Multiple sclerosis (MS) is a disease of the brain and spinal cord where your immune system attacks the myelin coating that surrounds and protects your nerves. Nerve damage causes symptoms such as numbness, weakness, vision problems, and difficulty walking.

A small percentage of people with MS also have hearing problems. If it becomes harder for you to hear people talking in a noisy room or you hear distorted sounds or ringing in your ears, it’s time to check in with your neurologist or a hearing specialist.

Hearing loss is the loss of 30 decibels or more of hearing. Hearing loss isn’t common for people with MS, but it can happen. According to the National Multiple Sclerosis Society, about 6 percent of people with MS have hearing loss.

Your inner ear converts sound vibrations on the eardrum into electrical signals, which are carried to the brain via the auditory nerve. Your brain then decodes these signals into the sounds you recognize.

Hearing loss could be a sign of MS. Lesions can form on the auditory nerve. This disturbs the nerve pathways that help your brain transmit and understand sound. Lesions may also form on the brain stem, which is the part of the brain involved in hearing and balance.

Hearing loss can be an early sign of MS. It can also be a sign that you’re having a relapse or flare of symptoms if you have had transient hearing loss in the past.

Most hearing loss is temporary and improves when a relapse has subsided. It’s very rare for MS to cause deafness.

SNHL makes soft sounds hard to hear and loud sounds unclear. It’s the most common type of permanent hearing loss. Damage to the nerve pathways between your inner ear and your brain can cause SNHL.

This type of hearing loss is much more common in people with MS than other forms of hearing loss.

Sudden hearing loss is a type of SNHL where you lose 30 decibels or more of hearing over a period of a few hours to 3 days. This makes normal conversations sound like whispers.

Research suggests that 92 percent of people with MS and sudden SNHL are in the early stages of MS. Rapid hearing loss can also be a sign of an MS relapse.

Usually, hearing loss in MS affects one ear only. Less often, people lose hearing in both ears.

It’s also possible to lose hearing in one ear first and then in the other. If this occurs, your healthcare provider may evaluate you for other diseases that could look like MS.

Tinnitus is a common hearing problem. It sounds like a ringing, buzzing, whistling, or hissing in your ears.

Usually aging or exposure to loud noises causes tinnitus. In MS, nerve damage disrupts the electrical signals that travel from your ears to your brain. That sets off a ringing sound in your ears.

Tinnitus isn’t dangerous but can be very distracting and annoying. There currently is no cure.

A few other hearing problems linked to MS include:

  • increased sensitivity to sound, called hyperacusis
  • distorted sound
  • difficulty understanding spoken language (receptive aphasia), which is not actually a hearing problem

The only treatment for hearing loss is avoiding triggers. For example, heat can sometimes trigger a flair up of old symptoms such as hearing problems in people with MS.

You may find you have more trouble hearing in hot weather or after exercising. Symptoms should improve once you’ve cooled down. If heat affects your hearing, try to stay indoors as much as possible when it’s hot outside.

A white noise machine can drown out ringing to make tinnitus more bearable.

See a doctor if you’ve lost hearing or you hear ringing or buzzing sounds in your ears. Your doctor can evaluate you for causes of hearing loss, such as:

  • an ear infection
  • ear wax buildup
  • medications
  • ear damage from exposure to loud noises
  • age-related hearing loss
  • an injury to your ear or brain
  • a new MS lesion

Also, see the neurologist who treats your MS. An MRI scan can show whether MS has damaged your auditory nerve or brain stem. Your doctor can prescribe steroid drugs when you have an MS relapse to improve hearing loss if it is in the early stages.

Your neurologist or ear, nose, and throat (ENT) doctor may refer you to an audiologist. This specialist diagnoses and treats hearing disorders and can test you for hearing loss. You can also find an audiologist through the American Academy of Audiology or the American Speech-Language-Hearing Association.

Hearing aids can help with temporary hearing loss. They’re also a treatment for tinnitus.

You can buy a hearing aid on your own, but it’s best to see an audiologist to get it properly fitted. An audiologist might also recommend an induction loop to filter out background sounds in your home to help you hear more clearly.

Medications like tricyclic antidepressants are sometimes prescribed to help with tinnitus symptoms.

Though MS can cause hearing loss, it’s rarely severe or permanent. Hearing loss may be worse during MS flares and should improve once the flare is over. Your doctor can prescribe medications to help you recover faster and may refer you to an ENT specialist or audiologist for further testing.