Hearing Loss

Symptoms, Causes, Treatment, and More

Abram Bailey, AuD

Doctor of Audiology

07 December 2020

If­ you have trouble understanding conversations in restaurants or in other noisy settings, or if you need to turn up the TV louder than those around you, you may well have hearing loss – and you're not alone. Around one out of every seven adults in the United States reports some difficulty hearing.

Here, we share what you need to know about symptoms, treatments and more — along with links to a deeper dive on all of those.

What Are the Symptoms of Hearing Loss?

Hearing loss has a way of sneaking up over time: Many times, a loved one notices a problem before the person with the hearing loss does. Typical symptoms may include difficulty hearing in background noise — say, in a café, restaurant, store, church, or in the car.

Another signal of hearing loss is that it’s difficult to hear what someone is saying when that person is not facing you. You may also feel as if people are mumbling when they speak to you. Tinnitus, which can be described as a ringing or buzzing sound in the ears, is another common symptom.

Read More: Hearing Loss Symptoms

What Are the Types of Hearing Loss?

Hearing loss refers to a decrease in sensitivity to sounds that are audible to those with normal hearing. There are a few key types to be aware of:

Conductive hearing loss is due to the sound signal not being directed properly to the inner ear from either the outer or middle ear. This type of hearing loss does not typically cause complete deafness, but a reduction in the loudness of sounds. Among the causes of conductive hearing loss are allergies, earwax blockage, and a perforated ear drum among others.

Causes can include fluid in the middle ear space from congestion due to colds, perforations (holes) in the eardrum, benign tumors, impacted cerumen (earwax), and infection in the outer ear canal (often called Swimmer’s Ear). Another common cause is otosclerosis, or a stiffening of the chain of bones in the middle ear.

Sensorineural hearing loss occurs in the inner ear itself or along the auditory pathway as sound signals travel to the brain. It can be triggered by excessive exposure to loud sounds, certain medications, head trauma, and other factors. The most common form of sensorineural hearing loss is age-related hearing loss, also known as presbycusis, but regardless of the cause, it is usually permanent and often involves a reduction in the ability to understand speech.

Mixed hearing loss is a combination of both conductive and sensorineural hearing losses, and often reflects two or more different conditions affecting the inner ear as well as either the outer or middle ear.

Auditory processing disorders can also trigger hearing loss that occurs in the pathway to the brain or in the processing areas of the brain responsible for hearing and language. For example, a stroke can be the source of this kind of hearing loss.

Read More: Hearing Loss Types and Causes

The Consequences of Untreated Hearing Loss

While at least 10% of the population self-reports some degree of hearing loss, only about 3% actually wear hearing aids, according to recent data. That’s a cause for concern:

  • In general, those with hearing loss who do not wear hearing aids are more likely to report feelings of depression, loneliness, worry, and dissatisfaction with family life.
  • Difficulty communicating often leads to loss of interest in participating in social activities.
  • Safety is also a concern for those with hearing loss who cannot hear alarms, the phone, the doorbell, or someone entering their home. Nor can they successfully converse over the phone. These create barriers to maintaining an independent lifestyle.
  • Strong associations have been found linking hearing loss to reduced cognitive function. Researchers do not suggest that hearing aids can prevent dementia but the use of amplification may reduce or delay the disease’s impact.
  • Individuals with hearing loss who do not wear hearing aids report more fatigue due to the extra effort put forth in trying to listen and understand all day.

Read More: Consequences of Untreated Hearing Loss

How Is Hearing Loss Treated?

Treatment depends on the type and degree of hearing loss an individual has been diagnosed with. For conductive hearing loss, it may be possible to remove or repairing whatever it is that is preventing the conduction of sound. For sensorineural loss (the moss common type, with up to 90% of all cases), hearing aids are the most common treatment. Individuals with severe cases are often candidates for cochlear implants.

Read More: Hearing Loss Treatment

How Common Is Hearing Loss?

Hearing loss is the third most common physical health problem in the United States, behind such common ailments as heart disease and arthritis. Approximately 15% of Americans adults (or 37.5 million people) report some difficulty in hearing, with those aged 60-69 demonstrating the greatest degree of hearing loss. Men aged 20-69 were found to be almost twice as likely as women to have hearing loss.

Read More: Hearing Loss Prevalence

Can Hearing Loss Be Prevented?

A common cause of hearing loss is loud noise, which can cause both temporary and permanent hearing loss. Avoiding damagingly loud sounds at work and home is a key preventive measure. Your environment is deemed too loud if you must raise your voice to be heard, you can't hear someone three feet away from you, speech around you sounds muffled after you leave the noisy area, and you have pain or ringing in your ears after exposure to noise.

Read More: Hearing Loss Prevention

Does Hearing Loss Cause Dementia?

There is currently no evidence to show that hearing loss causes dementia. However, research does support that individuals with diminished hearing tend to demonstrate poorer cognitive function. As for why: Those with hearing loss tend to invest more effort when listening, which may leave fewer cognitive resources available for other tasks. Another hypothesis suggests that when individuals live with untreated hearing loss for a long time, their auditory system is deprived of critical input and loses its processing abilities.

Read More: Hearing Loss and Dementia

Who Are Some Celebrities with Hearing Loss?

Oscar-winners Whoopi Goldberg and Jodi Foster as well Rob Lowe have spoken about their experiences with hearing loss. Former President Bill Clinton noticed his hearing decline with age and now uses hearing aids.

Read More: Celebrities with Hearing Loss

How Do I Know If I Have Hearing Loss?

Here are some questions to ask yourself to determine if you have hearing loss:

  • Do I hear a ringing in my ears or head that is not present in the environment?
  • Does it seem as if other people are mumbling?
  • Do I hear better out of one ear than another?
  • Is there a history of hearing loss in my family?
  • Am I over 50 years of age?

The surest way to know if you have a hearing loss, of course, is to have a comprehensive hearing evaluation by a licensed audiologist.

Read More: Do I Have Hearing Loss?

How Can I Cope with My Hearing Loss?

If you have hearing loss, consult an audiologist. They can likely offer options for mediating hearing loss. Also address the emotional aspects of living with a hearing loss; most individuals have to go through a grieving process just like any other type of loss, disease, or disorder. It’s also important to be a good self-advocate and create a good support system. For instance, be open with family members, friends, and co-workers about your hearing loss and what they can do to help with communication. Seek out a local support group to meet and talk with others who have gone through the same experience

Read More: Do I Have Hearing Loss?

How Do I Read a Hearing Test?

Hearing tests are complex ways to determine your abilities, including such factors as intensity (what we perceive as volume) and frequency (what we perceive as pitch).

An audiogram is a graph of pitch along the X-axis and volume along the Y-axis. The low pitches are on the left side of the graph and the high pitches on the right side, like a piano. The soft sounds are at the top and loud sounds at the bottom, so the higher you are on the scale the more sensitive you are to the sounds. While these graphs are complex to read, here’s an important bit of information: The cutoff for what’s considered normal hearing is 20 dB HL or 25dB HL, so any of the scores you see on the graph that are at or above that are within normal limits. Any of the scores you see below the 20 to 25 dB HL line are considered a hearing loss.

Your audiologist can help break down the test results, explain why you are experiencing communication problems, and provide recommendations.

Read More: Reading Your Audiogram