Pulsatile tinnitus (PT) is the perception of a rhythmic sound in the ears, often described as a throbbing, whooshing, or thumping noise synchronized with the individual’s heartbeat. This differs from general tinnitus, which is typically perceived as a constant ringing, buzzing, or hissing sound without an external source. Pregnancy can cause or worsen this specific auditory sensation. Up to one-third of pregnant individuals may experience some form of tinnitus, with the pulsatile type being the most commonly reported.
The Physiological Link Between Pregnancy and Pulsatile Tinnitus
The perception of a heart-synchronized sound stems directly from profound changes the cardiovascular system undergoes to support the growing fetus and placenta. To meet the demands of pregnancy, the body significantly increases its total blood volume, which can rise by 40 to 50% by the third trimester. This hypervolemia, or increased fluid volume, necessitates a corresponding rise in cardiac output, increasing it by 30 to 50% above pre-pregnancy levels.
This greater volume of blood being pumped more forcefully through the body’s vessels increases the likelihood of turbulent flow. The quick, forceful flow, especially through large arteries and veins near the ear, creates an audible rushing sound. Hormonal influences from elevated estrogen and progesterone levels also cause systemic vasodilation, widening blood vessels and contributing to decreased peripheral resistance, which further alters blood circulation dynamics.
Another contributing factor is the common occurrence of mild anemia during pregnancy, often due to iron deficiency. Anemia reduces the blood’s viscosity, making it thinner, which causes it to flow at a faster velocity. This higher flow rate intensifies the turbulent sound waves near the temporal bone and inner ear, making the heart’s rhythm more perceptible. The sound heard is often the actual noise of blood circulating, magnified by temporary circulatory overdrive.
Recognizing Warning Signs and Seeking Medical Evaluation
While pulsatile tinnitus in pregnancy is frequently a benign consequence of normal physiological changes, it requires a medical evaluation to exclude more serious, though rare, underlying conditions. A medical professional, such as an otolaryngologist, will determine if the sound is synchronized with the pulse and look for non-pregnancy-related causes. This assessment is often performed by listening with a stethoscope over the neck and around the ear to hear the noise objectively, confirming its vascular origin.
Certain associated signs, or “red flags,” warrant immediate investigation. These include if the pulsatile sound is confined only to one ear (unilateral), or if it is accompanied by severe headaches, dizziness (vertigo), visual disturbances, or sudden hearing loss. These symptoms can indicate conditions like idiopathic intracranial hypertension or, more commonly in pregnancy, be an early sign of gestational hypertension or preeclampsia.
Preeclampsia is a serious condition characterized by high blood pressure and other signs of organ damage, occurring in 3 to 10% of pregnancies. Because the inner ear is sensitive to changes in blood pressure, pulsatile tinnitus can occasionally be an initial symptom, making blood pressure monitoring an important part of the evaluation. Ruling out rare vascular abnormalities exacerbated by increased blood flow is also important.
Symptom Management and Expecting Resolution
For individuals whose pulsatile tinnitus is confirmed to be a benign, pregnancy-related effect, the focus shifts to managing the distraction and discomfort. Non-invasive strategies concentrate on decreasing the contrast between the internal sound and the environment, making the whooshing noise less noticeable. Using sound masking devices, such as white noise machines or quiet fans, especially during sleep, can effectively cover the sound of the pulse.
Stress reduction and relaxation techniques, like focused breathing or gentle prenatal yoga, can help alleviate the anxiety that often makes the tinnitus sensation feel worse. Simple positional changes, such as slightly elevating the head while lying down, can reduce venous return pressure and offer a temporary decrease in perceived volume. These methods aim to improve concentration and sleep quality without introducing medications.
The most reassuring aspect of this condition is its temporary nature. Once pregnancy concludes, the cardiovascular system begins returning to its pre-gestational state. As blood volume and hormonal levels normalize, the turbulent flow diminishes. For the vast majority, the pulsatile tinnitus resolves completely within a few weeks or months following delivery.