The essentials

Ménière's disease is an inner ear disorder that causes attacks of spinning vertigo lasting 20 minutes to 12 hours, with fluctuating hearing loss, ringing and a feeling of fullness in one ear. It is diagnosed from your symptoms and a hearing test (audiogram). Blood tests cannot confirm it: they are used to rule out look-alikes such as syphilis or thyroid disease. Sudden vertigo with a drooping face, weak arm or slurred speech is a stroke until proven otherwise: call 911.

What is Ménière's disease, at a glance?

Ménière's disease is a long-term disorder of the inner ear, which handles hearing and balance. Symptoms come in attacks separated by calm periods[3][4]. It is not contagious and it is not an ear infection.

Ménière's disease in brief
TopicKey facts
Other namesMeniere's disease, idiopathic endolymphatic hydrops; "Ménière's syndrome" when the same symptoms have a known cause[4]
How commonAbout 190 per 100,000 adults in the United States[4], roughly 615,000 people, with about 45,500 new diagnoses each year[3]
Usual ageMost often 40 to 60; rare before 18[3]; slightly more common in women[4]
Ears affectedUsually one; both ears in 15 to 25% of people[3]
Key testsHearing test (audiogram); MRI to exclude other causes; targeted blood tests (syphilis, thyroid, blood sugar, autoimmune markers) to rule out look-alikes
Main specialistEar, nose and throat doctor (otolaryngologist), with an audiologist[3]

What are the symptoms of Ménière's disease?

  • Common Vertigo: you or the room seems to spin for 20 minutes to 12 hours, often with nausea and vomiting[2][4].
  • Common Fluctuating hearing loss in the affected ear, low pitches first; it improves between attacks early on[1][4].
  • Common Tinnitus: buzzing, roaring or hissing in the same ear, not linked to head position[4].
  • Common Ear fullness or pressure, often with sensitivity to loud sounds, before and during an attack[4].
  • Possible Loss of balance during and after the spinning[5].
  • Rare Drop attacks: sudden falls without loss of consciousness, as if pushed to the ground[3].

Over the years, hearing tends to fluctuate less and then stay reduced, and tinnitus can become constant even between attacks[4]. For ringing without vertigo, see our guide to tinnitus causes and treatments.

Is it Ménière's disease or another cause of vertigo?

Most dizziness is not Ménière's disease. Vertigo attacks without hearing changes in someone with migraines suggest vestibular migraine; inflamed balance nerves, a brainstem stroke or a benign tumor of the hearing nerve can also look similar[4]. Our page on dizziness causes and tests walks through them. A painful ear with fever is more likely an ear infection.

When should I see a doctor?

When to see a doctor

  • Emergency: call 911 if vertigo comes with a drooping face, an arm you cannot lift, slurred or garbled speech, sudden loss of vision in one eye, or being so off-balance you cannot stand or walk. These are signs of a stroke, not of Ménière's disease. Do not drive yourself[5].
  • Within 24 to 48 hours for a sudden drop in hearing in one ear, a first severe attack of vertigo with vomiting that stops you from keeping fluids down, or vertigo after a head injury.
  • At your next appointment if you have had repeated spells of spinning with hearing changes, ringing or fullness in one ear[5].

What causes Ménière's disease, and who gets it?

Symptoms are linked to excess fluid (endolymph) in the inner ear, called endolymphatic hydrops, which disturbs hearing and balance signals[3]. Why it builds up is unclear: narrowed blood vessels, viral infections, allergies, autoimmune reactions and genes have been proposed[3].

  • Age and sex: peak onset between 40 and 60, with more women than men affected[4].
  • Migraine: some people have both Ménière's disease and migraine, and vestibular migraine can mimic it[4][7].
  • Autoimmune diseases: in 690 patients, rheumatoid arthritis, lupus and ankylosing spondylitis were more frequent than expected[7]. See our overview of autoimmune diseases and their blood tests.
  • Known causes of the same picture (Ménière's syndrome): head trauma, autoimmune inner ear disease, allergies and, more rarely, an underactive thyroid or syphilis of the ear[4]. Hence the blood tests below.

How is Ménière's disease diagnosed?

