Ménière’s disease - Symptoms of Ménière's disease

The symptoms of Ménière's disease vary from person to person. They often begin as sudden attacks, lasting for a few hours. Some people may experience several attacks each week or they may be separated by weeks, months or even years.

See your GP if you experience any of the symptoms of Ménière's disease, so they can try to identify the problem and refer you to a specialist, if necessary.

Main symptoms

The main symptoms of Ménière's disease are:

• vertigo – the sensation that you, or the environment around you, is moving or spinning
• tinnitus – hearing sounds from inside your body, rather than from an outside source
• hearing loss, with a particular difficulty hearing deep or low sounds
• a sense of pressure or fullness deep inside the ear

These symptoms usually only affect one ear at first, but both ears often become affected over time.

Vertigo and tinnitus are described in more detail below.

Vertigo

Vertigo is one of the most common and noticeable symptoms of Ménière's disease. 

As well as a sensation of spinning, you may also experience additional symptoms during an attack of vertigo, such as dizziness, feeling or being sick, and problems with balance. You may have difficulty standing or walking. Occasionally, you may have "drop attacks", where you suddenly fall to the ground.

During a severe attack, you may also experience sweating, diarrhoea and rapid or irregular heartbeats.

Tinnitus

Tinnitus is usually more noticeable when you're tired or when it's quiet, as there's less background noise to distract you from sounds coming from inside your body.

Examples of sounds you may hear include buzzing, humming, grinding, hissing and whistling.

Stages of Ménière's disease

Ménière's disease is often divided into early, middle and late stages.

However, the progression of Ménière's disease varies between individuals. You may not necessarily pass through each of these stages and the severity of the symptoms may also vary. In general, people experience more attacks during the first few years, and then as the attacks decrease in frequency over time, the hearing loss becomes progressively worse.

Some or all of the following symptoms may be experienced before an attack:

• loss of balance 
• dizziness and lightheadedness
• headache and increased ear pressure
• increased hearing loss or tinnitus
• sensitivity to sound
• a feeling of uneasiness

If a person is aware of these warning symptoms, it can allow them to move to a safer or more comfortable situation before an attack.

The stages of Ménière's disease are described in more detail below.

Early stage

The early stage of Ménière's disease consists of sudden and unpredictable attacks of vertigo. These are usually accompanied by nausea, vomiting and dizziness. You may lose some hearing during the attack, and you may experience tinnitus at the same time. Your ear may also feel blocked and uncomfortable, with a sense of fullness. Some people may also experience sensitivity to sound.

Attacks of vertigo at this stage can last from 20 minutes to 24 hours, but usually last around two to three hours. Your hearing and the full sensation in your ear usually returns to normal between attacks.

Middle stage

The middle stage of Ménière's disease consists of continuing attacks of vertigo, with the attacks becoming less severe for some people. However, tinnitus and hearing loss often become worse.

During the middle stage, you may experience some periods of remission (where your symptoms go away), which can last for up to several months. Some people may still experience symptoms of tinnitus, sensitivity to sound or loss of balance between attacks of vertigo.

Late stage

During the late stage of Ménière's disease, the episodes of vertigo occur far less frequently. There may be months or even several years between attacks or they may stop altogether. However, you may be left with balance problems, and you may be unsteady on your feet, particularly in the dark.

Hearing problems and tinnitus tend to become progressively worse during the late stage of Ménière's disease.

Vertigo
Vertigo is the sensation that you or the environment around you is moving or spinning.

Tinnitus
Tinnitus is the medical name for the perception of noise in one ear, both ears or in the head. The noise comes from inside the brain rather than an outside source.