Hearing loss can affect anyone, at any age. Although age-related changes are a common cause, hearing can also be affected by noise exposure, genetics, earwax, infections, injury, certain medical conditions and some medications.
If you notice a change in your hearing, a professional assessment can help identify the type and level of hearing loss and whether further medical investigation is advisable.
How common is hearing loss?
Hearing loss becomes more common as we grow older. Current RNID estimates suggest that almost 80% of people over 70 have some degree of hearing loss.
However, hearing loss is not limited to older people. It may be present from birth, develop gradually or occur suddenly following illness, injury or noise exposure.
Many people who could benefit from hearing support do not currently use hearing aids. Because hearing loss often develops gradually, its early signs can be easy to overlook.
How hearing works
Sound waves travel through the outer and middle ear to the cochlea in the inner ear. Inside the cochlea, specialised sensory hair cells help convert sound vibrations into electrical signals. The auditory nerve carries these signals to the brain, where they are interpreted as recognisable sounds.
Damage to the inner-ear hair cells or hearing nerve can reduce both the volume and clarity of sound. In humans, damaged cochlear hair cells do not currently regenerate naturally, so this type of hearing loss is usually permanent.
Not every hearing loss involves the inner ear. A blockage or condition affecting the outer or middle ear can also prevent sound from travelling normally.
Common causes of hearing loss
Hearing loss can result from:
- Age-related changes
- Repeated or sudden exposure to loud sound
- Noise exposure at work
- Impacted ear wax
- Outer- or middle-ear infections
- A perforated eardrum
- Fluid in the middle ear
- Head or ear injuries
- Genetic or inherited conditions
- Certain illnesses and medical conditions
- Some medications that can affect hearing
- Conditions affecting the auditory nerve
- Congenital conditions present from birth
Tinnitus, the perception of ringing, buzzing or other sounds without an external source, is commonly associated with hearing loss, but it is a symptom rather than a type or cause of hearing loss in itself.
Can hearing loss be prevented?
Not every form of hearing loss can be prevented. Genetics, illness and age-related changes may affect hearing even when someone has taken good care of their ears.
However, noise-induced hearing loss is often preventable. You can help protect your hearing by:
- Wearing suitable hearing protection around loud machinery, music or other noise
- Moving away from very loud sound where possible
- Keeping personal listening devices at a comfortable volume
- Taking listening breaks when using headphones
- Following workplace hearing-protection procedures
- Seeking medical advice for ear pain, infection or discharge
- Managing conditions such as diabetes and high blood pressure with professional guidance
- Arranging a hearing assessment if you notice a change
Some medicines can affect hearing, particularly at certain doses or when combined with other treatments. Never stop or alter prescribed medication without advice. If you are concerned, speak to your GP, pharmacist or prescribing clinician.
The three main types of hearing loss
There are two primary types of hearing loss – sensorineural and conductive. When both occur together, it is known as mixed hearing loss.
Sensorineural hearing loss
Sensorineural hearing loss occurs when the sensory cells in the inner ear or the auditory nerve become damaged.
It is usually permanent and is the most common type of hearing loss.
Possible causes include:
- Age-related changes
- Long-term or sudden exposure to loud sound
- Genetic conditions
- Certain infections or illnesses
- Some medications
- Head or ear injuries
- Conditions affecting the inner ear or auditory nerve
Someone with sensorineural hearing loss may hear speech but find it unclear, particularly when there is background noise. Certain pitches or speech sounds may be more difficult to distinguish, and tinnitus may also be present.
Hearing aids can often help by providing personalised amplification and improving access to speech. Other specialist options may be considered for more severe losses.
Conductive hearing loss
Conductive hearing loss occurs when sound cannot pass normally through the outer or middle ear to the inner ear.
Possible causes include:
- Impacted earwax
- An outer- or middle-ear infection
- Fluid behind the eardrum
- A perforated eardrum
- A foreign object in the ear canal
- Changes affecting the small bones of the middle ear
- A narrowed or blocked ear canal
Sounds may seem quieter or muffled. Depending on its cause, conductive hearing loss may be temporary and treatable with earwax removal, medication or another medical procedure.
Mixed hearing loss
Mixed hearing loss is a combination of sensorineural and conductive hearing loss.
For example, someone may have permanent age-related inner-ear damage as well as impacted earwax or a middle-ear condition. Treatment and support will depend on both components of the hearing loss.
How hearing loss is assessed
Your audiologist will discuss your symptoms and hearing history, examine your ears and carry out tests to measure your hearing.
The results can help identify:
- Whether hearing loss is present
- Whether one or both ears are affected
- Which pitches are difficult to hear
- The severity of the loss
- Whether the pattern appears conductive, sensorineural or mixed
- Whether further medical investigation may be advisable
An audiologist cannot always establish the underlying medical cause from a routine hearing assessment alone. When appropriate, they will recommend that you speak to your GP or another medical specialist.
