Pregnancy is a time of extraordinary physical transformation. Most expectant mothers are well prepared for the nausea, the fatigue, the swollen ankles and the shifting centre of gravity. What very few anticipate — and what antenatal classes rarely mention — is that pregnancy can also affect your hearing. From a persistent feeling of blocked ears to the sudden onset of tinnitus, hearing changes during pregnancy are more common than most people realise. Research suggests that up to one in three pregnant women experience some form of auditory change, yet the topic remains largely absent from mainstream pregnancy advice.
The good news is that most pregnancy-related hearing symptoms are temporary and resolve after delivery. But in some cases, pregnancy can trigger or accelerate permanent hearing conditions — most notably otosclerosis. Understanding what to expect, when to seek help, and how hearing tests work during pregnancy can help you stay informed and in control throughout this important period.
How Pregnancy Affects the Auditory System
To understand why hearing changes occur during pregnancy, it helps to know what is happening inside the body. Two hormones dominate the physiological landscape of pregnancy: oestrogen and progesterone. Both rise dramatically from the first trimester onward, and both have effects that extend far beyond the reproductive system.
Fluid retention is one of the most significant effects. Oestrogen and progesterone promote fluid accumulation throughout the body — in the ankles, hands, and face, but also in the delicate structures of the inner ear and the Eustachian tube, the narrow passage connecting the middle ear to the back of the throat. When excess fluid builds up in or around these structures, it can alter the way sound is transmitted and perceived. The Eustachian tube may swell and fail to equalise pressure properly, creating a sensation of fullness or blockage similar to what you experience during a cold or on an aeroplane descent.
Increased blood volume is another major factor. During pregnancy, blood volume rises by approximately 40 to 50 per cent to support the growing placenta and foetus. This increased volume means more blood flowing through vessels near the ear, which can create audible sounds — a phenomenon known as pulsatile tinnitus. The tiny blood vessels within the cochlea are also affected, and changes in blood flow to the inner ear can subtly alter hearing sensitivity.
Changes to middle ear pressure are also common. The hormonal softening of cartilage and connective tissue that prepares the body for childbirth can affect the Eustachian tube's ability to open and close efficiently, leading to fluctuating pressure in the middle ear. This can cause intermittent hearing changes that many women describe as their ears "popping" or feeling "underwater."
Common Hearing Symptoms During Pregnancy
If you are pregnant and have noticed changes in your hearing, you are not alone. The most commonly reported symptoms include:
- Fullness or blocked sensation: A feeling that one or both ears are plugged, similar to the sensation of having water trapped in the ear canal. This is usually caused by Eustachian tube dysfunction or fluid retention in the middle ear.
- Mild conductive hearing loss: Sounds may seem muffled or quieter than usual, particularly in the affected ear. This is typically temporary and related to fluid or pressure changes rather than damage to the inner ear.
- Autophony: Hearing your own voice, breathing, or chewing unusually loudly. This occurs when the Eustachian tube remains partially open (a condition called patulous Eustachian tube), which is more common during pregnancy due to weight loss in the tissue surrounding the tube.
- Pulsatile tinnitus: A rhythmic whooshing, pulsing, or throbbing sound in one or both ears that synchronises with the heartbeat. This is typically caused by increased blood flow near the ear and is most common in the second and third trimesters.
- Sound sensitivity (hyperacusis): Some pregnant women report that everyday sounds — cutlery on plates, traffic noise, children's voices — seem uncomfortably loud. Hormonal changes affecting the auditory processing pathways may contribute to this heightened sensitivity.
These symptoms are typically most noticeable in the second and third trimesters, when hormonal levels and blood volume are at their peak. For most women, they resolve within a few weeks of delivery.
Otosclerosis and Pregnancy: A Critical Connection
Otosclerosis is a condition in which abnormal bone growth in the middle ear progressively immobilises the stapes — the tiny stirrup-shaped bone that transmits sound vibrations from the eardrum to the inner ear. As the stapes becomes fixed, sound transmission is impaired, causing progressive conductive hearing loss. The condition affects approximately 1 in 200 adults in the UK, and it disproportionately affects women — who are diagnosed roughly twice as often as men.
The relationship between otosclerosis and pregnancy is one of the most well-documented associations in audiological medicine. Research published in the Journal of Laryngology & Otology has demonstrated that pregnancy can accelerate the progression of otosclerosis, with many women reporting a noticeable deterioration in hearing during or immediately after pregnancy. The mechanism is believed to involve hormonal effects on bone metabolism — the same oestrogen-driven processes that cause bone remodelling elsewhere in the body during pregnancy appear to stimulate the abnormal bone growth characteristic of otosclerosis.
