Hearing loss: what you need to know

Losing your hearing can have a big impact on your life. Some people experience gradual hearing loss without realising it, meaning it goes untreated. Not being able to hear properly can be frustrating and upsetting and even lead to feelings of isolation and depression, so it’s important to be aware of your hearing health and seek treatment if you think there’s a problem.

What is hearing loss?

Hearing loss is when your ability to hear sound reduces or is lost completely. It can be caused by problems with any of the three different sections of your ear ie outer ear, middle ear and inner ear, or by problems with your auditory nerve, which carries sound information from your ears to your brain. There are two main types of hearing loss:

Conductive hearing loss

This is when you lose your hearing due to a problem with your outer or middle ear, which prevents sound passing through into your inner ear. It can usually be improved with treatment to address the underlying cause affecting your outer or middle ear.

Sensorineural hearing loss

This is when you lose your hearing due to a problem with your inner ear or auditory nerve. It’s usually permanent but you may be able to improve your hearing with a hearing aid or cochlear implant.

Some people have both types of hearing loss, which is known as mixed hearing loss.

Causes of hearing loss

Your risk of hearing loss increases as you age with over 40% of people over 50 having some degree of hearing loss. If left untreated, it can worsen and cause other problems. 

Causes of sensorineural hearing loss include prolonged exposure to loud noises, birth defects that affect the inner ear, head trauma, noncancerous tumours in the ear and infections such as meningitis, measles, mumps, and scarlet fever.

Causes of conductive hearing loss include a buildup of wax that blocks your ear canal, a hole in your ear drum, defects in the three small bones in your middle ear, or fluid in the space between your eardrum and the part of your inner ear called the cochlea.

Signs and symptoms

In most cases, hearing loss is gradual. It can happen in one ear or both and the early signs can be easily missed. If your hearing loss is age-related, high-pitched sounds are often the first to go.

Hearing loss can make conversation difficult, especially in crowded places or if there is background noise. You may find that the lower pitched background noise is easier to hear than the person you’re talking to. This can make socialising exhausting, as you’re concentrating that much harder to work out what’s being said. 

We often lipread subconsciously to help the brain understand what’s being said. If you have hearing loss you may find yourself subconsciously or consciously doing this more and more. Consequently, you may find speaking on the phone harder as you won’t be able to lipread.

Other signs to look out for include having to turn the volume on the television or radio up higher than you used to. Others listening may complain that the volume is too loud.

Sometimes, hearing loss is accompanied by a blocked or full feeling in the ear. This can be caused by a buildup of wax or fluid. Other possible symptoms related to hearing loss include pain in your ear, dizziness and ringing sounds in your ears (tinnitus).

When to talk to a doctor

If you’re concerned you have hearing loss, see your GP. They will ask about your symptoms and look inside your ears using a device called an otoscope. If needed, they may refer you to a doctor who specialises in treating the ears (an otolaryngologist) who can perform hearing tests. 

Hearing tests may include listening to sounds through headphones and indicating when you hear something (pure tone audiometry), listening to speech (speech perception test) and checking for fluid behind your eardrum using a small device placed in your ear (tympanometry).

If you have hearing loss, getting a diagnosis is important. Failing to treat hearing loss caused by an infection can cause long-term hearing loss and untreated sensorineural hearing loss increases your risk of depression, memory problems and dementia.

Treatment for hearing loss

Hearing loss treatments depend on the underlying cause. If your hearing loss is caused by an infection, you will usually be given antibiotics, while a buildup of earwax is treated with a simple removal procedure. 

Sensorineural hearing loss can be improved with hearing aids or cochlear implants. Don’t be put off by the thought of wearing hearing aids, technology has advanced a lot in recent years and some hearing aids are practically invisible and easy to recharge. Getting hearing aids can make a huge difference to your life.

How to prevent hearing loss

You can reduce your risk of some types of hearing loss by looking after your ears. It’s important to protect your ears from loud noises — wear ear protection if you’re using noisy power tools or garden machinery at home. If you work in a loud environment, talk to your employer about ear protection. It’s also a good idea to protect your ears if you go to concerts regularly, and wear earplugs for swimming to prevent ‘swimmer’s ear’, a bacterial infection caused by water in the ear. 

If you’re often exposed to loud noises, make sure you have regular hearing tests. Early treatment for hearing loss can help prevent it getting worse.