Hearing loss usually creeps up so slowly that family and friends notice it before you do. A hearing test is painless, takes about an hour and gives you a clear picture of what is happening.
Imagine your family complaining that the TV is too loud, and restaurants becoming exhausting because you cannot follow the conversation. You laugh along at jokes you did not quite catch. A hearing test finally shows why.
Signs you might need a hearing test
- Asking people to repeat themselves often
- Turning the TV or radio up louder than others like
- Struggling to follow conversations in noisy places
- Thinking people are mumbling
- Ringing or buzzing in your ears (tinnitus)
- Difficulty hearing on the phone
- Feeling tired after social events from concentrating to hear
Before the test
The audiologist will ask about your hearing, ear health, noise exposure, family history and medicines. They will look in your ears with an otoscope to check for earwax, infection or other problems. Too much earwax can affect results and may need removing first.
Pure-tone audiometry
This is the main hearing test. You wear headphones in a quiet room or soundproof booth and press a button or raise your hand every time you hear a beep. The beeps get quieter until you can barely hear them, at different pitches from low to high.,Sometimes a headband is placed behind your ear to send sounds through the bone of your skull. This bone conduction test helps work out where in the ear the problem lies.
Other tests
- Speech testing: how well you hear and understand words at different volumes
- Tympanometry: checks how the eardrum moves, useful for fluid behind the eardrum or eustachian tube problems
- Otoacoustic emissions: used in newborn hearing screening and young children
- Speech-in-noise tests: how well you understand speech with background noise
How to read an audiogram
An audiogram is a chart of your results. Pitch (frequency, in hertz) runs across the top from low to high. Volume (in decibels, dB) runs down the side, with quieter sounds at the top and louder sounds at the bottom.,Symbols mark the quietest sound you heard at each pitch: often a red circle for the right ear and a blue cross for the left ear. The lower the marks are on the chart, the louder sounds had to be for you to hear them.
Levels of hearing loss
- Normal: hearing quiet sounds up to about 20 dB
- Mild: about 20 to 34 dB, difficulty with soft speech and noisy places
- Moderate: about 35 to 49 dB, difficulty with normal conversation
- Moderately severe: about 50 to 64 dB
- Severe: about 65 to 79 dB
- Profound: 80 dB or more
- These categories follow the World Health Organization grading; some clinics use slightly different bands
Types of hearing loss
- Sensorineural: from the inner ear or hearing nerve, often age-related or noise-related; usually permanent
- Conductive: sound cannot pass through the outer or middle ear, for example from earwax, fluid or a perforated eardrum; often treatable
- Mixed: a combination of both
What happens next
Depending on your results, you may be offered hearing aids, advice on communication tactics, or referral to an ear, nose and throat (ENT) specialist. Hearing in one ear that is much worse than the other, or sudden hearing loss, needs medical assessment.,Treating hearing loss matters for more than hearing. It helps relationships, work and confidence, and research has linked untreated hearing loss in midlife with a higher risk of dementia.
Sudden hearing loss is an emergency
If you lose hearing in one or both ears suddenly, over hours or a few days, seek urgent medical help. Early treatment, sometimes with steroids, gives the best chance of recovery.
Hearing aids today
Modern hearing aids are small, digital and often nearly invisible. Many connect to phones by Bluetooth, adjust automatically to different environments and are rechargeable. Over-the-counter hearing aids are now available in some countries for adults with perceived mild to moderate hearing loss, though a professional assessment is still recommended.
It usually takes a few weeks to get used to hearing aids, because the brain needs time to adapt to sounds it has not heard clearly for years. Wearing them every day, and returning for adjustments, helps.
Protecting your hearing
- Turn down the volume on headphones; a common guide is no more than 60% volume for no more than 60 minutes at a time
- Wear ear protection at concerts, nightclubs and in noisy workplaces
- Give your ears rest after loud events
- Do not put cotton buds or objects in your ears
- Get ear infections checked and treated
Hearing and children
Most countries screen newborn babies for hearing loss, because early support is crucial for speech and language development. Older children may need a hearing test if they have speech delay, do not respond to their name, turn up the TV or struggle at school. Glue ear, fluid behind the eardrum, is a common and usually temporary cause of hearing problems in young children.
Frequently asked questions
Are hearing tests free?
It depends on your country and health system. Many offer free tests for adults, children and older people.
How often should I have my hearing checked?
Adults over about 50 may benefit from regular checks, especially if they notice changes.
Can I use an online hearing test?
Online tests can suggest a problem but do not replace a full assessment.
But I am not old enough for hearing aids
Hearing loss affects people of all ages, and modern hearing aids are small and discreet. Getting help early makes adjusting easier.
Your next step: If two or more of the warning signs sound familiar, book a hearing test.
Related: Signs you need a hearing aid · Tinnitus
Sources: World Health Organization World Report on Hearing, RNID, American Speech-Language-Hearing Association, The Lancet Commission on dementia prevention.
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