Understanding an audiogram
The results of your hearing test are plotted on a chart called an audiogram.
An audiogram shows the quietest sounds you can hear at different pitches. Hearing levels are recorded in decibels hearing level, written as dB HL.
Your audiologist will explain your results in relation to everyday listening, rather than relying only on a category.
Levels of hearing loss
Hearing within the typical range: up to 20 dB HL
You can detect many quiet sounds. It is still possible to experience tinnitus or difficulty hearing speech in noise even when pure-tone results fall within this range.
Mild hearing loss: 21–40 dB HL
You may miss quieter speech and certain consonants. Conversations can become difficult when people speak softly or there is background noise.
Moderate hearing loss: 41–70 dB HL
Normal conversation may be difficult to follow without support, particularly in groups. You may need the television or radio at a higher volume.
Severe hearing loss: 71–95 dB HL
You may hear only louder speech and sounds without amplification. Following conversation can be very difficult, even in quiet settings.
Profound hearing loss: above 95 dB HL
Many speech sounds may be inaudible without suitable technology. Communication preferences vary and may include powerful hearing aids, cochlear implants or other specialist devices, lipreading and sign language.
These categories describe hearing sensitivity, but they do not capture every aspect of listening. Two people with similar audiograms may experience very different challenges.
When to seek urgent medical help
Ask for an urgent GP appointment or contact NHS 111 if:
- You experience sudden hearing loss in one or both ears
- Your hearing becomes noticeably worse over several days or weeks
- Hearing loss occurs alongside earache or discharge
Sudden or rapidly changing hearing loss should not wait for a routine hearing appointment. See the latest NHS guidance.
Hearing loss FAQ
To search our ear wax removal FAQ for specific answers, use the search box to type in specific keywords like “is there a cure” or “hearing loss in one ear” to filter for answers to relevant questions.
What are the signs of hearing loss? Common signs include:
Difficulty following conversation, especially in background noise
Frequently asking people to repeat themselves
Thinking that others are mumbling
Difficulty understanding speech on the phone
Turning up the television or radio
Missing doorbells, alarms or other everyday sounds
Feeling tired from concentrating on listening
Withdrawing from conversations or social situations
Experiencing tinnitus
Is there a cure for hearing loss? That depends on its cause. Some conductive hearing losses may improve when the underlying issue, such as impacted ear wax, infection or fluid, is treated. Most sensorineural hearing loss is permanent, but hearing aids and other hearing technologies can provide effective support.
How is hearing loss diagnosed? An audiologist will discuss your symptoms, examine your ears and carry out hearing tests. They will explain the results and recommend the appropriate next step. Amplify Hearing offers free hearing tests for people aged 55 and over. If you are under 55, ask when booking whether a charge applies at your chosen location.
Will hearing aids make everything sound too loud? Modern hearing aids are programmed for your individual hearing profile. They provide amplification across the frequencies where you need support and use sound-processing technology to manage different listening environments. They should not simply make every sound equally loud. Your audiologist can adjust them as you become accustomed to hearing more sound. Are hearing aids noticeable? Modern hearing aids are available in many discreet styles. Some sit inside the ear canal, while others use a small casing positioned behind the ear with a fine wire or tube. The right style will depend on your hearing, ear anatomy, dexterity, preferred features and personal preferences.
How long does it take to adjust to hearing aids? Adjustment varies from person to person. Many people notice benefits quickly, but becoming comfortable with a wider range of sounds can take several weeks. Regular wear, follow-up appointments and fine-tuning can help. Amplify Hearing provides free aftercare for the lifetime of your hearing aids, subject to the applicable terms.
How much do hearing aids cost? Amplify Hearing’s main range starts from £995 for a pair, with prices varying according to the model, style, technology and features selected. A separate exclusive Beltone range is also available. Your audiologist will explain the suitable options and provide a clear quotation. Hearing aids include a 60-day money-back guarantee and warranty options of up to five years, subject to terms.
What happens if I only have hearing loss in one ear? Hearing loss in one ear is known as unilateral hearing loss. The appropriate solution depends on its type, severity and cause. Options may include a conventional hearing aid, a CROS system that sends sound from the poorer-hearing side to the better ear, or referral for further medical assessment. A sudden loss in one ear requires urgent medical advice.
Does Amplify Hearing provide support groups? Amplify Hearing does not currently operate its own hearing-loss support groups. However, your audiologist can direct you to suitable charities, local organisations and online communities, including resources from RNID.
Find your local practice
We have over 480 practices across the UK, with a growing network and more practices opening all the time.
Find your nearest Amplify Hearing practice and arrange to see your local independent, qualified audiologist. Our hearing care professionals will build a relationship with you, taking the time to make sure you get the very best advice and the most from your hearing aids. When we talk through your hearing options with you, you’re guaranteed to receive unbiased hearing advice you can trust.