There is no single test or symptom that proves Ménière's disease[3]. The diagnosis rests on your history, a hearing test and the exclusion of other causes. Specialists use international criteria[1][2]:

Diagnostic criteria for Ménière's disease (Bárány Society and partner societies, 2015)
CriterionDefiniteProbable
Spontaneous vertigo attacks2 or more, each lasting 20 minutes to 12 hours2 or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours
Hearing loss shown on an audiogramLow- to mid-frequency, in the affected ear, before, during or after an attackNot required
Fluctuating ear symptoms (hearing, tinnitus, fullness)Yes, in the affected earYes, in the affected ear
Another diagnosis explains it betterNoNo

How do I read my hearing test (audiogram)?

With headphones on, you signal each beep you hear. The audiogram records the softest sound you can hear at each pitch, in decibels hearing level (dB HL). Hearing tones from 250 to 8,000 Hz at 25 dB or lower is normal; a higher number means you need a louder sound, so worse hearing[6]. In Ménière's disease the typical pattern is a sensorineural loss at the low pitches of one ear, which can change from one test to the next[4].

Fictitious example of a hearing test and blood test report (United States format), woman aged 52 after three vertigo attacks
TestResultReference rangeFlag
Pure-tone threshold, left ear, 250 Hz45 dB HL≤ 25 dB HLH
Pure-tone threshold, left ear, 500 Hz50 dB HL≤ 25 dB HLH
Pure-tone threshold, left ear, 4,000 Hz20 dB HL≤ 25 dB HL
Pure-tone thresholds, right ear, 250 to 8,000 Hz10 to 15 dB HL≤ 25 dB HL
RPR (syphilis screen)NonreactiveNonreactive
TSH2.1 mIU/L0.4-4.8 mIU/L
  1. Left ear, low pitches: 45 and 50 dB HL are above the 25 dB limit: "H" means a higher threshold, so reduced hearing[6]. Low-pitch loss in one ear, with normal high pitches, is the pattern the diagnostic criteria look for[2].
  2. Right ear: normal, so only one ear is affected, which is the usual picture[3].
  3. RPR nonreactive: the screening test for syphilis is negative. A reactive result would need a second, treponemal test to confirm it[8]. Read more on the RPR blood test.
  4. TSH normal: an underactive thyroid is unlikely to explain the symptoms[9]. See how to read a TSH result.

Normal blood tests next to an abnormal hearing test can be confusing. BloodSense explains each line of your lab report in plain words, so you know what has been ruled out.

Get my lab report explained

Which blood tests might my doctor order, and what do the results mean?

No blood test detects Ménière's disease. Tests are chosen according to your history to look for a treatable mimic; a normal result is the expected one.

  • Syphilis tests (RPR or VDRL, then a treponemal test): syphilis can reach the inner ear and cause tinnitus, vertigo and hearing loss in one or both ears, sometimes suddenly; it is treatable, but the hearing loss can become permanent[8]. Our page on syphilis stages and blood tests explains both test types.
  • Thyroid test (TSH): hypothyroidism is a rare cause of the same symptoms[4]. A high TSH points to an underactive thyroid.
  • Blood sugar (fasting glucose or HbA1c): hearing loss is about twice as common in adults with diabetes[10], so doctors may check for it. See our guide to fasting glucose results.
  • Autoimmune markers (such as ANA, inflammation markers): mainly when you have joint pain, rashes or symptoms in both ears, given the link with autoimmune diseases[7]. A positive ANA test alone does not mean an autoimmune disease.

Will I need an MRI or balance tests?

An MRI of the inner ear canals, with contrast, can be offered when hearing is clearly worse on one side, mainly to exclude a benign tumor of the hearing nerve (vestibular schwannoma)[1][4]. The 2020 US guideline advises against balance tests or electrocochleography just to make the diagnosis[1].

How is Ménière's disease followed over time?

  • Repeat audiograms: to see how hearing changes in each ear. Blood tests are not needed to follow the disease itself.
  • Attack diary: the date, length and severity of each attack show whether a treatment works[1].
  • Hearing aids: discuss them as soon as hearing loss affects daily life[1][3].

How is Ménière's disease treated?

There is no cure yet; doctors start with the least invasive options[1][4]. No doses are given here.

