitched buzz.
2. Hypertension (High Blood Pressure): Ever heard a pulsing or throbbing in sync with your heartbeat? That’s called pulsatile tinnitus, and it’s often tied to circulatory issues like high blood pressure.
3. TMJ Disorders: The joint connecting your jaw to your skull sits close to your ear canal. Misalignment or stress in this joint can indirectly cause tinnitus, due to the pressure or nerve irritation in the area.

What makes these conditions tricky is that they don’t always feel related to your ears. However, if you have persistent tinnitus and symptoms like dizziness, jaw pain, or heart issues, don’t ignore them. Addressing the root condition could also ease your tinnitus.

Recognizing these common causes of bilateral tinnitus can help you filter through the noise and pinpoint what might be behind your symptoms. Each cause varies widely in treatment and prevention, so the key is understanding what fits your situation best.

Diagnosis of Tinnitus in Both Ears

When you’re dealing with tinnitus in both ears, the constant noise can feel like a puzzle with too many missing pieces. For many of us, figuring out the cause starts with a proper diagnosis. The tricky part? There’s no single test that gives you all the answers. Instead, doctors rely on a combination of examinations, from hearing tests to detailed looks at your medical history. By digging into these diagnostics, you can begin to understand what’s fueling the ringing or buzzing you’re experiencing—and how to address it effectively.

The Role of Audiometric Testing

One of the first steps in diagnosing tinnitus is a hearing test, often called an audiogram. This test isn’t just about detecting how well you hear; it helps uncover any hearing loss, a common companion of tinnitus in both ears.

Here’s how it works: You’ll sit in a soundproof booth, wear headphones, and listen for tones at various pitches and volumes. For many people with tinnitus, especially those experiencing age-related or noise-induced hearing loss, the silent parts of the test reveal gaps in hearing ability. These gaps often correlate with the frequency of the tinnitus sound. Imagine trying to tune a radio, but a specific station is nothing but static—that’s similar to how the brain compensates for missing auditory input, creating the “phantom” noise known as tinnitus.

Audiometric testing doesn’t stop at general hearing. Specialists also use tools like:

• Tinnitus pitch matching: This helps identify the frequency of the sound you’re hearing, whether it’s a high-pitched buzz or a low hum.
• Loudness discomfort level (LDL): Determines how loud a noise needs to be before it’s uncomfortable. Believe it or not, this can often play into how tinnitus feels day-to-day.
• Minimum masking levels (MML): Gauges how much external sound might be needed to mask or suppress the tinnitus.

Hearing tests lay a foundation, giving both you and your doctor critical insights. Plus, if hearing loss is present, addressing it with hearing aids or sound therapies could not only improve your hearing but also reduce the tinnitus you’re experiencing. It’s like cleaning a foggy window, you might not get rid of all the haze, but the view becomes much clearer.

Identifying the Root Cause Through Medical History

Audiometric testing tells one part of the story, but your medical and medication history fills in the gaps. Your past can reveal so much about why you’re hearing that ringing or buzzing. Whether it’s certain medications, health conditions, or life events, even small details can guide your doctor toward an answer.

For example, have you been exposed to loud noises consistently over time—say, at a concert, the workplace, or during hunting trips? Even hobbies like woodworking or riding motorcycles could contribute to damage in the auditory system. Noise-induced hearing loss is one of the most common culprits behind tinnitus.

Your doctor might ask questions like:

• Are you on any medications that could affect your ears? Aspirin, certain antibiotics, or diuretics could stir up trouble.
• Have you noticed changes in your blood pressure or circulation? Pulsatile tinnitus, which syncs with your heartbeat, sometimes ties back to vascular issues.
• Do you experience vertigo or dizziness alongside tinnitus? This may point toward inner-ear conditions like Meniere’s disease.
• Have you experienced jaw pain or stiffness? The temporomandibular joint (TMJ), which sits close to your ear, can sometimes contribute to tinnitus.

Taking over-the-counter painkillers too often? Or managing chronic illnesses like diabetes or hypertension? These can be important. Even seemingly insignificant details—like untreated allergies or sinus issues—can shed light on what’s going on.

Some people learn that their tinnitus has roots in stress or anxiety, which can heighten sensitivity to sound and cause the perception of phantom noises. And sometimes, it’s something as everyday as earwax buildup that’s causing the noise.

By taking stock of your history and sharing these clues with your doctor, you’re drawing a roadmap to pinpoint the cause. Think of it as piecing together a jigsaw puzzle; each bit of information brings the bigger picture into focus. While this process can take time and patience, being thorough here means fewer surprises and better treatment outcomes in the long run.

With both hearing tests and medical history evaluations, you can begin to map out the complex web of factors contributing to tinnitus in both ears. And while no single diagnostic tool holds all the answers, combining these approaches brings you closer to clarity and relief.

How to Manage and Treat Tinnitus in Both Ears

Dealing with tinnitus in both ears can be a frustrating experience. The constant ringing, hissing, or buzzing can sometimes feel like it takes over your entire life. But there’s good news—while there’s no one-size-fits-all cure, there are plenty of effective strategies to help manage and reduce symptoms. From addressing physical causes to adjusting your daily habits, the right combination of treatments can ease the noise and improve your quality of life.

Addressing Underlying Causes

Sometimes, tinnitus is a symptom of something else going on in your body. Identifying and treating those underlying causes can significantly reduce or even eliminate the ringing in your ears.

• Earwax Buildup: If wax becomes compacted in the ear canal, it can block sound and irritate your eardrum, triggering tinnitus. A quick visit to your doctor can help clear it safely—please resist the urge to use cotton swabs, as they can push wax farther in and make matters worse.
• Infections: Ear infections or sinus infections can also cause tinnitus. Treating the infection with antibiotics (if required) or decongestants for sinus relief can address the inflammation, reducing irritation in the ear and relieving the symptoms.
• Medication Adjustments: Did you know some medications can make tinnitus worse? Drugs labeled as ototoxic—like certain antibiotics, diuretics, or even high doses of aspirin—can contribute to ringing in the ears. Work with your healthcare provider to see if alternatives or adjusted doses are an option for you.

When you address what’s fueling your tinnitus, it’s like putting out a fire at its source. It might not silence the ringing overnight, but it can lay the foundation for long-term relief.

Hearing Aids and Sound Therapy

For many people, managing tinnitus is about distracting the brain from the noise. Sound therapy, including hearing aids and masking devices, works wonders in minimizing the perception of tinnitus.

• Hearing Aids: If your tinnitus is linked to hearing loss, hearing aids can be transformative. By amplifying external sounds, hearing aids give your brain more to focus on, effectively “drowning out” the ringing or buzzing in the background. It’s like turning up the volume of the real world while the phantom noises fade into the background.
• White Noise Devices: These devices generate soothing background sounds like rain, ocean waves, or static that help mask tinnitus. Whether it’s at night to help you fall asleep or during quiet work hours, a gentle layer of sound can stop tinnitus from dominating your thoughts.
• Streaming Therapy Apps: Got your phone handy? Apps like Calm, White Noise, and others provide a library of customizable sounds to help you manage symptoms. Pair this with noise-canceling headphones, and you’ve got portable relief at your fingertips.

Sound therapy doesn’t get rid of tinnitus it shifts your focus away from it, which can be life-changing if the constant noise has been overwhelming you.

Cognitive Behavioral Therapy (CBT) and Habituation Techniques

Tinnitus can take a toll on your mental health, especially if it’s severe or persistent. That’s where Cognitive Behavioral Therapy (CBT) comes in. This evidence-backed approach teaches you to reinterpret the way you think and feel about tinnitus.

• Changing the Mindset: CBT helps you shift your reaction from “I can’t stand this” to “This is something I can manage.” It doesn’t erase the ringing, but it rewires how your brain perceives it. Over time, the sound becomes less bothersome—like tuning out a ticking clock in the room.
• Tinnitus Retraining Therapy (TRT): This combines counseling with sound therapy to help your brain “habituate” or adapt to tinnitus. It’s a slow but steady mental shift where the noise becomes a background detail you barely notice rather than a constant annoyance.
• Emotional Resilience: Stress and anxiety often amplify tinnitus. By managing your emotional response, CBT and similar therapies help break the vicious cycle where worrying about tinnitus makes it feel louder.

Therapy is a powerful tool—not just for coping with tinnitus, but for reclaiming control over how you live with it. Mental health is half the battle.

Lifestyle Modifications to Ease Symptoms

Sometimes, small changes in how you live your life can have a big impact on tinnitus. It’s not just about managing the sound in your ears; it’s about creating a healthier, balanced environment that keeps symptoms at bay.

• Manage Stress: Stress tightens your body like a coiled spring, which aggravates tinnitus. Techniques like yoga, meditation, or deep breathing can help relax your mind and quiet the noise. Ever just taken a deep breath and felt calmer? That’s the kind of intentional stress relief that works wonders.
• Avoid Caffeine and Alcohol: Both of these can make tinnitus worse by increasing your blood flow or stimulating your nervous system. You don’t have to quit cold turkey, but limiting how much you consume might ease your symptoms.
• Cardiovascular Health: Good circulation is crucial for ear health. Activities like walking, jogging, or swimming improve blood flow, which can sometimes reduce the ringing caused by poor circulation. Think of it as a win-win—you’re caring for your heart and your ears.
• Get Restful Sleep: Tinnitus can feel worse when you’re tired because your brain has less energy to filter out the noise. Aim for regular sleep routines and use aids like blackout curtains or white noise machines to help you rest.
• Avoid Loud Environments: Protect your ears at concerts, in noisy workplaces, or during events with sustained loudness. Earplugs can be lifesavers in preventing further hearing damage—and they’re easy to keep in your bag.

These lifestyle changes might not “cure” tinnitus, but they give you tools to manage it. It’s about building resilience, one small step at a time.

Finding a way to manage tinnitus in both ears may take some experimentation, but there’s hope. Whether adjusting your lifestyle, tapping into therapies, or focusing on what’s driving your symptoms, each action you take brings you closer to relief.

When to See a Doctor

Tinnitus in both ears can range from mildly irritating to downright disruptive, and sometimes, it’s a sign that something more serious is going on. While occasional ringing or buzzing might not seem like a big deal, there are moments when it’s essential to involve a healthcare professional. Knowing when to seek help could make all the difference in addressing potential underlying issues effectively.

Signs It’s Time to Make an Appointment

Not all tinnitus requires a trip to the doctor, but certain red flags shouldn’t be ignored. If you’re unsure whether you need medical attention, here are some key signs that it’s time to act:

• Persistent Tinnitus: If the ringing, buzzing, or other noises last longer than a week—especially if they don’t fluctuate in intensity—it’s best to consult a healthcare provider. Chronic symptoms could be your body’s way of alerting you to an overlooked issue.
• Sudden Changes in Sound: Did the tinnitus come on suddenly or change dramatically in pitch or volume? A noticeable shift in your symptoms might indicate an underlying issue, such as an ear infection or nerve damage, that needs attention.
• Tinnitus with Hearing Loss: Ringing accompanied by hearing difficulties is often linked to age-related or noise-induced hearing loss, but it could also indicate something more serious. An ENT specialist can help determine if your auditory system is strained or damaged.
• Pulsatile Tinnitus: If the noise in your ears feels rhythmic and seems to beat in time with your pulse, this could point to a vascular issue such as high blood pressure or more complex conditions like an aneurysm. Don’t dismiss this as a coincidence—get it checked out.
• Additional Symptoms: Experiencing tinnitus alongside dizziness, nausea, or ear discharge? These symptoms might signal inner-ear disorders like Meniere’s disease or even an infection that requires treatment. Vertigo and balance issues tied to tinnitus shouldn’t be ignored either.

Sudden or Severe Tinnitus

If there’s one thing I’ve learned, it’s this: tinnitus that appears out of nowhere or becomes severe almost overnight isn’t something to brush aside. Imagine waking up to a high-pitched screech you can’t escape—this kind of scenario often signals an acute issue, such as trauma to the ear, sudden hearing loss, or an adverse reaction to medication. Immediate medical care might help preserve your hearing or address the root cause before it worsens.

Why Professional Help Matters

Seeing a doctor isn’t just about stopping the noise. It’s about getting to the bottom of why it’s happening. Tinnitus can stem from a range of conditions, including something as simple as earwax buildup or as complex as a circulatory disorder. An ENT specialist or audiologist can help pinpoint whether your tinnitus is tied to temporary factors or something that might require ongoing care.

Here’s what a doctor might do to help:

1. Evaluate Symptoms: Through conversations and tests, they’ll assess the duration, intensity, and type of tinnitus you’re experiencing.
2. Check for Underlying Causes: Possible causes could range from ear infections to issues like hypertension or even benign tumors.
3. Recommend Treatments: Based on their findings, treatment options may include sound therapy, hearing aids, medication adjustments, or even surgery in rare cases.

Think of your doctor as a detective piecing together the clues behind the noise. Trust me, the peace of mind that comes from knowing what’s going on is worth any momentary discomfort about asking for help.

When in Doubt, Err on the Side of Caution

Let’s be real, listening to your body is never a bad idea, especially when it’s giving off clear signs to pay attention. If the noise in your ears is interfering with life, getting worse, or coming with other symptoms, don’t wait. Sometimes we think we can push past discomfort, but with tinnitus, early intervention can prevent bigger issues down the line.

Conclusion

Tinnitus in both ears may seem like an odd quirk at first, but it’s often a sign that your body is trying to tell you something. Whether it’s tied to aging, loud noise exposure, or a health condition, understanding the cause is the first step toward relief. While there’s no universal fix, tools like hearing aids, sound therapy, or simply addressing the root issue can make a huge difference.

If the ringing persists or worsens, don’t dismiss it. A quick chat with your doctor could uncover opportunities to manage it more effectively. You don’t have to navigate this alone—there are options, and there’s hope. What’s one thing you can do for your ears this week? Start there.