How do I know if I have hearing loss?

Hearing loss can be due to the aging process, exposure to loud noise, certain medications, infections, head or ear trauma, congenital (at birth) or genetic factors, diseases, as well as a number of other causes. Recent data suggests there are over 34 million Americans with some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime. People with hearing loss compensate often without knowing they have hearing loss.

You may have a hearing loss if:

  • You hear people speaking but you have to strain to understand their words.
  • You frequently ask people to repeat what they said.
  • You don’t laugh at jokes because you miss too much of the story or the punch line.
  • You frequently complain that people mumble.
  • You need to ask others about the details of a meeting you just attended.
  • You play the TV or radio louder than your friends, spouse and relatives.
  • You cannot hear the doorbell or the telephone.
  • You find that looking at people when they speak to you makes it easier to understand.
  • You miss environmental sounds such as birds or leaves blowing.
  • You find yourself avoiding certain restaurants because they are too noisy, or certain people, because you cannot understand them.

If you have any of these symptoms, you should see a Licensed Hearing Healthcare Professional to have a formal hearing evaluation. This hearing test, or audiologic evaluation, is diagnostic in nature. A diagnostic audiologic evaluation is more than just pressing a button when you hear a beep! Rather, an audiologic evaluation allows the Hearing Healthcare Professional to determine the type, nature and degree of your hearing loss. In addition, your sensitivity, acuity and accuracy to speech understanding will be assessed. In addition, the Hearing Healthcare Professional may test for speech understanding at different volume levels and in different simulated environments. This additional testing may be performed in order to provide the Hearing Healthcare Professional with an indication as to how successful of a candidate you might be for amplification.

The hearing evaluation should also include a thorough case history (interview) as well as a visual inspection of the ear canal and eardrum. Additional tests of the middle ear function may also be performed. The results of the evaluation can useful to a physician, if the Hearing Healthcare Professional believes your hearing loss may benefit from medical intervention. Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech (250-8000 Hz).

The audiogram and results from your speech understanding tests are used to create a prescription and program the hearing aids, when so indicated.

Effects of Hearing Loss



hearing loss and dementia

Hearing Loss and Dementia

A breakthrough study by Johns Hopkins University School of Medicine in Baltimore found a link between those who develop hearing loss and dementia. Dr. Frank Lin from Johns Hopkins states that “our research is now demonstrating that hearing loss doesn’t just affect a person’s quality of life. It may also lead to a decline in cognitive function.”

depression and hearing loss

Hearing Loss and Depression

Hearing loss has been linked to depression. Many people believe this is due to the social isolation caused by poor hearing and communication. People with an untreated hearing loss are much more likely to avoid social situations and activities that they would otherwise enjoy.

hearing loss and falls

Hearing Loss and Falls

Hearing loss has been linked in an increased risk of falling. Certain portions of the ear help with balance and a Johns Hopkins study found that those with an untreated hearing loss were more likely to lose balance.

Causes of Hearing Loss

cancer and hearing loss risk

Hearing Loss and Cancer

Many of the treatments available to treat cancer can also damage a patient’s hearing over time. Some chemotherapy drugs, including cisplatin, are known as ototoxic medications.

heart disease risk of hearing loss

Hearing Loss and Cardiovascular Disorders

Recent studies link cardiovascular disease to hearing loss. The same inadequate blood flow and damage to vessels that can lead to heart problems can also lead to a deterioration in blood flow to the inner ear.

hearing loss and diabetes

Hearing Loss and Diabetes

The high blood glucose levels that can damage the kidneys and eyes also appear to damage the small vessels and nerves in the inner ear. Some studies show that the incidence of hearing loss is twice as common in people with diabetes than those without. 33

genetic factors of hearing loss

Hearing Loss and Genetics

As with many other conditions, susceptibility to hearing loss and other ear-related diseases can be passed down. According to the Centers for Disease Control, 50% to 60% of hearing loss found in babies is due to genetic causes.

Type and Degree of Hearing Loss


Degree of Hearing Loss

Results of the audiometric evaluation are plotted on a chart called an audiogram. Loudness is plotted from top to bottom; top of the graph is very quiet and bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing loss (HL) is measured in decibels (dB) and is described in general categories. Hearing loss is not measured in percentages. The general hearing loss categories used by most hearing professionals are as follows:

Normal hearing (0 to 25 dB HL)
Mild hearing loss (26 to 40 dB HL)
Moderate hearing loss (41 to 70 dB HL)
Severe hearing loss (71 to 90 dB HL)
Profound hearing loss (greater than 91 dB HL)

Types of Hearing Loss

The external and the middle ear conduct and transform sound; the inner ear receives it. When there is a problem in the external or middle ear, a conductive hearing impairment occurs. When the problem is in the inner ear, a sensorineural or hair cell loss is the result. When there are problems in the middle and inner ear, a mixed hearing impairment is the result (i.e. conductive and a sensorineural impairment). Central hearing loss has more to do with the brain than the ear, and will be discussed only briefly.

Conductive hearing loss occurs when sound is not conducted efficiently through the ear canal, eardrum, or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane, or disease of any of the three middle ear bones.

A person with a conductive hearing loss may notice that their ears may seem to be full or plugged. This person may speak softly because they hear their own voice quite loudly. Crunchy foods, such as celery or carrots, sound very loud and this person may have to stop chewing to hear what is being said. All conductive hearing losses should be evaluated by a physician to explore medical and surgical options.

Sensorineural hearing loss is the most common type of hearing loss. More than 90 percent of all hearing aid wearers have sensorineural hearing loss. The most common causes of sensorineural hearing loss are age related changes and noise exposure. A sensorineural hearing loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure, or from disturbances of nerve transmission. Sensorineural hearing loss is also called “cochlear loss,” an “inner ear loss” and “nerve loss.” Years ago, many professionals said there was nothing that could be done for sensorineural hearing loss – that is totally incorrect today. There are many excellent options for the patient with sensorineural hearing loss. A person with a sensorineural hearing loss may report that they can hear people talking, but they can’t understand what they are saying. An increase in the loudness of speech may only add to their confusion. This person will usually hear better in quiet places and may have difficulty understanding what is said over the telephone.

Central hearing impairment occurs when auditory centers located within the brain are affected by injury, disease, tumor, hereditary, or unknown causes. Loudness of sound is not necessarily affected, although speech understanding and clarity is affected. With this condition, a loss of loudness and clarity may occur at the same time.