Tinnitus (ringing in the ears) during pregnancy

By trimester

Weeks 1–13

1st trimester

Tinnitus can start as early as the first trimester as hormone levels climb. It's rarely linked to anything serious at this stage, but mention it at a prenatal visit if it's persistent.

Weeks 14–27

2nd trimester

In the second trimester, if ringing is new or getting worse, ask your provider about checking your iron levels, since anemia becomes more common as blood volume expands and iron demand rises.

Weeks 28–birth

3rd trimester

By the third trimester, tinnitus on its own isn't a preeclampsia sign, but if it shows up alongside a severe headache, vision changes, or swelling, those are the real reasons to call your provider.

What does the evidence show for tinnitus?

• About one in four pregnant women report tinnitus, compared with about one in ten among non-pregnant peers, most often linked to hormone-driven changes in inner-ear fluid balance. 1
• Iron-deficiency anemia is associated with a substantially higher risk of new-onset tinnitus, plausibly through reduced oxygen delivery to the cochlea and compensatory changes in blood flow. 2
• In a large cohort, women with iron-deficiency anemia had nearly four times the risk of new tinnitus at one year compared with matched controls, and the risk was even higher with more severe anemia. 2
• Current NICHD-listed symptoms of preeclampsia, eclampsia, and HELLP syndrome, including headache, vision changes, upper right abdominal pain, swelling, high blood pressure, and easy bruising, do not include tinnitus. 3
• Tinnitus reflects processing changes in the central nervous system rather than always signaling an ear-specific problem, and affects roughly 15 to 20 percent of the general population at some point. 4

When should I call my provider about tinnitus?

Sudden hearing loss, tinnitus in only one ear, or tinnitus paired with vertigo or dizziness is worth a prompt call rather than watchful waiting. Tinnitus alone isn't a listed preeclampsia symptom, but if it shows up alongside a severe headache, vision changes, swelling, or upper right abdominal pain, those are the real reasons to seek same-day care. New or worsening tinnitus is also a reasonable prompt to ask your provider about checking your iron levels, since anemia becomes more common as pregnancy progresses. When in doubt, call your obstetric team the same day. Early input almost always beats waiting, and the on-call line exists exactly for this.