Hearing loss symptoms

Are you concerned you or a loved one has hearing loss?

The symptoms of hearing loss depend on the type of hearing loss you have—and the severity. A person with mild hearing loss in both ears, for example, experiences sound differently than a person with a profound hearing loss in just one ear.

General symptoms of hearing loss

For adults with any kind of hearing loss, these are all good indicators that you may not be hearing as well as you used to. You may experience all or just a few of these scenarios:

• Friends or family say you turn the television or radio up too loud
• You struggle to understand speech, especially in noisy environments
• You have difficulty hearing people on the phone
• A feeling that you can hear, but not understand
• You are not sure where sound is coming from, known as localization
• You often ask people to repeat themselves
• You're dependent on a spouse or a loved one to help you hear
• You find yourself avoiding social situations
• You feel exhaustion after attending social events, known as listening fatigue
• You notice tinnitus, or ringing in the ears
• Paradoxically, some sounds seem too loud, known as "recruitment"

Symptoms by hearing loss type:

• High-frequency: high-pitched sounds are hard to hear
• Noise-notch: some high-pitched sounds are hard to hear
• Mid-range (cookie-bite): mid-range sounds are hard to hear
• Low-frequency: low-pitched sounds are hard to hear
• Conductive (general): muffled hearing from damage or blockage to the middle or outer ear
• Sudden: hearing loss onset is rapid
• Flat: all pitches are hard to hear
• Single-sided: only one ear is affected
• Temporary noise related: reduced hearing after loud sound exposure that may improve with 48 hours

Hearing loss from inner ear or nerve damage (sensorineural)

The most common type of hearing loss is sensorineural hearing loss, which is caused from damage to the delicate hair cells in the inner ear and/or the nerve pathways that deliver sound to your brain. About 90% of people with hearing loss have this type, and it has a wide range of causes.

Volume and clarity are affected

Sensorineural hearing loss is usually gradual—you don't wake up overnight not being able to hear. Instead, you slowly lose the ability to hear. Both how loudly (volume) and how clearly (clarity) you perceive sound are affected. You might also experience a phenomenon known as recruitment, which causes some louder sounds to be uncomfortable to listen to. For example, you once loved fireworks shows, but now find the booming sounds nearly unbearable. 

Sensorineural hearing loss can affect all ranges of hearing, including the examples below. Some people may struggle to hear both low-pitched and high-pitched sounds, while others may only struggle with one range. One ear may hear better than the other, too. There's wide variability among people, even with the same type of hearing loss. Have you had a hearing test, but don't understand the results? This primer on how to read an audiogram can help.

High-frequency hearing loss symptoms

One of the more common types of sensorineural hearing loss is high-frequency hearing loss, which appears as a "ski slope" pattern on an audiogram. Many people who have presbycusis, a type of age-related hearing loss, develop this kind of hearing loss. It results in the reduced ability to hear things like:

• Women and children’s voices
• Certain consonant sounds like s, sh, f, v, th, f, p, making it difficult to understand some words
• The car’s turn signal
• Beeping sounds on timers and microwave ovens
• Birds chirping

Symptoms of noise-notch hearing loss

Similar to high-frequency hearing loss, noise-notch hearing loss means you can't hear certain high-pitched sounds very well (such as children's voices). But unlike high-frequency hearing loss, you may still hear very high-pitched sounds (birds or beeps). This type of hearing loss is associated with noise-induced hearing loss, especially loud gun blasts. For example, hunters who develop shooter's ear often have a noise-notch pattern of hearing loss. 

Symptoms of 'cookie-bite' hearing loss (mid-range frequency loss)

Less common than high-frequency hearing loss, "cookie-bite" hearing loss (which gets its name from its distinctive pattern on an audiogram) is when a child or adult has trouble hearing sounds in the mid-range frequencies. These are sounds that are neither particularly high-pitched nor low-pitched. As you can imagine, this includes many common sounds, making everyday situations like talking to friends or listening to music challenging. Generally people with this kind of hearing loss will realize they can easily hear things like squealing alarms or booming thuds, yet struggle to hear speech or music at what are seemingly normal volumes for other people.

