It can be scary to realize that you can’t hear as well as you used to, or to see your parent or child display signs of hearing loss or hearing impairment.

While hearing loss is typically thought of as a condition that develops later in life, it can happen at any age. Exposure to loud noises, genetics, certain medications and surgeries are just some of the factors that can contribute to hearing loss or hearing impairment.

The good news is there are a range of treatments available for hearing issues, and the first step is a hearing test to learn more. But when should you get your hearing tested? Before you notice any changes? Or only if you’ve started to notice signs of hearing loss? How do hearing tests work? What hearing loss treatments are available?

Below, we answer all these questions and more.

Signs of hearing loss to watch for

Most often, hearing loss happens so gradually that it can be hard to notice early on. There are multiple causes, including some that are unrelated to aging or exposure to loud noises.

Signs of hearing loss include:

  • Voices and other sounds seem muffled
  • Losing the ability to clearly hear high-pitched or middle-frequency sounds, like bird song, sirens, the voices of women and children, your cell phone ringtone or phone conversations
  • Frequently asking others to repeat themselves or speak louder and slower, especially when talking in noisy places
  • Having trouble hearing consonants, or mixing up common consonant sounds
  • Feeling fatigued or stressed from concentrating on hearing during a conversation
  • Needing the volume on the TV or stereo turned up higher than normal, or higher than is comfortable for the people you’re with
  • Experiencing tinnitus, which is a persistent ringing in your ears

Some symptoms related to our hearing and ears require immediate medical attention. See a doctor right away if you experience any of the following:

  • Sudden hearing loss in one or both ears
  • Hearing loss in one or both ears that occurs over several days or weeks
  • Hearing loss accompanied by earache or discharge leaking from the ear canal

If you or a loved one has concerns about hearing loss, the first step is making an appointment with a primary care doctor or clinician. They’ll listen to your symptoms, examine your ears and may do a hearing screening. And if you need more advanced care, a primary care doctor can refer you to an audiologist for a diagnostic hearing test, or an ear, nose and throat (ENT) doctor who can treat underlying conditions that may be contributing to hearing issues.


Reasons why you should get a hearing test

The people around you may be the first to notice that you have a problem with your hearing. Hearing loss is nothing to be ashamed of, and it’s important to address it right away.

Untreated hearing loss can lead to:

  • Social anxiety – The fear of being unable to hear another person in conversation, or missing much of what they say, can be a source of anxiety for many people suffering from hearing loss.
  • Social isolation – In order to avoid the anxiety-provoking experience of conversation, someone with hearing loss may forego social gatherings altogether. This can lead to isolation.
  • Cognitive decline – As we age, strong social connections help us stay sharp. Without them, cognitive decline can accelerate and lead to Alzheimer’s disease and dementia.
  • Auditory deprivation – When hearing loss is left untreated for several years, the parts of the brain that process and interpret sound can weaken. Even after getting hearing aids, someone with auditory deprivation will be able to hear words again, but won’t always understand what they mean.
  • Safety concerns – When you can’t hear the world around you, things become much more dangerous. We need to be able to hear emergency sirens, car horns and alarms to stay safe.

The first step to understanding any problems with your hearing is knowing they exist. Then, you can begin to address them.

How often should I have my or my child’s hearing checked?

Most children have an initial hearing screening at birth before they go home from the hospital. If your baby wasn’t born at a hospital, you should have their hearing checked within their first three weeks of life.

Hearing loss usually doesn’t have any obvious physical symptoms, but there are certain behaviors in children that may indicate hearing loss. Your child may have some degree of hearing loss if they are:

  • Unresponsive to sounds like sudden loud noises or their name being called
  • Exhibiting developmental delays in speech and language

Every few years, children will have hearing screenings at school, typically in the form of pure-tone tests. Hearing screenings are also part of well-child checkups with a primary care clinician.

Unlike a hearing test, a hearing screening can be passed or failed. Failing a hearing screening is not an immediate indication of hearing loss, it only means that a full hearing test is needed for further evaluation.

Adults (18 years of age and older) without any signs of hearing loss, and who are not at risk, should have their hearing screened at least once every 10 years. After 50 years of age, the frequency should increase to every three years.

What to expect at a hearing test

The goal of a hearing test is to determine your auditory threshold, or the quietest level of sound you are able to hear, at any frequency.

Hearing tests are conducted by ear specialists called audiologists. In addition to auditory threshold, they will assess the physical function of your ears, examining inside your ear canal with a lighted magnifying device called an otoscope. They may also perform tests to see how well your brain processes sound.

How to prepare for a hearing test

A hearing test is a simple procedure that won’t require much preparation, but the experience will vary depending on the type of test you are having. Most tests usually last about 30 minutes. The following steps are recommended:

  • Avoid loud noises for 12-16 hours before your scheduled test. Going to something like a rock concert the night before a hearing test can cause skewed results.
  • Be prepared to tell your audiologist about any medications you’re currently taking or have taken in the past that can affect hearing, known as ototoxic medications.

Types of hearing tests

There are several hearing tests that a hearing specialist may conduct to evaluate hearing capabilities in both children and adults:

  • Audiogram, which involves listening to tones at different frequencies and sound levels, and speech testing
  • Tympanometry test
  • Otoacoustic emission test
  • Auditory brainstem response

Online hearing test

Online hearing tests can give you an idea of your hearing threshold and your potential degree of hearing loss, but that’s about it. Only a hearing test conducted by a trained audiologist can help you get to the root of your hearing loss and begin to treat it.

There are several different styles of hearing tests offered online, with some of the most popular ones estimating the age of your hearing based on the frequency levels you can hear. As we age, we lose the ability to hear high frequency sounds, or sounds that are very high-pitched. Sound frequency is measured in hertz (Hz). Healthy hearing can detect sounds between 20 and 20,000 Hz.

Hearing test results

While frequency (Hz) measures the pitch of sound, the volume of sound is measured in decibels (dB). A whisper is 30 decibels and a normal level of conversation is 60 decibels, whereas a revving motorcycle is 95 decibels (depending on how close you are to it). And a rock concert? Between 100 and 120 decibels.

Based on your ability to hear sounds of different volumes and frequencies, your audiologist will categorize your hearing loss according to this scale (provided by the Minnesota Department of Health):

  • None: 0-15 dB
  • Slight: Unable to hear sounds below 16-20 dB
  • