What’s Causing My Pulsatile Tinnitus?

Man with his hand on his ear in pain from pulsatile tinnitus.

When most people talk about their tinnitus, they describe a ringing, humming or tone-like sound. It’s generally the result of damage to your inner ear. This causes mixed signals that your brain interprets as a strange sound.

Pulsatile tinnitus is something else entirely.

Pulsatile tinnitus happens when you can hear the blood circulating near your ears. With each heartbeat, you might hear something like a tha-thump, wha-whoosh or chu-chug.

It may not sound like what most people call tinnitus, but just like the other tinnitus, it could be a warning sign. Let’s explore what causes pulsatile tinnitus and what you may be able to do you stop it.

Pulsatile Tinnitus Causes

Doctors don’t consider tinnitus to be a disease itself. Instead, they label it as a symptom of an underlying condition. Understanding what that condition is will often give hearing specialists the clues they need to help reduce your tinnitus symptoms.

This is especially true when people hear a heartbeat in the ear, which accounts for only 10% of tinnitus cases. Here are the most common causes.

High Blood Pressure

Any time you feel like you’re going to blow your top, that’s your arteries constricting or getting narrower. As they narrow, it’s harder for blood to move through them.

Life-giving blood has to force itself through so it can deliver oxygen and nutrients to your body. This puts a lot of pressure on those arterial walls. And because that artery is so close to your inner ear you can actually hear it each time blood forces its way through the narrowed passage.


This is arterial plaque. It’s a hard buildup of bad cholesterol and fat inside the arteries. When it’s bad, it’s bad, creating a whole range of mountains and valleys along the artery wall. In order for blood cells to get where they’re going, they must navigate up and down and around these obstructions.

All of this maneuvering causes a lot of racket.

Carotid Arteries & the Jugular Vein

Your carotid arteries are the major arteries responsible for getting nutrients from the heart to the brain. If you were to squeeze the sides of your neck (which we don’t recommend), you’ll note that your face turns red. The Jugular vein takes the blood back to the heart after it drops off the nutrients it was carrying.

Either one of these can become narrowed, causing irregular circulatory patterns you can hear.


In rarer cases, a neck tumor may be pressing on your arteries or veins. Your doctor will be able to help diagnose whether this is the cause of your pulsatile tinnitus.

Capillary Abnormalities

Capillaries are the small vessels that branch out from the artery to reach more precise locations. Other capillaries draw up expended blood cells, carrying then back to the veins. Capillaries can grow abnormal as the result of birth defects and diseases.

Some people can hear the blood working its way through this network. If this is the cause, it’s normally experienced only on one side.

Anemia & Overactive Thyroid

Also less common, these ailments can cause blood to move more quickly and forcefully through the arteries.

Is Pulsatile Tinnitus Dangerous?

Even if you cast aside the health risks of the most likely culprit which is heart disease, the sound itself can cause its own set of health and life problems like:

  • Insomnia
  • Fatigue (because of the insomnia)
  • Weight gain (associated with poor sleep)
  • Irritability, anxiety and even depression
  • Difficulty concentrating and increased accidents
  • Worsened cardiac symptoms

Pulsatile Tinnitus Treatments

Depending on the cause of your tinnitus, a specialist may recommend that you do one or more of the following:

  • Learn stress management techniques like yoga, meditation or taking “me time”
  • Get more exercise
  • Manage your blood pressure
  • Reduce sodium intake
  • Lower your cholesterol
  • Stop smoking
  • Take medication for the underlying health condition
  • Sound therapy — If the blood vessel isn’t treatable, then a hearing specialist can administer a sound into your ear that desensitizes your brain to the sound.
  • Cognitive Behavioral Therapy — A CBT specialist helps you identify harmful thinking habits and replace them with more positive, healthy ways of thinking. For example, if you have a tendency to fume for hours over something your friend said or did, this can raise your blood pressure. CBT helps you redirect your thoughts and let stuff go.

Stop This Pulsing In My Ears!

If you have a pulsing sound in your ears, don’t ignore it. Speak with a professional about the symptoms so that they can identify the cause.

You may be able to speculate about the cause of your pulsatile tinnitus, but you should always seek professional help if you hear a pulsing sound in your ears. Any of these causes could pose a risk to your health and you need to address it.


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