Symptoms of low-frequency loss (reverse-slope)

Rarer still, reverse-slope hearing loss is essentially the opposite of high-frequency hearing loss. Symptoms include finding men's voices harder to hear than women's or children's voices, struggling to hear people on the phone but not so much during face-to-face conversations, and inability to hear environmental sounds that are low-pitched, such as the bass in music or thunder. A person with reverse slope hearing loss also might seem unusually sensitive to high-pitched sounds, too. Sometimes, Meniere's disease can cause this type of hearing loss in the earlier stages of the disease. 

Conductive hearing loss symptoms

About 10% of people with hearing loss have conductive hearing loss, which means that their inner ear works fine, but their outer or middle ear isn't working normally for some reason (causes can range from a severe earwax blockage to head trauma). Most other types of permanent conductive hearing loss are detected at birth or soon after.

In adults, when it does occur, it tends to develop must faster than sensorineural hearing loss, and depending on the cause, may be reversible. The symptoms will be similar to general hearing loss symptoms, just occurring at a faster rate. For example, if you are in a bad car accident and notice you're struggling to hear speech, and feel like your own voice sounds odd to you, you may have conductive hearing loss. Any pain, pressure, or strange odor in your ears are other clues you may have a condition that causes conductive hearing loss.

Symptoms of sudden hearing loss

In rare cases, a person can develop sudden hearing loss, usually in one ear. It may be conductive or sensorineural. The symptoms and signs are generally pretty obvious—you suddenly can't hear well out of one ear. But if you have a bad cold or ear infection, it may be hard to tell if it's just temporary congestion or actual hearing damage from the virus or bacteria. In some cases, people hear a loud pop and then lose their hearing. The affected ear may feel stuffy, or "full," and a person may feel dizziness or hearing ring in their ear. Because prompt treatment is key, act fast if you experience sudden hearing loss.

Flat hearing loss symptoms

A conductive hearing loss can present as a flat hearing loss, muffling hearing across the frequency spectrum (all pitches). However, sensorineural hearing loss can also sometimes cause a loss of hearing across all pitches.

Symptoms of single-sided deafness 

For people with severe to profound hearing loss in one ear, you may notice it's harder to tell where sound is coming from, known as localization. You also may have a hard time focusing on a single source of sound in a noisy environment, such as at a party. You might also struggle to discern how loud a sound is, because your brain relies on sensory input from both ears to detect volume. People with single-sided deadness also experience something known as the "head shadow" effect, which makes high-pitched sounds harder to hear. 

Temporary noise-related hearing loss symptoms

Temporary hearing loss is often related to exposure to loud noises, such as gunfire, fireworks, concerts or exposure at work. Temporary hearing loss is characterized by a temporary threshold shift (TTS), meaning that hearing is temporarily worse following loud sound exposure but may improve within one to two days. It's often accompanied by tinnitus, or ringing in the ears. It can last for only a few hours or several days before hearing returns to normal.

The ears have a harder time recovering from TTS after each occurrence. Any regular noise exposure puts you at risk of hearing loss, including noise-notch hearing loss (see above), linked to noise-induced hearing loss. You can avoid this by learning how to prevent hearing loss.

Symptoms of hearing loss in children

Hearing loss in children is usually detected with the help of a newborn infant hearing screening soon after birth. Some parents also may be able to detect hearing loss in their child if it's not caught at birth. 

Symptoms of hearing loss in children include:

• A delay in speech and language development
• Child does not startle when loud sound is present
• Child cannot localize sound (tell where sound is coming from)
• Poor performance in school
• Behavioral problems in school
• A learning disability diagnosis

Signs of hearing loss

A "sign" is what a health care provider can detect with testing or a medical exam (and a "symptom" is what you notice but can't necessarily be measured). To look for the signs of hearing loss, a hearing care provider will generally start with questions about symptoms you're experiencing, and then conduct a formal hearing test to see how well you hear beep-like sounds (known as a pure-tone test), speech in noise and other sounds. Your hearing is then plotted on an audiogram that shows the extent of your hearing loss in both ears. Here's how to know if you need your hearing tested.

Treatment options

Permanent hearing loss cannot be restored and usually involves damage to the auditory nerves or the tiny hair cells of the inner ear. For most people, the best solution is properly fitted hearing aids. In some cases, cochlear implants or bone-anchored hearing systems may be recommended. 

Next steps

If you suspect hearing loss in yourself, your child or someone close to you, use our directory of consumer-reviewed clinics to find a hearing specialist or audiologist near you. The sooner you seek help, the better your outcome will be.