Hearing loss causes and symptoms

For millions of Canadians, hearing loss is more than just a misheard word. It can be the difference between waking up on time or sleeping in because you didn’t hear your morning alarm. It can be a hindrance in social interactions, straining relationships and compromising your performance at work. 

Still, nearly two-thirds of men and about half of women aged 40 to 79 years old are unaware they have hearing loss.

Hearing loss is an invisible illness, but the consequences in your life may be increasingly harder to ignore. Poor hearing can impact your safety, mental health and overall well being.

The good news? Hearing loss is well-understood and treatable. It is important to know you are not alone and have ample resources available. 

If you suspect you have a hearing loss, book a hearing consultation at a clinic near you.

What causes hearing loss?

There are many causes of hearing loss. Some causes are beyond your control, and other causes may be preventable. You can inherit hearing loss. External factors like noise exposure can exacerbate hearing loss. Causes include:

• Age-related hearing loss in adults (presbycusis)
• Loud noise exposure, including short-term exposure to very loud sounds, such as blasts
• Ear infections, trauma or ear disease, such as acoustic neuroma or otosclerosis
• Damage to the inner ear or eardrum from contact with a foreign object (cotton swabs, bobby pins, etc.)
• Damage to the auditory nerve
• Illnesses, including Meniere's disease
• Certain medications (ototoxic drugs)

Hearing loss symptoms

The signs and symptoms of sensorineural hearing loss can present at any time and in many ways. Symptoms are generally similar regardless of the cause. It can affect one ear (known as unilateral hearing loss) or both ears. For most people with hearing loss, the onset is gradual and occurs later in life. Hearing loss in one ear usually starts earlier in life and may come on suddenly.

Here are some symptoms of hearing loss:

• Difficulty hearing people in noisy environments
• People seem to “mumble” frequently.
• Difficulty understanding people over the phone
• Family, friends or colleagues need to repeat themselves when speaking with you.
• Trouble hearing people when you can’t see their faces or are in other rooms
• Difficulty following conversations
• Ringing, buzzing or hissing sounds in your ears, known as tinnitus
• Fatigue after attending social events or work events.
• You avoid social situations due to difficult communication.
• You have misunderstood messages or mixed up verbal instructions.

Hearing loss types

There are three types of hearing loss. Hearing loss can occur due to issues in different parts of the ear. Hearing loss treatment varies based on the type of hearing loss you have.

1. Sensorineural hearing loss

The most common type of hearing loss is sensorineural hearing loss. You struggle to hear higher-pitched sounds, such as birds singing or children's voices.

This hearing loss occurs when tiny hair cells within the inner ear (the cochlea) are damaged. These hair cells detect sound waves. They are often damaged through noise and aging. 

High-frequency hearing loss may be difficult to notice. It worsens gradually over the years. It's not unusual for people to report that they can hear, but not understand.

2. Conductive hearing loss

Another common type of hearing loss is conductive hearing loss. It is a result of a problem in the outer or middle ear. It prevents sound waves from entering the ear canal and inner ear. Often this is caused by an obstruction, such as earwax.

3. Mixed hearing loss

Mixed hearing loss involves both sensorineural and conductive hearing loss components. It can be more complicated to diagnose and treat. Be sure to follow-up with your physician, otolaryngologist (ENT) or hearing care professional. 

Treatment options for mixed hearing loss will depend on whether the loss is more sensorineural or conductive in nature.

Degrees of hearing loss

Hearing care professionals use the terms normal, mild, moderate, severe and profound to characterize the degree of hearing loss. Hearing loss is measured in decibels (dB), and these terms refer to the lowest threshold a person can hear.

• People with normal hearing (hearing threshold levels of approximately 0-20 dB) can hear most speech sounds in quiet and comfortable listening situations. They can also hear leaves rustling and birds chirping.
• People with mild hearing loss (between 21 and 40 dB) may hear reasonably well in one-on-one conversation but may miss words and speech sounds when a person is talking softly or when there is background noise.
• People with moderate hearing loss (between 41 and 70 dB) will miss many speech sounds. They may mishear parts of conversations or ask others to repeat themselves.
• People with severe hearing loss (between 71 and 90 dB) will miss the majority of conversational speech and using standard telephones will be very difficult. 
• People with profound hearing loss (91 dB or more) cannot hear speech sounds even when they are very loud.  

Why does it matter?

Untreated hearing loss makes it difficult to follow conversations and often leads to reduced contact with family, friends and colleagues, which can further turn into feelings of isolation and depression. Hearing is central to your health and quality of life. People with untreated hearing loss often experience a decreased quality of life. Meanwhile, hearing aids have health benefits, like delaying the onset of dementia.

Hearing loss treatments

For most people, hearing aids will be the recommended treatment. However, for people with more serious hearing loss, cochlear implants and bone-anchored hearing systems may work better. Read more about hearing loss treatment and hearing aids. 

Can you prevent hearing loss?

In many cases, yes! Wearing hearing protection when you're in a loud environment will help you preserve your hearing.

Hearing loss prevention also includes healthy habits like avoiding cigarette smoke and taking medication for conditions, especially those that affect blood flow, such as high blood pressure and diabetes.

Diminished blood flow to the ears can lead to sensorineural hearing loss and is more common among people with uncontrolled hypertension and diabetes.

What's noise-induced hearing loss?

Noise-induced hearing loss (NIHL) is caused by damage to the hair cells that are found in your inner ear. Hair cells are tiny sensory cells that convert the sounds we hear (sound energy) into electrical signals that travel to the brain. Once they are damaged, these hair cells cannot grow back, causing permanent hearing loss.

Harmful sounds that can damage your hearing include, but are not limited to:

• A sudden intense sound such as an explosion 
• Continuous exposure to loud sounds over an extended period of time, such as sitting too close to a speaker at a concert
• Harmful sounds at work, at home and during recreational activities.

If you work in a hazardous noise environment, speak with health and safety personnel about noise exposure risk.

Myths and misconceptions about hearing impairments

People who have no experience with hearing aids tend to have all sorts of misconceptions about them. Here are some of the most common:

• Myth: It’s unusual to have a hearing loss.
• Fact: It is not uncommon. In fact, 10 percent of all people and around 40 percent of people over 50 years old have a hearing loss.
   
• Myth: Hearing loss is for old people.
• Fact: Not true. About 65 percent of people with hearing loss are younger than 65.
   
• Myth: Hearing aids are big and ugly.
• Fact: Today’s hearing aids are stylish, tiny and almost invisible when worn and include many types and styles.
   
• Myth: Hearing aids beep and squeal
• Fact: This may have been true many years ago. Today’s technologies ensure that these effects have been almost completely eliminated. Modern hearing aids even have Bluetooth.
   
• Myth: My hearing loss only affects my hearing.
• Fact: Not true. Having a hearing loss also affects your mental energy, ability to recall conversations and take part in social activities. It also affects your loved ones, family, friends, colleagues and anyone else who wants to communicate with you.

How do I get help for hearing loss?

Our online hearing screening is a good first step. If you suspect you already have hearing loss, book a hearing test with a hearing clinic near you.

References
¹David McDaid, A-La Park & Shelly Chadha (2021) Estimating the global costs of hearing loss, International Journal of Audiology, 60:3, 162-170, DOI: 10.1080/14992027.2021.1883197