Hearing Loss Causes and Treatment

If you’re finding it harder to follow conversations or hear the TV, you’re not alone. Hearing loss that occurs gradually in older adults is a common condition called presbycusis. Anyone of any age can have hearing loss in one or both ears that ranges from mild to profound. In older adults, age-related hearing loss is common and can have troubling effects.

Struggling to hear can lead to increased risk of falls, depression, social isolation, and poor quality of life. According to Johns Hopkins Bloomberg School of Public Health, people with hearing loss over a period of 10 years have a 47% increased rate of hospitalization. The Lancet International Commission on Dementia, Prevention, Intervention, and Care has estimated that treating and eliminating midlife hearing loss can reduce the risk of dementia by 9%. 

According to the World Health Organization, an individual who has hearing loss can’t hear as well as someone with normal hearing, which means a hearing loss threshold of 20 decibels or more in both ears. An example of a 20-decibel sound is someone whispering from 5 feet away. To test for hearing loss, an individual is played tones at different frequencies, typically between 125–8,000 hertz.

What Are the Symptoms of Hearing Loss?

Age-related hearing loss comes on gradually and may be imperceptible at first. If you have hearing loss, you may find yourself turning up the volume on your phone, computer, or television often. You may also realize you’re asking people to repeat themselves or are leaving social situations because you can’t follow conversations easily. Typically, friends and family are the first to notice these signs.

Over time, you may find yourself experiencing the following symptoms:

• Having trouble hearing higher-pitched sounds, such as birds chirping or children speaking
• Sounds seeming muffled
• Having trouble making out words
• Experiencing difficulty hearing nearby speech when you’re in a noisy environment, such as a crowded room
• Having trouble hearing consonants, such as S, T, or Z

What Are the Causes of Hearing Loss? 

There are many potential causes of hearing loss. Some causes, such as wax buildup, can cause temporary hearing loss. Most hearing loss is permanent, but it can be treated with devices such as hearing aids.

Common hearing loss causes include:

• Ear infections
• Chronic sinus issues
• Acute noise exposure such as gunshots or explosions
• Presbycusis (changes in the inner ear caused by aging)
• Repeated or consistent exposure to loud noise
• Family history of hearing loss (genetics)
• Medical conditions such as diabetes
• Meniere’s disease (disruption of fluid balance in the inner ear)
• Autoimmune inner ear disease 
• Medications (over 200 medications are ototoxic, which means they can cause hearing loss). These medications include chemotherapy drugs, certain antibiotics, and Viagra.
• Viral infection
• Stroke
• Earwax buildup (causes temporary hearing loss)
• Abnormal tumor of the hearing nerve (acoustic neuroma) 
• Abnormal bone growth in the outer or middle ear
• Ruptured eardrum (this can be caused by pressure changes, intense blasts of noise, infection or a foreign object in the ear)

Difference Between Loud Noises of Common Sounds

Decades ago, the Environmental Protection Agency (EPA) determined that 70 decibels is the safe noise level threshold. Consistent or prolonged exposure to sounds over 70 decibels may cause hearing loss over time. The louder the noise is, the faster permanent hearing loss may occur. 

Here are some examples of decibel sound levels:

Maximum Sound Exposure Duration

The amount of time you are exposed to loud noise is a significant indicator of your risk for hearing loss. Based on recommendations by the Occupational Safety and Hazard Commission, by law, employers must create and maintain a hearing conservation program if workers are exposed to noise that averages above 85 decibels over the course of an eight-hour day. 

Many occupations require intermittent or prolonged noise exposure. Wearing protective gear, such as noise-reduction earmuffs, earplugs, and semi-insert earplugs are essential in these situations for protecting your ears and avoiding hearing loss.

Complications of Hearing Loss

Hearing loss that is untreated can have physical and emotional effects. Loss of sound means less brain stimulation. This can cause the brain to atrophy more quickly, leading to cognitive decline. This may be why untreated hearing loss is associated with an increased risk for dementia. Studies indicate that mild hearing loss can double dementia risk. Moderate loss triples risk, and severe loss increases the risk by five times. . 

