Hearing loss: signs, types and causes

Hearing loss means sounds must be louder before you hear them, or speech sounds unclear. It is conductive (often treatable by an ENT), sensorineural (usually permanent, helped by hearing aids) or mixed. A 30-minute hearing test tells you which.

Right earLeft earEveryday speech

Audiogram: pitch from 250 to 8000 hertz across, loudness in decibels down. The shaded band is where everyday speech sounds sit. Pitch (Hz) → Louder ↓ (dB) -1001020304050607080901002505001k2k4k8k z vmooeed baok gch shfsth
A typical age-related loss: near normal low pitches, sloping down from 2,000 Hz, below the s, f and th sounds.

What are the signs of hearing loss?

It creeps in over years, so the brain fills the gaps. Signs by situation.

  • At homeTV louder than others like. Missing the doorbell or the cooker whistle.
  • At work or outMeetings and functions are hard to follow, especially women's and children's voices.
  • On the phoneCalls feel unclear, so you prefer video calls to see faces.
  • What family noticesSaying "what?" often, answering a different question, going quiet in groups.
  • How you feelTired after talking, ringing in the ears, people seem to mumble.
  • Loud, but not clear"I can hear, but I can't understand."
Why speech sounds loud but unclear
At home
The TV or radio is louder than others like. You miss the doorbell, the pressure cooker whistle or someone calling from another room.
At work or out
Meetings, restaurants and family functions are hard to follow. You catch the start of a sentence and lose the end. Women's and children's voices are harder than men's.
On the phone
Calls feel unclear, you keep the phone on one ear only, or you prefer video calls so you can see faces.
What family notices
You answer a different question from the one asked, say "what?" often, or seem to withdraw in groups. Family usually notices months or years before you do.
How you feel
Tired after conversations, a ringing in the ears, or a sense that people mumble.

Usually it is other people who notice first. You catch the start of a sentence and lose the end. The pattern on the chart above explains the most common complaint, "I can hear, but I can't understand". Vowels are low-pitched and loud, so you still hear that someone is talking. The quiet high consonants that tell words apart, like s, f and th, are the first to go. Noise makes this worse, because background sound covers the little high-pitched detail that is left.

Types: conductive, sensorineural and mixed

The type tells you who treats it: an ENT doctor, a hearing aid, or both.

TypeWhere the problem isCommon causesUsual treatment
ConductiveOuter or middle ear. Sound is blocked on its way in.Wax, fluid, infection, a hole in the eardrum, stiff middle-ear bonesOften an ENT doctor; hearing may return. A hearing aid if not.
SensorineuralInner ear (cochlea) or hearing nerve.Age, loud noise, genetics, some medicines, sudden loss, some illnessesPermanent. Hearing aids, or a cochlear implant when aids stop giving clear speech.
MixedBoth at once.For example, age-related loss plus fluid or an old ear infectionENT treats the conductive part first, then a hearing aid.
Sensorineural vs conductive hearing loss, explained

A hearing test finds the type by comparing sound through headphones with sound through a small vibrator behind the ear, which goes straight to the inner ear.

With conductive loss, the inner ear is healthy but sound cannot reach it properly. It is like listening with your fingers in your ears. Voices sound quieter but not distorted, and the cause is often something an ENT doctor can treat. With sensorineural loss, sound reaches the inner ear but the damaged hair cells or nerve pass it on unclearly. Making sounds louder helps, but clarity also has to be shaped pitch by pitch, which is what a well-fitted hearing aid does.

Mild, moderate and severe hearing loss

The degree is the average of how loud the main speech pitches had to be before you heard them.

Degrees of hearing loss, from the WHO World Report on Hearing (2021). Based on the average across the main speech pitches in the better ear.
Average levelGradeWhat it is like in a quiet room
Under 20 dBNormalHears quiet speech without trouble
20 to 34 dBMildMisses soft voices, struggles in noisy rooms
35 to 49 dBModerateAsks people to repeat, TV turned up
50 to 64 dBModerately severeMisses most conversation without help
65 to 79 dBSevereHears only loud speech
80 to 94 dBProfoundHears very loud sounds only
What the grade means for you

Mild loss is easy to miss and easy to dismiss, yet it already makes noisy rooms tiring. By the severe range, hearing aids help with loudness but speech may still be unclear, and a cochlear implant becomes worth discussing. Your audiologist will also look at how clearly you understand words, not only the grade.

What causes hearing loss?

Often more than one. The causes we see most in Electronic City.

  • Age (presbycusis)Inner-ear hair cells wear out, high pitches first. The most common cause over 50.
  • NoiseLoud work, earphones, wedding speakers, crackers. Often comes with ringing.
  • Ear infections and fluidCommon in children and after colds. A conductive loss an ENT doctor can usually treat.
  • Ear waxMakes hearing dull. An ENT clears it; we don't. Never dig with buds.
  • GeneticsRuns in families. Test children with a family history early: child tests.
  • Medicines and healthSome strong antibiotics and cancer drugs harm the inner ear. Diabetes is linked too.
Never stop a prescribed medicine yourself

If you think a medicine is affecting your hearing, ask the doctor who prescribed it.

