Ear Congestion: Causes and Specialist Guidance

Severe earplug use?

Hello Doctor, I have started my third pack of oral contraceptives, alternating between YAZ and NINA.
I have been experiencing ear congestion issues for several years.
Initially, it did not affect my daily life, but recently, I have been experiencing multiple episodes of congestion throughout the day.
The only relief I find is when lying down or keeping my head lower than my thighs; otherwise, my ears feel blocked, similar to the sensation of being underwater.

I first visited an otolaryngologist, who diagnosed me with eustachian tube congestion and prescribed medication.
After two follow-up visits with no significant improvement, I switched to another hospital's ENT department.
The doctor there suggested that my eustachian tube is too patent and recommended blood tests.

This week, my blood test results indicated thyroid dysfunction, which has led to weight loss, and I was referred to the endocrinology department.
I would like to know if the oral contraceptives could be causing my thyroid dysfunction and whether the weight loss has exacerbated my ear congestion.
Which specialty should I consult for this condition?

Mei Ying, 10~19 year old female. Ask Date: 2018/10/22

Dr. Zheng Jueyi reply Otolaryngology

Hello, it may be related to eustachian tube dysfunction.
If there are no obvious nasal symptoms such as allergies, you may first consult the Metabolism Department to address thyroid issues.
Generally, oral contraceptives do not significantly affect thyroid function.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/10/22

More Info

Ear congestion can be a frustrating and uncomfortable experience, and understanding its causes is essential for effective management. Based on your description, it seems you have been dealing with ear congestion that has worsened over time, despite consultations with various specialists.
Ear congestion often relates to dysfunction of the Eustachian tube, which connects the middle ear to the back of the throat. This tube helps equalize pressure in the ear and drains fluid. When it becomes inflamed or blocked, it can lead to feelings of fullness, pressure, or discomfort in the ear. In your case, the initial diagnosis of Eustachian tube dysfunction (ETD) aligns with your symptoms, especially since you mentioned that lying down or bending your head helps alleviate the pressure.

The fact that you have been prescribed medication without significant improvement suggests that the underlying cause may not be solely related to Eustachian tube dysfunction. It’s important to consider other factors that could contribute to your symptoms. For instance, allergies, sinus infections, or even changes in atmospheric pressure can exacerbate ETD. Additionally, hormonal changes due to contraceptive use could potentially influence mucosal swelling in the nasal passages and Eustachian tube, although direct links to Eustachian tube dysfunction are not well established.

Your recent diagnosis of thyroid dysfunction is also noteworthy. Thyroid hormones play a crucial role in regulating metabolism, and abnormalities can lead to various systemic effects, including changes in weight and potentially affecting the mucosal linings of the respiratory tract. Weight loss can lead to changes in body composition and fluid balance, which might indirectly affect your Eustachian tube function. However, it is essential to clarify that while hormonal changes can influence various bodily functions, there is no direct evidence linking the use of contraceptive pills to thyroid dysfunction.

Given your complex symptoms and the interplay between your ear congestion and thyroid issues, it would be prudent to consult an Ear, Nose, and Throat (ENT) specialist who can perform a thorough evaluation. They may recommend further diagnostic tests, such as tympanometry or audiometry, to assess your middle ear function and hearing. Additionally, they might consider imaging studies if they suspect structural abnormalities.

Furthermore, since your thyroid function is abnormal, it would also be wise to follow up with an endocrinologist. They can help manage your thyroid condition and determine if treatment for your thyroid issues could alleviate some of your ear symptoms.
In summary, your situation involves a multifaceted approach. You should continue to work with both an ENT specialist and an endocrinologist to address your ear congestion and thyroid dysfunction comprehensively. This collaborative approach will help ensure that all potential causes of your symptoms are explored and treated appropriately. Remember, managing ear congestion often requires patience and a thorough understanding of the underlying causes, so keep communicating with your healthcare providers about your symptoms and any changes you experience.

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