Pulsatile tinnitus is a symptom linked to mental health conditions, such as anxiety. Management and treatment of the condition can help reduce the distress caused by the sound.

You may have pulsatile tinnitus if you’re experiencing ringing, beating, or whooshing sounds in your ear. Not only can this condition be annoying, but it also has connections to your mental health. Pulsatile tinnitus could be the source of anxiety.

Anxiety can also lead to pulsatile tinnitus, which may be a potential sign it’s time to obtain treatment. Learning about the causes of pulsatile tinnitus, how anxiety influences the condition, and being open to treatment options can help you find relief.

If you have this condition, you’re probably no stranger to how it can affect your mental health. Finding support and evaluation can help improve your quality of life.

Pulsatile tinnitus is the auditory perception that may feel and sound like:

  • buzzing
  • ringing
  • whistling
  • whooshing
  • beating

Tinnitus can be pulsatile or non-pulsatile:

  • Pulsatile tinnitus: the sounds are synchronous with your heartbeat
  • Non-pulsatile tinnitus: non-synchronous with your heartbeat

Pulsatile tinnitus is linked to mental health conditions. Research from 2023 of a population-based cohort study in Germany suggested that individuals with tinnitus experienced higher rates of anxiety, depression, and somatic symptoms when compared to individuals without tinnitus.

Common symptoms of pulsatile tinnitus

If you’re wondering whether you may be experiencing pulsatile tinnitus, it’s vital to get an evaluation of your symptoms. You can often get evaluated for pulsatile tinnitus by an audiologist.

Some common signs of pulsatile tinnitus, according to 2017 research, include:

  • regularly hearing a steady beat or whooshing sound in one or both of your ears
  • auditory perceptions that only you can hear
  • synchronous heartbeat with the sound you’re hearing
  • increases in your heart rate make the sound faster
  • decreases in your heart rate make the sound slower
  • dizziness
  • anxiety
  • depression
  • distress
  • difficulty sleeping
  • hearing loss

If you’re experiencing these symptoms, you may consider getting them evaluated, as pulsatile tinnitus could be a potential precursor to a stroke.

There are various causes of pulsatile tinnitus. Many of them stem from underlying health conditions.

One 2022 overview lists these potential causes of pulsatile tinnitus:

A 2020 case review mentions these common causes of pulsatile tinnitus:

  • vascular malformations
  • vascular tumors
  • conditions linked to high cardiac output
  • developmental abnormalities
  • lesions of the middle ear, temporal bone, cranial cavity, or internal auditory canal

Additionally, pulsatile tinnitus can be caused by mental health conditions, like anxiety. 2018 research indicates anxiety symptoms are present in approximately 28%-45% of those with pulsatile tinnitus.

According to the research, depression is present in 10%-60% of those with the condition and it’s suggested that stress can also cause pulsatile tinnitus.

The researchers also suggest that many people with tinnitus also have psychological distress that occurs before the onset of pulsatile tinnitus symptoms.

Pulsatile tinnitus treatment often involves seeing an ear, nose, and throat doctor (ENT), audiologist, or otolaryngologist. There are various strategies for managing and treating pulsatile tinnitus.

How is pulsatile tinnitus diagnosed?

Pulsatile tinnitus is often diagnosed by obtaining a medical history and report of your symptoms. Evaluations for underlying conditions can determine the course of treatment and what options may be best suitable for you.

If you have pulsatile tinnitus, research indicates you may also undergo various imaging studies such as:

  • magnetic resonance imaging (MRI) of your head and auditory canal
  • computed tomography (CT) scan
  • magnetic resonance venography
  • angiography

These imaging methods may help determine the underlying causes of pulsatile tinnitus and your treatment plan.

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Research suggests these potential treatment options for pulsatile tinnitus:

Reducing noise

Many cases of pulsatile tinnitus are caused by sensorineural hearing loss. In these cases, reducing exposure to loud noises when possible and watching the volume of auditory output on headphones can help you manage tinnitus.

Using hearing protection devices is also an option.

Conservative management

Making lifestyle changes can help alleviate symptoms of pulsatile tinnitus. Lifestyle changes that may be helpful include reducing stress, decreasing alcohol consumption, and reducing caffeine intake.

Sound amplification

Hearing aids can help you manage pulsatile tinnitus by reducing or masking other sounds by introducing more ambient noise.

Additional devices, such as specialized tinnitus markers or white noise generators, can help minimize pulsatile tinnitus severity and help you sleep better.


Melatonin can help decrease tinnitus severity and improve your sleep.

If you experience anxiety and depression, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants can help you reduce the disturbances caused by pulsatile tinnitus.

Tinnitus retraining therapy

Retraining therapy can help you adapt to tinnitus. This treatment uses directive counseling ear-level noise generators to help lessen negative responses to the sound.

Cognitive-behavioral therapy (CBT)

CBT can help you lessen tinnitus symptoms can improve your quality of life. This treatment is helpful if you have conditions like anxiety and depression linked to your tinnitus. This treatment involves counseling and learning relaxation strategies.


Surgical treatment for tinnitus is rare and only used when the underlying causes are clear and treatable.

Some potential reasons for surgical interventions include:

  • resectioning the nerves leading from your inner ear to your brain
  • surgery for internal ear disorders such as Meniere’s disease
  • removal of the stapes bone for those who have the formation of new bones around the middle bones of the inner ear

Receiving the proper evaluation and diagnosis from an audiologist and exploring treatment options with a medical professional may be the best course of action for treating pulsatile tinnitus. Consider speaking with your doctor to determine the best treatment plan for you.

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Pulsatile tinnitus can be a disruptive disorder that causes distress to your mental health. Mental health conditions, as well as underlying health issues, can cause pulsatile tinnitus.

If you’ve been experiencing bothersome pulsatile tinnitus, consider finding a provider near to get evaluated. You can use the FindCare tool to find a provider near you.

Additionally, you can find support and resources at these organizations:

You don’t have to deal with pulsatile tinnitus alone. Connecting with others who have similar problems from the condition can help you cope.