Dear health-conscious friends,

That rhythmic whoosh in your ear may actually be the sound of your own blood flowing. Here’s when it’s harmless — and when it deserves a check.

Have you ever been lying quietly in bed and suddenly noticed a whoosh, thump, or pulsing sound in your ear?

Then you realise something strange: it’s perfectly in time with your heartbeat.

This phenomenon has a name: pulsatile tinnitus.

Unlike ordinary tinnitus, which is usually described as ringing, buzzing, or hissing, pulsatile tinnitus tends to follow your pulse. In many cases there is a perfectly innocent explanation. Occasionally, however, it can be a clue that something affecting the blood vessels or blood flow needs investigating.

Why can you hear your own heartbeat?

Blood is constantly travelling through arteries and veins close to your ears.

Normally, you don’t notice it. Your brain is remarkably good at filtering out the everyday sounds produced inside your own body.

But sometimes blood flow becomes faster, more turbulent, or simply easier to hear. The result can be a rhythmic “whoosh-whoosh” that matches your pulse.

It may seem particularly obvious at night because the outside world is quiet and there are fewer sounds competing for your attention.

Common causes of a pulsing sound in the ear

Sometimes there is nothing seriously wrong. Pulsatile tinnitus can become noticeable temporarily when your circulation is working harder.

Exercise increases heart rate and blood flow, for example. Stress and anxiety can make your heartbeat stronger and make you more aware of bodily sensations.

Other possible causes include high blood pressure, anaemia, an overactive thyroid, or conditions affecting the ear itself.

Even something as simple as earwax or fluid in the middle ear may make internal body sounds more noticeable by reducing the amount of outside sound reaching the ear.

Pregnancy can also increase blood volume and cardiac output, making pulsatile tinnitus more noticeable in some people.

Sometimes the blood vessels are responsible

Because pulsatile tinnitus is closely related to circulation, doctors sometimes investigate the blood vessels of the head and neck.

Narrowing or abnormalities of arteries, unusual connections between arteries and veins, or changes in nearby veins can create turbulent blood flow that becomes audible.

Another condition associated with pulsatile tinnitus is idiopathic intracranial hypertension (IIH), in which pressure around the brain is increased. It may also cause headaches or visual disturbances.

These causes are much less common than everyday explanations, but they are one reason persistent pulsatile tinnitus shouldn’t simply be dismissed.

One ear or both?

This distinction can matter.

Hearing a pulse occasionally in both ears, particularly after exercise or when lying quietly, may simply reflect increased awareness of normal circulation.

A new, persistent pulsing sound in only one ear deserves more attention, particularly if there is no obvious explanation.

A doctor may examine your ears, check your blood pressure and listen around the neck and skull for abnormal blood-flow sounds. Depending on the findings, blood tests, a hearing assessment or imaging may be recommended.

When should you see a doctor?

Arrange a medical assessment if the pulsating sound is new, persistent, repeatedly affects one ear, or is becoming more noticeable.

Seek urgent medical attention if it occurs alongside symptoms such as sudden hearing loss, severe or unusual headache, visual changes, dizziness, weakness, numbness, difficulty speaking, or other new neurological symptoms.

The bottom line

Occasionally hearing your heartbeat in your ear is often nothing to worry about — particularly when it happens briefly after exercise or while lying in a silent room.

But a sound that repeatedly goes whoosh… whoosh… whoosh in perfect time with your pulse has a medical name: pulsatile tinnitus.

And if it is new, persistent, or mainly on one side, it is worth getting checked.

Your body makes plenty of noises.

Most of the time, your brain simply has the good manners not to let you hear them.

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​AskADoc Weekly: Clear medical insights without the jargon.

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Stay healthy!

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👩‍⚕️ Dr. Joanna​
​AskADoc4Advice — where medicine meets curiosity (and a little bit of weird).

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