  • During an attack: medicines that calm vertigo and nausea, for attacks only[1][4].
  • Diet and habits: less salt (1,500 to 2,000 mg of sodium a day), caffeine and alcohol, and no smoking[3]; a 2023 Cochrane review found no placebo-controlled trial of salt or caffeine limits, so the benefit is uncertain[11].
  • Long-term medicines: a water pill (diuretic) or betahistine may be offered[1]. In a large trial, betahistine did not reduce attacks more than a placebo over nine months[12].
  • Injections through the eardrum: corticosteroids, with little risk to hearing, or gentamicin, which controls vertigo but can damage hearing[3].
  • Surgery: only when other options have failed[3].
  • Vestibular rehabilitation: exercises with a physical therapist for lasting imbalance between attacks[1].

There is no evidence that acupuncture, ginkgo or other supplements work for Ménière's disease[3].

How can I live well with Ménière's disease?

  • Keep your attack medicines with you at all times[5].
  • Do not drive if you feel dizzy or an attack is starting; take care with ladders, swimming or machinery[5].
  • At the first warning sign, sit or lie down somewhere safe and keep your head still.
  • Ménière's disease can affect your mood; counselling and relaxation techniques help[5]. See our guide to anxiety symptoms and treatments.

Questions to ask your doctor

  1. Do my symptoms meet the criteria for definite or probable Ménière's disease?
  2. Which ear is affected on my audiogram, and how much hearing have I lost at low pitches?
  3. Do I need an MRI to rule out a tumor of the hearing nerve?
  4. Should I be tested for syphilis, thyroid disease, diabetes or autoimmune disease?
  5. Which symptoms mean I should go to the emergency room instead of waiting?

Frequently asked questions

Can Ménière's disease go away on its own?

It cannot be cured, but it often becomes calmer over the years, and quiet periods of more than a year are possible early on[4][5]. Hearing in the affected ear, however, tends to worsen slowly.

Will I go deaf?

Hearing loss usually affects one ear and progresses gradually; the other ear keeps working in most people[3][4]. Hearing aids help when the loss becomes a problem.

Is Ménière's disease hereditary?

Sometimes. It can affect more than one member of the same family, which suggests a genetic role[3].

  1. Basura GJ, Adams ME, Monfared A, et al. Clinical Practice Guideline: Ménière's Disease. Otolaryngol Head Neck Surg. 2020;162(2_suppl):S1-S55. doi:10.1177/0194599820909438 (accessed November 10, 2026)
  2. Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7. doi:10.3233/VES-150549 (accessed November 10, 2026)
  3. National Institute on Deafness and Other Communication Disorders (NIDCD). Ménière's Disease. US National Institutes of Health. nidcd.nih.gov (accessed November 10, 2026)
  4. MSD Manual Professional Version. Meniere Disease. msdmanuals.com (accessed November 10, 2026)
  5. NHS. Ménière's disease. nhs.uk (accessed November 10, 2026)
  6. MedlinePlus Medical Encyclopedia. Audiometry. US National Library of Medicine. medlineplus.gov (accessed November 10, 2026)
  7. Gazquez I, Soto-Varela A, Aran I, et al. High prevalence of systemic autoimmune diseases in patients with Menière's disease. PLoS One. 2011;6(10):e26759. doi:10.1371/journal.pone.0026759 (accessed November 10, 2026)
  8. Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1 (accessed November 10, 2026)
  9. MedlinePlus Medical Encyclopedia. TSH test. US National Library of Medicine. medlineplus.gov (accessed November 10, 2026)
  10. Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149(1):1-10. doi:10.7326/0003-4819-149-1-200807010-00231 (accessed November 10, 2026)
  11. Webster KE, George B, Lee A, et al. Lifestyle and dietary interventions for Ménière's disease. Cochrane Database Syst Rev. 2023;2(2):CD015244. doi:10.1002/14651858.CD015244.pub2 (accessed November 10, 2026)
  12. Adrion C, Fischer CS, Wagner J, et al. Efficacy and safety of betahistine treatment in patients with Meniere's disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial). BMJ. 2016;352:h6816. doi:10.1136/bmj.h6816 (accessed November 10, 2026)
  13. Medicare.gov. Hearing & balance exams. US Centers for Medicare & Medicaid Services. medicare.gov (accessed November 10, 2026)

This page is general information. It does not replace the advice of a doctor, who makes the diagnosis from your symptoms, examination and hearing tests; no blood test can confirm or rule out Ménière's disease.