Hearing loss: signs you shouldn’t ignore and when to get tested
Hearing loss is a reduction in how well you detect or understand sound. It is not only about loudness. It is often about clarity, especially for high-pitch consonants that carry word meaning.
There are three main types. Conductive loss affects the outer or middle ear and blocks sound (earwax, fluid, eardrum or ossicle problems). Sensorineural loss affects the inner ear or auditory nerve and reduces clarity (aging, noise, genetics, ototoxic drugs). Mixed loss combines both.
Severity is measured in decibels hearing level (dB HL). Typical ranges: normal 0–25, mild 26–40, moderate 41–55, moderately severe 56–70, severe 71–90, profound 91+. Shape matters too. High-frequency loss makes speech sound muffled in noise. Low-frequency loss can cause fullness. “Cookie-bite” loss hits mid-pitches and can sneak up in quiet settings.
What hearing loss looks like day to day
TV volume wars: you keep turning it up; others complain.
Speech sounds “mumbled”: S, F, T, and SH blur first.
Noise wipes out words: restaurants, meetings, and group chats feel garbled.
Frequent repeats: “Sorry, what?” becomes routine.
Tinnitus: ringing or buzzing that’s steady or recurring.
Phone trouble: voices are harder to follow without lip cues.
Listening fatigue: you feel drained after conversations.
Localization issues: harder to tell where sounds come from.
Ear fullness or pressure: sometimes linked to wax or middle-ear issues.
Diagnosis is straightforward:
An audiologist reviews history, inspects the ear canal, checks middle-ear function, measures pure-tone thresholds, and tests speech in quiet and in noise. Results map what pitches are affected and guide treatment.
Treatment depends on cause. Conductive problems may resolve with wax removal, medicine, or surgery (tubes, stapes surgery). Sensorineural loss is usually permanent but manageable. Options include modern hearing aids, CROS/BiCROS systems for single-sided loss, cochlear implants for severe-to-profound loss, remote microphones for classrooms or meetings, and aural rehabilitation to cut listening effort. Tinnitus is managed with sound therapy, counseling, and treating co-factors like stress and sleep.
Act the same day for sudden hearing loss, one-sided loss with new tinnitus or fullness, severe ear pain, drainage, bleeding, spinning vertigo with new hearing change, or head injury with hearing change.
Prevention is practical. Use hearing protection in loud settings. Follow the 60/60 rule for personal audio. Do not use cotton swabs in the canal. Manage cardiovascular risks and review drug side effects when hearing changes.
Next step: get a baseline hearing test in adulthood, then repeat periodically, or yearly if you have noise exposure, risk factors, or existing loss. This is general information, not medical advice. See a licensed audiologist or physician for personal care.