The social and emotional impact of hearing loss can also be profound. An inability to follow conversations can lead to social withdrawal and isolation from family and friends. Complaints from neighbors about your TV being too loud may cause you to limit the amount of external stimulation you have even further, exacerbating feelings of isolation. 

Tinnitus, a condition that often accompanies hearing loss, may cause anxiety and depression. It may be harder to enjoy the peace and quiet of nature, robbing you of simple pleasures. 

Different Types of Hearing Loss

The ear contains three major sections, which are all required for optimal hearing. These sections are the outer ear, middle ear, and inner ear. Hearing loss can be caused by conditions affecting one or all of these locations. 

There are three types of hearing loss:

Sensorineural 

The most common type of hearing loss is sensorineural hearing loss. It is permanent and is caused by damage to the tiny hair cells of the cochlea. 

Sensorineural hearing loss causes include:

• Aging
• Illness
• Loud sound exposure
• Accidents, such as a blow to the head
• Genetics and heredity
• Ototoxic medications, including certain cancer drugs 

Hearing aids can help with this type of hearing loss. 

Conductive

This type of hearing loss occurs when sound can’t get through the outer and middle ear. It may be hard to hear soft sounds, and loud sounds may be muffled. 

You can be born with conditions that cause this type of hearing loss, such as irregularities in the way your ear is constructed or formed. 

You can also experience hearing loss due to conditions such as:

• Ear infections
• Fluid in the middle ear (poor Eustachian tube drainage)
• Benign tumors
• Ear wax buildup 
• Otosclerosis (abnormal bone growth inside the ear)
• Eardrum perforation
• Ossicular disarticulation (separation of the middle ear bones)

This type of hearing loss can often be treated. The passage of time, medication, and surgery are all potential treatments. 

Mixed 

Mixed hearing loss is caused by a combination of sensorineural and conductive hearing loss. Hearing aids may help with this type of hearing loss. 

Degrees of Hearing Loss

The amount of hearing loss you have is defined by how loud sounds must be in order for you to hear them. You can have varying degrees of hearing loss in each ear. 

According to the American Speech-Language-Hearing Association, the following decibel levels indicate degree of hearing loss: 

Hearing Loss Prevention

Age-related hearing loss cannot be prevented, but hearing loss due to noise exposure and other causes can. Here are our recommendations for avoiding hearing loss: 

• If you’re in a noisy environment, try to create as much distance from yourself and the source of the noise as possible. 
• Limiting the amount of time you’re exposed to noise is also very important.
• Keep the volume down on devices that require headphones.
• Protect your ears in noisy environments by wearing foam ear plugs or other devices.
• Speak with your doctor about your over-the-counter and prescription medications. When possible, ask to use drugs that won’t affect your hearing.
• Keep foreign objects out of your ear, including ear cleaners. 
• Don’t ignore ear pain or feelings of fullness in the ear. If you’re uncomfortable, see your doctor for diagnosis and treatment.

Helpful Devices for People With Hearing Loss

If you’re struggling with hearing loss, you may also be struggling with the solution for it. Obstacles to treating hearing loss include the cost of hearing aids and concerns about how you’ll look wearing them. 

If you’re looking for the best hearing aids available, keep in mind that there are many types. Some are worn behind the ear and may be visible. These are often colored to blend with common hair colors. Other hearing aids are worn in the ear canal and may be practically invisible. The best type for you will be determined by the kind of hearing loss you have and other factors, such as the size and shape of your ear canal, degree and configuration of loss, lifestyle, and other factors like oxygen use, dexterity, and vision quality. 

If cost is a factor, you have options. Some of the best hearing aids on the market are less expensive than you might think. In addition, an FDA ruling has been passed that increases access to less expensive, over-the-counter hearing aids. These differ from personal sound amplification products (PSAPs), which amplify all sounds, not just those you have trouble hearing. PSAPs are not meant to treat hearing loss. In fact, they may actually increase hearing loss rather than treat it.