Hearing loss is one of the most common physical conditions in adults, after heart disease and arthritis. It affects an estimated 48 million people in the United States.

If you’re dealing with any level of hearing loss, getting answers and the right care is one of the best things you can do for your quality of life and overall well-being.

Some types of hearing loss can improve with treatment, while others are permanent and require long-term management. Understanding the differences and knowing the causes and symptoms can help you take the next step toward better hearing health.   

Types of Hearing Loss

According to Katherine Victoria Riedstra, AuD, an audiologist at Northwestern Medicine, there are three types of hearing loss:

• Conductive hearing loss happens when something blocks sound from reaching the inner ear. This could be earwax or fluid. It’s often treatable.
• Sensorineural hearing loss is caused by damage to the inner ear or auditory nerve. It’s usually permanent and often related to aging or loud noise exposure.
• Mixed hearing loss is a combination of both conductive and sensorineural hearing loss.

Common Causes of Hearing Loss

Specific conditions and issues that may affect your hearing include:

• Earwax buildup can block sound and cause temporary hearing loss. Removing the wax safely usually solves the problem. Riedstra warns against using cotton swabs, which can push the wax further into your ear canal.
• Ear infections can also cause temporary hearing loss. Antibiotics can help. For chronic ear infections, ear ventilation with tubes may be recommended.
• High blood pressure and diabetes can reduce blood flow to your ear, causing permanent damage if not managed.
• Viral infections: Measles, mumps and other viruses can damage the inner ear or trigger immune responses that affect hearing.
• Loud noise exposure: Sounds over 85 decibels for extended periods can cause permanent hearing loss. Sounds over 120 decibels, like firecrackers or jackhammers, can cause immediate and permanent hearing loss. For comparison, normal conversation is about 60 to 70 decibels.
• TMJ disorders (jaw joint problems) may not cause hearing loss directly but can lead to symptoms like muffled hearing or ringing. Treating the disorder may help reduce these symptoms.
• Age-related hearing loss risk increases with age. It’s often influenced by noise exposure or genetics and is not reversible.
• Ototoxic chemotherapy: Some cancer treatments can damage the hair cells in your inner ear, leading to permanent hearing loss. Ask your care team about hearing tests before, during and after chemotherapy.

Reversible vs. Irreversible Hearing Loss

Reversible hearing loss is often caused by earwax or infections. Treatment can include:

• Wax removal
• Antibiotics or decongestants for infections

Irreversible hearing loss is usually sensorineural (inner ear or nerve damage). Treatment options can include:

• Hearing aids
• Cochlear implants (for severe cases)
• Assistive listening devices that amplify sound and reduce background noise
• Communication strategies (like facing the person when speaking)

“Research is being done that suggests permanent sensorineural hearing loss may be reversible through regenerative or gene therapies,” says Riedstra. “However, these therapies are still being evaluated in animal studies or are very early in clinical trial stages. Their actual effectiveness is still being studied, and there’s no specific timeline for when these might be options for treatment.” 

Hearing Tests and Diagnosis

If you’re concerned about your hearing, Riedstra recommends these options:

• At-home tests: Some apps and websites offer basic hearing checks, but they aren’t as reliable as seeing a professional.
• Professional exams: Audiologists and ENT (ear, nose and throat) doctors use tools like:
  • Audiogram: Comprised of air and bone conduction tests, it pinpoints where the hearing problem is located (external, middle or inner ear) and measures the severity of hearing loss.
  • Otoscopy: This exam looks inside the ear.
  • Immittance testing: This test checks how well the eardrum and middle ear work.

When to See a Doctor

Get evaluated as soon as possible if you experience:

• A sudden change in hearing
• A difference in hearing level between your two ears
• Tinnitus (constant or intermittent ringing) that is getting worse or feels more prominent in one ear

“For some cases of sudden sensorineural hearing loss, early treatment with an ENT doctor can improve the chances of recovering hearing,” says Riedstra.

How to Protect Your Hearing

You can take steps to help preserve your hearing. Reidstra recommends:

• Wearing ear protection, such as earplugs or earmuffs, when you are at concerts, working with power tools or doing other activities that involve loud noise
• Staying physically active
• Avoiding smoking
• Managing chronic medical conditions like diabetes and high blood pressure
• Talking to your doctor about medications that may affect hearing