Hormonal and vascular contributions to tinnitus in pregnancy: a systematic review of literature

Introduction. Tinnitus, the perception of ringing or buzzing in the ears, can develop or worsen during pregnancy due to hormonal fluctuations, vascular changes and neu­ro­lo­gi­cal conditions. This review examines the role of es­tro­gen, pro­ges­te­rone, pregnancy-induced circulatory al­te­ra­tions, and their impact on tinnitus. It also explores the dif­fe­ren­ces between pulsatile and non-pulsatile tinnitus, and it eva­lua­tes available diagnostic and management stra­te­gies. Ma­te­rials and method. A systematic literature re­view was con­duc­ted, using PubMed, Google Scholar, ScienceDirect and SpringerLink, focusing on studies from 2014-2024. Key­words included “tinnitus in pregnancy”, “pul­sa­tile tin­ni­tus”, “hormonal influence on tinnitus” and “au­dio­lo­gi­cal tes­ting”. The inclusion criteria prioritized peer-re­viewed stu­dies on tinnitus etiology, diagnostic methods and treat­ment approaches in pregnancy. Results and dis­cus­sion. Hor­mo­nal shifts, particularly estrogen and pro­ges­te­rone fluc­tua­tions, influence auditory function by al­te­ring coch­lear blood flow and neural excitability. Vascular chan­ges linked to preeclampsia, idiopathic intracranial hyper­ten­sion, and mi­graines contribute to pulsatile tinnitus. Com­mon diag­nos­tic tests include pure-tone audiometry, tym­pa­no­me­try, oto­acous­tic emissions and auditory brainstem response tes­ting. While betahistine and steroids remain controversial, non­phar­ma­co­lo­gi­cal treatments such as sound therapy, cog­ni­tive behavioral therapy and dietary modifications are preferred. Conclusions. Audiological evaluations help deter­mine the under­lying causes, and nonpharmacological treatments are re­com­men­ded due to safety concerns with medications. Fur­ther research is needed to establish clear management guide­lines for tinnitus in pregnancy, but monitoring tinnitus after de­li­very is recommended if hearing loss is also diagnosed.