Hearing loss in adults

Hearing loss is common and can develop at any stage of your life, but most often happens as you get older. Many hearing problems develop slowly over time and other people may notice your hearing loss before you do.

Key points

  1. Almost 1 in 6 New Zealanders have some hearing loss. 
  2. Hearing loss can be caused by illness, accident, over-exposure to noise, some medications, misuse of drugs, trauma, genetics or simply getting older.
  3. Half of all hearing loss, including noise-induced hearing loss, can be easily prevented or treated.
  4. Hearing loss is treated with hearing aids, or for severe or profound hearing loss, with cochlear implants.

If you have a sudden and severe loss of hearing, see your doctor urgently. Immediate treatment may save your hearing which might otherwise be lost. Also, if you have some hearing loss, and your hearing doesn’t return to normal within two days, see your doctor.

How does hearing work? 

The outer part of your ear is designed to move sound in the air into your ear canal. Sound waves are changed into mechanical vibrations at your eardrum.

Your eardrum is attached to 3 bones that act as a lever to enhance sounds while moving them through your middle ear. The last of these bones are attached to an oval window with a thin tissue cover. This is the entry to your inner ear (the cochlea).

The cochlea is a snail-shaped tube. It contains sensory hearing cells on a flexible membrane. When the oval window vibrates, the membrane and sensory hearing cells move. The outer of these cells boost soft sounds and dampen loud sounds. The inner hair cells transfer sound information to your auditory nerve.

Your auditory nerve transfers sound information to various parts of your brain so you can process and make meaning of it.

What are the main types of hearing loss in adults?

There are two main types of hearing loss in adults.

Conductive hearing loss

This is where something gets in the way of sound being conveyed through your ear as described above. This type of hearing loss leads to a loss of loudness – it’s like listening to someone speaking very softly or from a distance.

Sensory hearing loss

The sensory hearing cells in your inner ear can be malformed or become damaged, leading to sensory hearing loss. This type of hearing loss reduces clarity as well as loudness. It’s distorted so that you find it hard to understand – a bit like listening to a language you don’t know.

Hearing loss can also be caused by a combination of these two types, and by auditory hearing loss. This does not cause loss of loudness, but it can cause problems with understanding what you hear.

What are the causes of hearing loss?

Conductive hearing loss can be caused by:

Sensory hearing loss can be caused by:

  • the outer hair cells deteriorating as you age reducing hearing of high pitch sounds. About a third of people aged 65 or more have a hearing loss that affects their daily lives
  • exposure to excessive noise, which causing greater hearing loss than you would have from ageing.

Other causes include:

  • one of your parents having a genetic hearing impairment or being Deaf
  • alcohol, nicotine, carbon monoxide or exposure to solvents
  • medications such as some antibiotics, pain relief medication and diuretics (water pills)
  • illness such as meningitis or untreated ear infections
  • trauma from objects beings poked into an ear, sports or other head injuries or occasionally changes to air pressure when flying or diving.

What are the symptoms of hearing loss in adults?

 You are likely to be experiencing hearing loss if you:

  • think people are often mumbling
  • often don’t hear something the first time
  • pretend to understand something because you didn’t hear it
  • have had someone else comment on your hearing
  • turn the TV or radio up louder than other people do
  • find it difficult to hear others on the phone
  • have become less tolerant of noise around you
  • have tinnitus
  • find social situations hard
  • notice a difference in how well you hear in each ear.

How good is my hearing?

Take this online hearing test to see how good your hearing is or answer the following questions. If you answer yes to one or more of them, see your doctor who can arrange an assessment for you.

  • Do you often need to ask people to repeat what they have said?
  • Do you typically have trouble understanding a conversation or mishear people in a group or in the presence of background noise?
  • Does it seem that people are regularly not speaking clearly or are mumbling?
  • When watching television do you need to set the volume higher than other people to hear comfortably?
  • Do you become frustrated or even totally avoid some social occasions because there is too much noise or because you cannot keep up with the conversation?
  • Can you become tired or stressed after you have been listening or in a conversation for an extended time?
  • Do you find you need to be close to the speaker at meetings, seminars, restaurants or in religious services to understand?
  • Do you need to maintain eye contact or see people’s faces to understand what they are saying?
  • Do you find it difficult to work out where sounds are coming from?
  • Have your family or friends questioned whether you have a hearing problem?

How is hearing loss in adults diagnosed?

If you have sudden hearing loss, see your doctor urgently.

If you notice – or other people notice – that your hearing is getting worse, see your doctor. They will refer you to a specialist to carry out some tests to measure your hearing.

If your hearing loss is not sudden, see an audiologist or hearing therapist to have your hearing assessed. There is no charge to see a hearing therapist and you may able to get funding assistance to see an audiologist.

How is hearing loss in adults treated?

The treatment of your hearing loss will depend on what is causing it. It’s important to seek treatment as researchers have found that if hearing loss is left untreated, it can make you more vulnerable to dementia after years of straining to hear.

Temporary hearing loss

Your doctor or nurse can treat earwax build-up with ear drops, syringing or other methods. Read more about earwax build-up and removal.

If you have an ear infection, your doctor can prescribe medication to clear it up.

Long-term hearing loss

Hearing aids are effective in treating sensory hearing loss due to ageing or excessive noise. Using hearing aids is much like wearing glasses. You’ll be able to enjoy life far more if you can hear what’s going on.

Otosclerosis is sometimes treated by surgery or through the use of hearing aids. Surgery can rarely help if you have sensorineural hearing loss, except for cochlear implants if you have profound deafness.

What support is available with hearing loss?

Hearing services Ministry of Health, NZ, 2018
Hearing New Zealand An organisation to improve the quality of life for people with hearing loss.
National Foundation for the Deaf NZ. An organisation that promotes the rights, interests and welfare of New Zealanders with hearing loss.
Deaf Aotearoa A national organisation representing the voice of Deaf people, and the national service provider for Deaf people in New Zealand. 
The Pindrop Foundation NZ A voice for New Zealand adults who are affected by a severe hearing loss and need a cochlear implant to restore their hearing.
Life Unlimited Provides free hearing evaluations, information and support.
New Zealand Audiology SocietyAudiologists are specialists at diagnosing hearing problems and the non-medical treatment of hearing loss.

There is funding for hearing aids available. There are also lots of products that can improve your quality of life with hearing loss, such as telephones, tv and telephone amplifiers, personal listening devices and so on.

How can I prevent hearing loss?

Noise is likely to be harmful when:

• it is as loud or louder than heavy city traffic
• you have to raise your voice to speak to someone a metre away
• things sound different after being exposed to the noise
• you hear ringing or other noises in your ears after the noise exposure.

Ringing in your ears or muffled hearing are a warning sign you are not looking after your hearing well enough.

Learn more

The following links provide further information about hearing loss. Be aware that websites from other countries may have information that differs from New Zealand recommendations. 

Hearing problems Patient Info, UK, 2018
Hearing loss of older people Patient Info, UK, 2018
Otosclerosis Patient Info, UK, 2018

References

  1. About us National Foundation for the Deaf, NZ
  2. Hearing health checklist New Zealand Audiology Society
  3. Youth hearing loss prevention National Foundation for the Deaf, NZ
  4. Losing your hearing Hearing New Zealand, 2016
  5. Noise in the workplace WorkSafe, NZ, 2017

Reviewed by

Dr Helen Kenealy is a geriatrician and general physician working at Counties Manukau DHB. She has a broad range of interests and has worked in a variety of settings including inpatient rehabilitation, orthgeriatrics and community geriatrics.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Helen Kenealy, geriatrician and general physician Last reviewed: 25 May 2020