Harvard Men's Health Watch

Ringing in the ears: Get it checked

Men with tinnitus should get a comprehensive hearing exam, with education on therapy options.

Image: Thinkstock

Tinnitus can't be cured, but find out about proven treatments for persistent and bothersome sounds.

About a quarter of men in their 60s and 70s develop hearing loss. Along with it may come tinnitus—ringing, hissing, buzzing, and other sounds in your head. For many men it's just a minor distraction. For others, it's a serious problem that causes depression, insomnia, and difficulties with work and family life.

Certain proven remedies help make tinnitus easier to live with. But first, see a hearing specialist for a comprehensive exam and to learn your options. "The worst thing we can do is tell the person there is nothing we can do about it, so go home and live with it," says Dr. Eduardo Corrales, an instructor in otology and neurotology at Harvard-affiliated Brigham and Women's Hospital. "Not everyone needs treatment, but some men may just need to know what it is and be reassured it isn't a dangerous condition."

How bad is it?

Most tinnitus traces to physical damage to the sound-sensing cells in the inner ear. Fortunately, most tinnitus is neither severe nor particularly bothersome. Some men just get used to it over time. In others, it may only be truly a problem in certain situations—like having a conversation in a quiet room, or lying in bed trying to fall asleep.

Exams have value

If your tinnitus is mild or occasional, Dr. Corrales still recommends that you see a specialist for a comprehensive evaluation to rule out underlying physical causes, such as problems in the brain or blood vessels. A hearing test can set a baseline for measuring future changes. "My recommendation is to get an annual audiogram," Dr. Corrales says. "Is your hearing getting worse? Your tinnitus may also get worse."

The doctor can also explain the basics of tinnitus and recommend simple strategies to cope with it. For example, a bedside environmental sound generator can help mask the ringing in your head and help you get to sleep.

Self-help guides and books can help you cope with tinnitus. A good first step is the American Tinnitus Association website, www.ata.org. It offers resources to educate yourself, and some of them are free.

Hearing aids can help

When hearing loss occurs with tinnitus, a properly fitted hearing aid can actually help with both. "The hearing aid will mask the tinnitus by providing clear, adequate volume," Dr. Corrales says. "The brain will tune in to the normal sounds more than the tinnitus."

It can require multiple visits to an audiologist to fit the hearing aid and adjust the settings. Unfortunately, insurance coverage for hearing aids remains limited, so the added tinnitus control may come at a cost. Medicare does not cover hearing aids.

Avoid unproven treatments

Certain therapies remain unproven at this time. This includes prescription medications such as antidepressants, tranquilizers, and antiseizure drugs. Also, if you hear about dietary supplements or other cures for tinnitus that seem too good to be true, they probably are. "Don't fall for anything on the Internet or the midnight ads on TV," Dr. Corrales says. "We know that none of that works."

Tinnitus treatments: What works?

If you have tinnitus that interferes with your mood, sleep, and daily activities, certain treatments can help. Here is guidance from the American Academy of Otolaryngology—Head and Neck Surgery.


  • Evaluation for a hearing aid. If you have hearing loss and tinnitus, clear sound at a sufficient volume may distract the brain from the tinnitus.

  • Cognitive behavioral therapy. This form of counseling could help you cope better with tinnitus. A program lasting eight weeks is typical.

Consider as an option

  • Sound therapy. This approach uses artificially generated sound, sometimes from a device worn on the ear, to alter your perception of or reaction to the tinnitus.

Not recommended

  • Prescription medication. Antidepressants, tranquilizers, antiseizure drugs, or steroid injections do not reduce tinnitus.

  • Dietary supplements. Ginkgo biloba, melatonin, zinc, or other dietary supplements don't relieve tinnitus.

No recommendation

  • Acupuncture. Research to date does not show that acupuncture does or does not relieve tinnitus. However, some people who try it think it helps them, and if it's done properly, it presents minimal risks.

Other approaches

  • Biofeedback and other stress-reduction approaches can lessen the emotional distress caused by the tinnitus. The American Academy of Otolaryngology did not evaluate the evidence for this.

For more information about tinnitus, check out "Tinnitus: Ringing in the ears and what to do about it"