Hearing loss living patient overview

Overview

Hearing loss is when you cannot hear as well as someone with normal hearing. It can affect one or both ears. It may be mild (trouble hearing soft sounds) to profound (cannot hear even loud sounds).

Yes, hearing loss is very common. In the UK, around 11 million people have some degree of hearing loss.

It can affect anyone, but it is most common in older adults. About 40% of people over 50 have some hearing loss, rising to over 70% of those over 70. Children can also be affected, often due to ear infections or genetic conditions.

Symptoms

Common symptoms

• Difficulty hearing conversations, especially in noisy places
• Often asking people to repeat themselves
• Turning up the TV or radio volume
• Feeling like people are mumbling
• Tinnitus – ringing or buzzing in the ears

Symptoms in children

• Not paying attention or seeming distracted
• Trouble with schoolwork or following instructions
• Speaking louder than necessary
• Not reacting to sounds or their name
• Delayed speech and language development

Symptoms in older adults

• Withdrawing from social situations because it's hard to follow conversations
• Feeling tired or stressed after trying to hear
• Missing doorbells, alarms, or phone calls
• Balance problems (if inner ear is involved)

Causes

Main causes

• Age-related changes to the inner ear (presbycusis)
• Damage from loud noises (noise-induced hearing loss)
• Earwax buildup blocking the ear canal
• Infections like otitis media (middle ear infection)
• Certain medications that can harm the ear (ototoxic drugs)
• Head injuries
• Genetic conditions (some present at birth)

Risk factors

• Getting older
• Long-term exposure to loud noises (e.g., machinery, concerts, headphones)
• Family history of hearing loss
• Smoking
• Chronic health conditions like diabetes or high blood pressure
• Ear infections that keep coming back

When to see a doctor

See a doctor urgently if:

• Sudden hearing loss (call emergency services first)
• Hearing loss after a head injury
• Hearing loss with dizziness or pain

Book a routine appointment if:

• If you think you have gradual hearing loss
• If family or friends notice you are not hearing well
• If you have trouble following conversations even in quiet settings
• If you experience ongoing tinnitus

Diagnosis

Your doctor will ask about your symptoms, medical history, and any exposure to loud noises. They will look in your ears with an otoscope (a special light). They may also do simple hearing checks, like whispering or using a tuning fork.

Tests that may be done

• Pure-tone audiometry: you wear headphones and press a button when you hear a sound
• Speech audiometry: tests your ability to hear and repeat words
• Tympanometry: checks how your eardrum moves
• Otoacoustic emissions (OAE) test: measures sound waves from the inner ear

What to expect at your appointment

Your appointment will likely start with a hearing test performed by an audiologist (a hearing specialist). The test is painless and takes about 30 minutes. You'll get results right away, and the audiologist will explain what they mean.

Treatment

Treatment depends on the cause and severity of your hearing loss. The goal is to improve your ability to hear and communicate.

Self-care at home

• Protect your ears from loud noises. Wear earplugs or earmuffs in noisy places (e.g., concerts, power tools).
• Keep volume low on headphones – aim for no more than 60% volume.
• Manage earwax safely – do not use cotton swabs; ask your pharmacist about ear drops.
• Reduce background noise when talking to others (e.g., turn off TV).

Medical treatments

For hearing loss caused by infection, your doctor may prescribe antibiotics or other medications (not named). For sudden hearing loss, steroids may be given. If hearing aids are suitable, you'll be referred to a hearing aid specialist who can fit them. Cochlear implants are another option for severe hearing loss – a small electronic device that helps you hear. Always discuss treatment options with your healthcare provider.

When is surgery considered?

Surgery may be an option for certain types of hearing loss, such as a condition called otosclerosis, or for fixing a damaged eardrum or small bones in the ear. Your ear specialist (otolaryngologist) will discuss this if appropriate.

Living with this condition

Living with hearing loss takes some adjustment, but many people manage well. Use hearing aids if recommended. Let people know you have hearing loss and ask them to face you when speaking. Use subtitles on TV. Consider a text-based phone or captioned phone.

Lifestyle tips

• Stay socially active – it's important for mental health. Join a hearing loss support group.
• Tell your family and friends how best to communicate with you (e.g., one person speaking at a time, reducing background noise).
• Use visual cues – sit where you can see faces clearly.
• Consider assistive devices like amplified phones or alerting systems for doorbells/alarms.

Diet and exercise

A healthy diet and regular exercise can reduce your risk of conditions like diabetes and high blood pressure, which are linked to hearing loss. Some research suggests a diet rich in fruits, vegetables, and omega-3 fatty acids (like in fish) may help protect hearing.

Mental health and emotional wellbeing

Hearing loss can lead to feelings of isolation, frustration, and sadness. It's normal to feel this way. Talk to your doctor if you feel depressed or anxious. Many people benefit from counselling or joining a support group. If you are in crisis, please contact your local mental health helpline or emergency services.

Prevention

Not all hearing loss can be prevented, especially age-related hearing loss. But you can reduce your risk by protecting your ears from loud noises, avoiding smoking, and managing health conditions like diabetes.

Vaccines

Vaccines can prevent some infections that cause hearing loss, such as measles, mumps, rubella, and meningitis. Ensure your vaccinations are up to date as recommended by your healthcare provider.

Screening programmes

Newborn hearing screening is routine in many countries. For adults, no routine screening is recommended unless you have symptoms, but your doctor may check your hearing during check-ups if you are at high risk.

Complications

If left untreated

• Untreated hearing loss can lead to social isolation and loneliness
• Increased risk of depression and anxiety
• Cognitive decline – studies link untreated hearing loss with a faster decline in thinking skills
• Difficulty at work and school
• Higher risk of falls (due to reduced awareness of surroundings)

Long-term outlook

The outlook for hearing loss depends on the cause. Many people with hearing loss can live full, active lives with the right support. Hearing aids and other devices are very effective. Research continues to improve treatments. While some hearing loss may not be reversible, adapting and seeking help early makes a big difference.

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