Meniere's Disease: Symptoms, Treatment, and Hearing Loss

Few inner ear conditions are as disruptive as Meniere’s disease. The episodes come without warning: sudden, intense vertigo that can last for hours, hearing that drops in and out, ringing or roaring in the ear, and a pressure that feels like the ear is about to burst.

Between episodes, everything can seem completely normal. That unpredictability is part of what makes the condition so difficult to live with.

If you or someone you know has been diagnosed with Meniere’s disease (or suspects they might have it), understanding the condition is the first step toward managing it effectively.

What is Meniere’s disease?

Meniere’s disease is a chronic disorder of the inner ear that causes recurring episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of fullness or pressure in the affected ear. It most commonly affects one ear, though it can eventually involve both in some cases.

The condition is named after Prosper Meniere, the French physician who first described it in 1861. It typically appears between the ages of 40 and 60, though it can develop at any age.

The exact cause is not fully understood. The leading theory involves endolymphatic hydrops, which is an abnormal buildup of fluid in the inner ear. The inner ear contains a fluid called endolymph that is critical for both hearing and balance. When too much of this fluid accumulates, it disrupts the signals the inner ear sends to the brain, producing the characteristic symptoms.

Why some people develop this fluid imbalance and others do not remains an open question in audiology and otolaryngology.

Recognizing the symptoms

Meniere’s disease has four hallmark symptoms. Not everyone experiences all four during every episode, but over time, most people with the condition will encounter each one.

Vertigo. This is usually the most debilitating symptom. True vertigo means the room feels like it is spinning or you feel like you are being pulled or tilted, even while sitting still. Episodes typically last between 20 minutes and several hours. During severe episodes, standing and walking may be impossible. Nausea and vomiting are common.

Hearing loss. Hearing fluctuates with Meniere’s disease, especially early on. During or just before an episode, hearing in the affected ear often drops noticeably, particularly in the low frequencies. Between episodes, hearing may return to near normal. Over years, however, the hearing loss tends to become more permanent.

Tinnitus. A ringing, buzzing, roaring, or hissing sound in the affected ear is common during and between episodes. The tinnitus may be constant or come and go, and it often gets louder before an episode begins.

Aural fullness. Many people describe a feeling of congestion, stuffiness, or pressure deep in the ear. It is similar to the sensation you get when driving up a mountain or during an airplane descent, except it does not go away with swallowing or yawning.

How Meniere’s disease is diagnosed

There is no single test that definitively confirms Meniere’s disease. Diagnosis is based on a pattern of symptoms and a process of ruling out other conditions.

Your physician or ear, nose, and throat (ENT) specialist will review your history of episodes, including how long they last, how often they occur, and which symptoms appear. They will typically order a comprehensive hearing test (audiogram) performed by an audiologist. The results often show a specific pattern: low frequency hearing loss in the affected ear, which is a strong indicator.

Additional tests may include an electronystagmography (ENG) or videonystagmography (VNG) to evaluate balance function, and in some cases, an MRI to rule out other causes like an acoustic neuroma.

In Edmonton, your family doctor can refer you to an ENT specialist for the diagnostic workup. A hearing test at a clinic like ours gives the specialist critical data to work with.

Treatment options

There is currently no cure for Meniere’s disease. Treatment focuses on reducing the frequency and severity of episodes, managing symptoms when they occur, and preserving hearing for as long as possible.

Dietary and lifestyle changes. Many people with Meniere’s disease find that reducing sodium intake helps control symptoms. Excess sodium can promote fluid retention, including in the inner ear. Staying well hydrated, limiting caffeine and alcohol, and managing stress are also commonly recommended.

Medication. During acute episodes, medications for nausea and dizziness (like dimenhydrinate or meclizine) can help manage symptoms. Some doctors prescribe a diuretic (a medication that reduces fluid retention) as a preventive measure to lower the frequency of episodes.

Vestibular rehabilitation. Between episodes, physiotherapy focused on balance and vestibular function can help your brain compensate for the mixed signals coming from your inner ear. This is especially useful for people who feel unsteady between episodes.

Betahistine. Widely prescribed in Canada and Europe, betahistine (Serc) is thought to improve blood flow to the inner ear and reduce fluid pressure. Research results are mixed, but many patients report fewer and less severe episodes while taking it.

Injections. In more severe cases, your ENT specialist may recommend injections through the eardrum into the middle ear. Gentamicin injections reduce vertigo by selectively damaging the balance cells in the inner ear, though there is a risk of further hearing loss. Steroid injections are a less aggressive alternative that can reduce inflammation.

Surgery. Surgery is reserved for cases that do not respond to other treatments. Options include endolymphatic sac decompression (which aims to reduce fluid pressure) and, in extreme cases, labyrinthectomy (removal of the inner ear balance organs) or vestibular nerve section.

How an audiologist helps manage the hearing component

While your physician or ENT specialist manages the medical side of Meniere’s disease, an audiologist plays a key role in monitoring and addressing the hearing loss that often accompanies it.

Regular hearing tests track how your hearing changes over time. Early stage Meniere’s disease often shows fluctuating low frequency hearing loss that may come and go with episodes. As the condition progresses, the hearing loss may become more stable and spread to other frequencies.

Knowing exactly where your hearing stands helps your care team make informed decisions. If hearing loss becomes significant enough to affect daily communication, your audiologist can discuss hearing aid options designed for the type of loss Meniere’s disease produces.

Tinnitus management is another area where an audiologist can help. If the ringing or buzzing in your ear is persistent, your audiologist can introduce strategies like sound therapy, tinnitus retraining, or hearing aids with built-in tinnitus masking features. You can learn more about these approaches on our tinnitus services page.

Living with Meniere’s disease

One of the hardest parts of Meniere’s disease is the uncertainty. Episodes can strike during a work meeting, while driving, or in the middle of the night. Many people develop anxiety about when the next episode will occur, which can lead to social withdrawal and avoidance of activities.

Building a management plan with your healthcare team reduces that uncertainty. When you know your triggers, have medications on hand for acute episodes, and are monitoring your hearing regularly, the condition becomes more manageable.

Support from family and coworkers also matters. Explaining the condition to the people around you means they can respond appropriately if an episode occurs, rather than panicking or assuming something more serious is happening.

When to seek help in Edmonton

If you are experiencing recurring episodes of vertigo with hearing changes, tinnitus, or ear pressure, talk to your doctor. The sooner Meniere’s disease is identified, the sooner you can start a management plan.

For the hearing side of things, Medicine Place Hearing Care is here to help. Our audiologist provides comprehensive hearing assessments that give your physician or ENT specialist the data they need for diagnosis. We also offer ongoing hearing monitoring, tinnitus management, and hearing aid fitting for patients whose hearing loss progresses.

No referral is needed for a hearing test. Contact us to book at either of our Edmonton locations.