Hearing & tinnitus
Tinnitus: what causes it besides noise?
Noise is by far the most commonly cited factor behind tinnitus, and our other guides largely confirm that. But it isn't the only possible cause, and plenty of assumptions circulate about other factors supposedly involved — sometimes with little real evidence behind them.
A large systematic review published in 2023 set out to sort well-established risk factors from merely assumed ones.
Quick answer
Beyond noise, the best-established links with tinnitus involve existing sensorineural hearing loss, middle ear infections, certain ototoxic treatments (including platinum-based chemotherapy), temporomandibular joint disorders, and depression. However, despite widespread belief, high blood pressure, migraines and head injury showed no significant association in this review.
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Discover our earplugsWhat the science says
Biswas R. et al., Journal of the Association for Research in Otolaryngology, 2023
Systematic review and meta-analysis, 25 case-control and cohort studies selected from 2,389 records identified
Significant associations were found for sensorineural hearing loss (relative risk 3.68), middle ear infection (1.63), platinum-based treatments (2.81), temporomandibular joint disorders (2.06) and depression (1.31). No significant association was found, however, for high blood pressure, migraines, stroke or head injury.
Limitation: The authors themselves stress that the vast majority of the factors studied remain inconclusive for lack of sufficiently high-quality studies — this is neither an exhaustive list nor proof of direct causation for each factor cited.
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Discover our earplugsPractical tips
Ototoxic medications
More than 200 medications and substances are recognized as potentially ototoxic, including certain chemotherapies, high-dose aspirin, or certain antibiotics. Talk to your doctor if tinnitus appears after starting a new treatment.
Middle ear problems
An ear infection or earwax blockage can cause temporary tinnitus, generally reversible once the cause is treated.
The temporomandibular joint, often overlooked
A jaw disorder (TMJ) is associated with an increased risk of tinnitus — something many affected people, and sometimes their GP, don't realize.
The link with depression
The association likely runs both ways: depression can promote tinnitus, and living with chronic tinnitus can also weigh on mood.
What's probably not a major cause
Contrary to widespread belief, this review found no significant link with high blood pressure or migraines — which doesn't mean you should never consider them, but that the evidence is lacking so far.
Noise remains the most actionable lever
Among all possible causes, noise exposure is the only one you have direct, simple control over day to day, through suitable hearing protection.
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You can't act on every risk factor for tinnitus, but you can limit your noise exposure — the easiest one to control. Discover our earplugs suited to each situation.
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Discover our earplugsFrequently asked questions
Can stress cause tinnitus?+
The link with depression is established, but stress alone, outside a depressive context, is harder to isolate as a direct cause in the studies available so far.
Do certain medications cause tinnitus?+
Yes, more than 200 medications are considered potentially ototoxic, with an effect sometimes reversible on stopping the treatment and sometimes lasting depending on the molecule and dose.
Can a jaw problem cause tinnitus?+
Yes, temporomandibular joint disorders are associated with an increased risk of tinnitus in this review — a dentist or TMJ specialist can be a relevant addition to seeing an ENT.
Should I see an ENT specialist or another specialist?+
The ENT specialist remains the first point of contact for persistent tinnitus. Depending on the associated factors identified (medications, jaw, mood), they can then refer you to another specialist if needed.
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