Hearing a rhythmic “whooshing” or thumping noise in the ears is common, especially during periods of high stress. While anxiety and stress can cause or amplify this sound, it requires evaluation. The sound is often the body’s internal processes becoming audible, but evaluation is needed to ensure the underlying cause is not a physical health condition. Understanding the relationship between the body’s stress response and the ear can bring clarity to this unsettling symptom.
Understanding the “Whooshing” Sound
The rhythmic, whooshing, or throbbing sound that aligns with the heartbeat is clinically defined as pulsatile tinnitus. This is distinct from the more common form of tinnitus, which is typically a steady ringing, buzzing, or hissing sound. Pulsatile tinnitus is the perception of internal body sounds, specifically the movement of blood, near the structures of the inner and middle ear.
The sound is often described as a swooshing, thumping, or pulsing noise that speeds up when the heart rate increases, such as during exercise. This synchronization with the pulse is a defining feature that helps differentiate it from non-pulsatile tinnitus. The proximity of major blood vessels, like the carotid artery and jugular vein, to the ear structure means that any change in blood flow can become audible.
The Physiological Link to Anxiety and Stress
Anxiety and chronic stress activate the sympathetic nervous system, initiating the body’s “fight or flight” response. These physiological changes can directly cause or exacerbate the perception of pulsatile tinnitus. The connection is rooted in the cardiovascular and muscular systems.
One of the most immediate effects of this activation is increased cardiac output, causing the heart to beat faster and with greater force. This increased blood flow intensity makes the sound of blood rushing through vessels near the ear louder. Elevated blood pressure, which can accompany anxiety or stress, further contributes to this turbulent and audible blood movement.
Physical tension is another contributing factor, as anxiety often leads to prolonged muscle contraction in the head, neck, and jaw. Muscles like the tensor tympani, located within the middle ear, can become tense, which may amplify internal sounds. Tightness in the neck muscles can also affect the blood vessels that pass through the area, potentially altering blood flow and making the whooshing sound more pronounced.
The brain’s state of heightened awareness, or hypervigilance, also plays a significant role. Anxiety makes the brain more sensitive to internal sensations that are usually filtered out, such as the normal sounds of blood flow. This increased sensitivity creates a feedback loop where the unsettling sound amplifies anxiety, intensifying the physical symptom and leading to a cycle of distress.
Other Potential Causes of Pulsatile Tinnitus
While anxiety can be a trigger, pulsatile tinnitus is a symptom that has many physical causes. Vascular issues are a frequent cause, where the blood flow near the ear is made turbulent or irregular. This includes conditions like atherosclerosis, where plaque buildup narrows arteries, or arteriovenous malformations, which are abnormal connections between arteries and veins. Narrowing of the neck arteries, such as the carotid artery, or the jugular vein can also create a localized change in pressure and blood noise.
Systemic conditions can also lead to pulsatile tinnitus. High blood pressure, or hypertension, increases the force of blood against vessel walls, making the flow more audible. Anemia, which is a low count of red blood cells, can increase the volume and velocity of blood flow to compensate for reduced oxygen-carrying capacity, creating a louder whooshing sound. Hyperthyroidism can also cause the heart to speed up, resulting in increased blood flow near the ear structures.
Other structural and pressure-related causes include idiopathic intracranial hypertension, a condition involving increased fluid pressure around the brain that can affect nearby blood vessels. Issues directly within the ear, such as an ear infection, excessive earwax, or certain types of benign tumors in the middle ear, can also block sound transmission and make internal sounds more perceptible.
When to Consult a Medical Professional
A medical evaluation is recommended because pulsatile tinnitus can be a symptom of conditions ranging from benign muscle tension to more serious vascular issues. Consulting a primary care provider or an ear, nose, and throat specialist (otolaryngologist) is advisable. They can perform an examination and listen with a stethoscope to determine if the sound is objective or subjective.
It is particularly important to seek prompt medical attention if the whooshing sound has a sudden onset or is accompanied by other neurological symptoms. These “red flag” signs include:
- Dizziness.
- Changes in vision.
- Sudden hearing loss.
- Muscle weakness.
- Severe head pain.
A doctor will work to rule out physical causes, often using imaging tests like MRI or CT scans to visualize blood vessels and surrounding structures.
While awaiting a diagnosis, managing the anxiety response can help reduce the symptom’s severity. Techniques such as deep breathing, meditation, and ensuring good sleep hygiene can help lower the activity of the sympathetic nervous system. If the symptom is attributed to anxiety, treating the underlying stress and hypervigilance can lead to a significant reduction in the whooshing sound.