What is Meniere's disease?

Meniere's disease is a disorder of the inner ear that causes hearing and balance problems. There is no cure, but the symptoms can be managed.

People with Meniere’s disease experience attacks vertigo that usually lasts between 2 and 4 hours. Some people have several attacks of Meniere’s disease in a short period of time, while other people only have it every few months or years. In between attacks, most people usually have mild or no symptoms.

Most people with Meniere’s disease have it in just one ear. It often leads to worsening hearing loss in that ear.

What are the symptoms of Meniere's disease?

During an attack, you might experience symptoms such as:

• vertigo (feeling like you’re spinning)
• losing your balance
• nausea and vomiting
• hearing loss

Attacks might start suddenly, or you might have warning symptoms beforehand, such as:

• a feeling of pressure in your ear
• earache
• tinnitus (a ringing, hissing, buzzing or humming noise in your ear)
• abnormal hearing

After the attack, your hearing will go back to normal and you may feel very tired.

Over time, attacks may improve, but tinnitus and other symptoms may become constant and hearing loss becomes worse, even between attacks.

During the later stages of Meniere’s disease, the attacks may stop altogether, but you may continue to have balance problems and your hearing loss will usually persist.

What causes Meniere's disease?

Meniere’s disease is probably caused by build-up of fluid in your inner ear. This affects the cells that are responsible for balance and hearing.

It’s not known why this build up occurs. It might be a result of ear problems, infections or injuries.

Meniere’s disease is most common in people in their 40s and 50s. Some people find that their symptoms are worse with their menstrual period or with stress, but this has not been proven.

How is Meniere's disease diagnosed?

There is no test to confirm that you have Meniere’s disease, but testing is important to rule out other causes of your symptoms. If you think you are experiencing symptoms of Meniere’s disease, you should see your doctor. They will examine you, ask about your symptoms and may refer you for a hearing test, balance tests and x-rays.

How is Meniere's disease treated?

There is no cure for Meniere’s disease. Treatments aim to control the symptoms.

During an attack, you can use medicine that reduces vomiting, nausea, vertigo and anxiety.

You may be advised to:

• limit the amount of salt in your diet
• avoid caffeine, chocolate, alcohol and smoking
• take medicines known as diuretics

These measures may reduce the fluid in your inner ear, so you have fewer attacks of vertigo. They don’t usually help tinnitus or hearing loss.

If you experience severe symptoms or frequent attacks, your doctor may suggest referral to an ear, nose and throat (ENT) surgeon. The surgeon may suggest:

• an injection of medicine into your eardrum
• surgery to cut the nerve responsible for balance or to drain fluid from your inner ear

There’s no clear evidence that herbal supplements will help. It’s possible that ginkgo biloba may help for vertigo, but not for tinnitus. Ginkgo biloba can cause side effects and interact with some medicines, so check with your doctor if it’s safe for you to try.

Other treatments to consider:

• If you experience hearing loss, a hearing aid may help.
• Vestibular physiotherapy may help manage vertigo.
• If your attacks are triggered by stress or if you are feeling anxious about attacks, talk to your doctor about psychological therapy.

Is there anything I need to avoid?

Because Meniere’s disease is unpredictable and can affect your balance and hearing, you may have to change some of your daily activities. Be careful when climbing ladders, swimming, or operating heavy machinery.

It’s not clear whether Meniere’s disease might affect your ability to drive. Talk to your doctor about driving, and if you need to inform your road traffic authority in your state.