The colder months inevitably carry with them an increased risk of contracting the flu, a common ailment that can have an unexpected impact on your hearing health.

At one time or another, we all come down with the flu. The congestion, the mental fog, the nagging cough — you can vividly imagine each of these symptoms because you’ve undoubtedly experienced them yourself. Yet despite our collective familiarity with the typical effects of the flu virus, most people aren’t aware that this annoying annual visitor can also cause abrupt, significant hearing loss.

It’s not uncommon to experience mild hearing loss when suffering from the flu. As congestion builds, the eustachian tubes — small vents in the back of the throat that help regulate air pressure in the middle ear — can become blocked, which will reduce a person’s ability to hear. This is the best-case scenario for flu-related hearing loss, as hearing usually returns to normal shortly after the underlying congestion dissipates. As with most flu symptoms, people suffering from this form of hearing loss are usually back to their old selves within a few days.

In less ideal circumstances, however, the flu virus may affect the nerves that facilitate hearing. As extremely precise organs, these nerves are also very fragile, and seemingly minor damage caused by the flu virus can have a notable, permanent effect on the volume, pitch, and tone of the sounds a person hears. Because those damaged hearing organs also help a person to maintain their balance, extensive viral nerve damage can also cause ongoing feelings of dizziness and equilibrium issues, eventually reducing a person’s overall mobility.

Happily, hearing loss from the flu is rare. Doctors have a number of treatment options to maintain a person’s hearing in the face of a virus rampaging through their sinuses. Even in cases of extensive damage and permanent hearing loss, there is a wide range of behavioral therapies, surgical options, and technologies that can restore some level of hearing, allowing the patient to live a full life.