If you have a family history of otosclerosis — a parent, grandparent, or sibling with the condition — you should be particularly alert to hearing changes during pregnancy, as the condition has a strong genetic component. Key warning signs include progressive hearing loss in one ear (otosclerosis often starts unilaterally), difficulty hearing low-pitched sounds, and a quiet, low-frequency tinnitus.
Treatment options for otosclerosis include hearing aids, which can effectively compensate for the conductive hearing loss, and stapes surgery (stapedotomy), a microsurgical procedure in which the fixed stapes is replaced with a tiny prosthesis. While stapedotomy has a high success rate, surgery is typically deferred until after delivery to avoid unnecessary anaesthetic risk. In the meantime, hearing aids can provide excellent interim support, and your audiologist can adjust the fitting as your hearing changes throughout the pregnancy.
Tinnitus During Pregnancy
Tinnitus — the perception of ringing, buzzing, hissing, or pulsing sounds in the ears without an external source — is reported by a significant minority of pregnant women. Studies suggest that between 10 and 15 per cent of pregnant women experience tinnitus at some point during their pregnancy, compared with approximately 10 per cent of the general adult population.
Several factors contribute to tinnitus during pregnancy:
- Hormonal changes: Fluctuations in oestrogen and progesterone can affect the sensitivity of the auditory nerve and the processing of sound signals in the brain.
- Increased blood flow: Higher blood volume and cardiac output can create turbulent blood flow near the cochlea, producing pulsatile tinnitus.
- Stress and fatigue: The physical and emotional demands of pregnancy can heighten awareness of tinnitus and lower the threshold at which it becomes bothersome.
- Iron-deficiency anaemia: Iron deficiency is common during pregnancy — affecting approximately 25 per cent of pregnant women in the UK — and research published by the British Tinnitus Association has identified a link between low iron levels and tinnitus. The mechanism may involve reduced oxygen delivery to the cochlea.
Management strategies for tinnitus during pregnancy include sound enrichment (playing gentle background sounds or nature recordings, especially at night), reducing caffeine intake, practising relaxation techniques such as deep breathing or mindfulness, and ensuring adequate sleep. If your midwife or GP suspects iron-deficiency anaemia, a blood test to check your ferritin and haemoglobin levels is straightforward, and iron supplementation — if indicated — may improve tinnitus symptoms alongside other benefits.
Always report tinnitus to your midwife or GP, particularly if it is pulsatile (in time with your heartbeat), sudden in onset, or accompanied by hearing loss. In rare cases, pulsatile tinnitus can indicate raised blood pressure or pre-eclampsia, which require urgent medical attention.
Ready to get your hearing checked?
Enter your postcode to compare audiologists and book today.
Find appointments →Sudden Sensorineural Hearing Loss in Pregnancy
Sudden sensorineural hearing loss (SSHL) — a rapid loss of hearing, usually in one ear, occurring over hours or days — is rare in pregnancy but constitutes a medical emergency. If you experience sudden hearing loss during pregnancy, you should seek immediate medical attention. SSHL in pregnancy may be related to vascular changes affecting the blood supply to the cochlea, autoimmune factors triggered by the altered immune state of pregnancy, or, very rarely, conditions such as acoustic neuroma.
The standard treatment for SSHL is oral corticosteroids, which must be initiated within 72 hours for the best chance of recovery. During pregnancy, the use of corticosteroids requires careful consideration by your obstetrician and ENT specialist, balancing the benefit to your hearing against potential risks to the pregnancy. Intratympanic steroid injection — delivered directly through the eardrum into the middle ear — is sometimes used as an alternative that minimises systemic exposure. The key message is simple: sudden hearing loss at any stage of pregnancy needs immediate ENT referral. Do not wait to see if it resolves on its own.
Safety of Hearing Tests During Pregnancy
Many expectant mothers worry about whether hearing tests are safe during pregnancy. The answer is unequivocal: hearing tests are completely safe for both mother and baby. A standard hearing test involves sitting in a quiet room, wearing headphones, and pressing a button when you hear a tone. There is no radiation, no medication, and no invasive procedure. Bone conduction testing, which uses a small vibrating device placed behind the ear, is also entirely safe during pregnancy.