Each cause, in more detail
Age (presbycusis)
The tiny hair cells in the inner ear wear out over decades, starting with the high pitches. It comes on slowly, in both ears, and is the most common cause in adults over 50.
Noise
Years of loud work, traffic, earphones, wedding speakers or crackers. Noise damage often shows a dip around 4,000 Hz and usually comes with ringing. Our tinnitus page explains that pattern.
Ear infections and fluid
Common in children and after colds. They cause a conductive loss that an ENT doctor can usually treat.
Ear wax
A blocked canal makes hearing dull. We do not remove wax. An ENT doctor clears it safely. Please do not dig with buds or candles.
Genetics
Hearing loss can run in families, at birth or later in life. Children with a family history should be tested early. See child hearing tests.
Medicines
Some strong antibiotics, some cancer treatments and high doses of some other drugs can harm the inner ear. Never stop a prescribed medicine yourself. Ask your doctor.
Diabetes and other health conditions
Studies find hearing loss is more common in people with diabetes. The reasons are not fully understood, so a hearing test now and then is sensible if you have diabetes.

Sudden or one-sided hearing loss

Age and noise usually affect both ears. One worse ear needs a doctor.

See an ENT the same day if hearing drops suddenly

Hearing that drops over hours or days is urgent. Early treatment works best.

  • One ear onlyEven if it came on slowly, it needs a doctor's opinion as well as a hearing test.
  • Pain or dischargeHearing loss with ear pain or discharge needs an ENT first.
  • Spinning dizzinessSee our vertigo and balance page for who to see.

Unsure where to start? Call +91 88848 64343 and we will tell you honestly.

Why treating hearing loss matters

Untreated hearing loss rarely stays a hearing problem.

  • Tiring conversationsEvery conversation takes more effort, so functions and meetings leave you drained.
  • Pulling awaySkipping gatherings and calls, nodding along. Over time, isolation and low mood.
  • Hearing and memoryThe Lancet Commission links midlife hearing loss with dementia risk. An association, not proof.
What a hearing aid can't do

It won't restore normal hearing or fix a problem that needs a doctor. Earlier fitting works best.

The research, in more words

Untreated hearing loss rarely stays a hearing problem. Conversation takes more effort, so people come home tired after a family function or a day of meetings. Many start to skip gatherings, stop using the phone, or nod along without following. Over time that can lead to isolation and low mood, for the person and for the family around them.

There is also research interest in hearing and memory. The Lancet Commission on dementia lists hearing loss in midlife as one of the risk factors linked with later cognitive decline. That is an association found in studies, not proof that hearing aids prevent dementia. It is one more reason not to wait years before getting tested.

What a hearing aid can't do is just as important. It will not restore normal hearing or fix a conductive problem that needs a doctor. It works best when fitted early, while the brain is still used to hearing the full range of speech.

What to do next

From a free three-minute check to an aid in your own life.

  1. Try a quick online checkOur online hearing check takes three minutes. It says whether to book; it is not a diagnosis.
  2. Book a full hearing testAbout 30 minutes at Phase 1 or Phase 2: type, degree, and whether you need an ENT. What the test involves.
  3. Try a hearing aid at homeWear one for 7 days before you pay. See hearing aids and aids for seniors.

Travel hard for an elderly parent? Ask about a home visit.

Two centres in Electronic City

Same team, same equipment, same hours at both. Pick whichever is closer.

Questions people ask us

What are the first signs of hearing loss?

Usually it is other people who notice first. You turn the TV up, ask people to repeat themselves, find it hard to follow talk in a noisy room, or feel that others mumble. Many people say "I can hear, but I can't understand". A hearing test shows whether that is hearing loss and how much.

Can hearing loss be cured or reversed?

It depends on the type. Conductive loss, from wax, fluid, an infection or some eardrum and middle-ear problems, can often be treated by an ENT doctor, and hearing may come back. Sensorineural loss, from age or noise damage to the inner ear, is permanent. It cannot be reversed, but hearing aids or a cochlear implant can make speech clear again.

What is the difference between sensorineural and conductive hearing loss?

Conductive loss means sound is blocked on its way in, in the outer or middle ear. Sensorineural loss means the inner ear or hearing nerve is damaged, so sound arrives but is not passed on clearly. A hearing test tells them apart by comparing sound through headphones with sound through a small vibrator behind the ear.

What does mild, moderate or severe hearing loss mean?

The grade comes from your audiogram: how loud sounds must be before you hear them, averaged across the main speech pitches. Mild loss misses soft voices. Moderate loss means asking people to repeat often. Severe loss means hearing only loud speech. The table on this page shows the WHO grades.

What should I do if I have hearing loss in one ear?

See an ENT doctor. Hearing loss in one ear only is not typical of ageing, so it needs a doctor's opinion as well as a hearing test. If it came on suddenly, over hours or a few days, go the same day. Early treatment gives the best chance of getting hearing back.

Is age-related hearing loss normal?

It is very common. Most people lose some high-pitched hearing from their 50s or 60s onwards. Common does not mean you should leave it. Treating it keeps conversation easy and life less tiring. See hearing aids for seniors for what helps.

Can I check my hearing at home first?

Yes. Our online hearing check takes about three minutes and tells you whether to book a full test. It is not a diagnosis. It cannot tell you the type of hearing loss, how much you have, or whether you need a doctor.

Find out what kind of hearing loss you have

A 30-minute hearing test at Phase 1 or Phase 2. You leave with your audiogram and a clear next step.

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