What causes ringing in the ears (tinnitus)?

Tinnitus is most commonly linked to damage to the sensory hair cells of the inner ear, which prompts the brain to create phantom sounds such as ringing or buzzing. Common triggers include age-related hearing loss, loud-noise exposure, ear wax blockage, ear infections and some medications. Around one in three Australians experience it at some point.

How tinnitus and ringing in the ears develop

When the inner ear's sensory hair cells are damaged or under-stimulated, the auditory system can respond. It generates its own internal sound signal. You experience this as ringing, buzzing, hissing or humming. This is why tinnitus so often accompanies hearing loss, since both frequently share the same underlying inner-ear cause.

Common causes and triggers of tinnitus

• Age-related hearing loss (presbycusis)
• Long-term loud-noise exposure, including a single very loud event
• Ear wax blockage, which can trigger or worsen tinnitus until cleared
• Ear infections or fluid in the middle ear
• Certain medications, where a single medication can sometimes trigger tinnitus; your GP, pharmacist or audiologist can advise on this
• Stress and poor sleep, which can make existing tinnitus feel more noticeable, though they are not usually the root cause

What is the single biggest cause (hearing loss, noise, ear wax)?

The leading causes are age-related and noise-induced hearing loss. Other contributors include ear wax build-up, ear infections, certain medications and, less commonly, other underlying ear conditions. Because tinnitus can have several causes, an assessment by an audiologist helps identify what is driving yours and how best to manage it.

Does everyone with tinnitus need management?

Not necessarily. Mild, occasional tinnitus that does not bother you day to day may not need active management, though it is still worth having your hearing checked if it is a new symptom. Tinnitus that is persistent, loud, or affecting sleep or concentration is worth assessing properly.

Does tinnitus mean you have hearing loss?

Not always, but the two are commonly linked as a sourced association, since they often share the same inner-ear cause. A hearing test alongside a tinnitus assessment helps clarify whether hearing loss is also present and, if so, whether hearing aids with built-in tinnitus support may help both at once.

For more information, visit Healthdirect (healthdirect.gov.au) (opens in a new tab).

Sources: Healthdirect; Mayo Clinic; Tinnitus Australia. Information current July 2026 and general in nature.