Both NHS hearing tests and private audiological assessments are available to pregnant women without restriction. Your GP or midwife can refer you to NHS audiology, or you can book directly with a private audiologist — many of whom offer same-week appointments. If you have any concerns about your hearing during pregnancy, there is absolutely no reason to delay getting tested.
Existing Hearing Aid Users During Pregnancy
If you already wear hearing aids, pregnancy may require some adjustments. Changes in hearing sensitivity, fluid retention, and even the shape of the ear canal (which can change subtly due to swelling) may mean that your hearing aids need reprogramming or that your ear moulds no longer fit as comfortably. Increased perspiration during pregnancy can also affect hearing aid performance, as moisture is one of the primary causes of hearing aid malfunction.
Practical steps for hearing aid users during pregnancy include scheduling a hearing aid aftercare appointment to check and adjust your devices, using a drying kit or dehumidifier case nightly to manage moisture, and keeping spare batteries or a charged backup. If your hearing changes significantly during pregnancy, your audiologist can reprogram your hearing aids to match your current audiogram and readjust them again after delivery when your hearing stabilises.
Newborn Hearing Screening: Your Baby's Hearing
While this article focuses on maternal hearing health, it is worth noting the connection to your baby's hearing. The NHS Newborn Hearing Screening Programme offers a hearing test to every baby in England within the first few weeks of life. The test — known as the automated otoacoustic emission (AOAE) test — is quick, painless, and usually performed while the baby is sleeping. Early detection of hearing loss in newborns is critical for language development, social communication, and educational outcomes. Approximately 1 to 2 babies per 1,000 are born with permanent hearing loss in one or both ears in the UK, and early identification allows intervention — including hearing aids or cochlear implants — to begin within the first months of life.
If you have a family history of hearing loss, or if you experienced hearing changes during pregnancy that suggest a genetic component (such as otosclerosis), mention this to your midwife so that your baby's hearing screening results can be interpreted with appropriate context.
After Delivery: What to Expect
For the majority of women, pregnancy-related hearing changes resolve within weeks to months of delivery as hormone levels, blood volume, and fluid balance return to their pre-pregnancy state. Eustachian tube dysfunction typically resolves first, with the sensation of fullness and pressure normalising within days to weeks. Tinnitus related to increased blood flow usually subsides as cardiac output returns to normal. Mild conductive hearing loss caused by fluid retention generally resolves by six to eight weeks post-partum.
However, if hearing symptoms persist beyond three months after delivery, a follow-up hearing assessment is strongly advisable. Persistent symptoms may indicate an underlying condition — such as otosclerosis — that requires ongoing monitoring or treatment. Women who experienced otosclerosis-related hearing loss during pregnancy should be aware that the condition may continue to progress, and regular audiological monitoring is recommended.
If you are planning future pregnancies and have a known hearing condition, discuss the potential impact with your audiologist or ENT specialist in advance. Proactive monitoring — including a baseline audiogram before conception — can help you and your clinician track any changes accurately and intervene early if needed.
A Practical Checklist for Pregnant Women
If you are pregnant and experiencing hearing changes, the following steps can help you manage the situation effectively:
- Do not ignore symptoms. Hearing changes during pregnancy are real and valid — report any concerns to your midwife or GP.
- Book a hearing test if you notice hearing loss, persistent tinnitus, fullness, or dizziness. Hearing tests are completely safe during pregnancy.
- Mention your family history. If relatives have hearing loss or otosclerosis, tell your audiologist — it can guide the assessment.
- Ask about iron levels. If you have tinnitus, a blood test for ferritin and haemoglobin is simple and may reveal a treatable cause.
- Seek urgent help for sudden hearing loss. Sudden loss of hearing in one ear is a medical emergency — contact your GP, call 111, or go to A&E.
- Adjust your hearing aids. If you are an existing hearing aid user, book a review appointment and use a drying kit to manage moisture.
- Follow up after delivery. If symptoms persist beyond three months post-partum, request a follow-up audiological assessment.
- Ensure your baby is screened. Take up the NHS newborn hearing screening — it is quick, painless, and could make a critical difference to your child's development.
Pregnancy is a time of remarkable change, and hearing health deserves the same attention you give to your blood pressure, iron levels, and general wellbeing. Most hearing changes during pregnancy are temporary and manageable, but recognising the signs early — and knowing when to seek professional help — ensures that you and your baby enter the next chapter with the best possible hearing health.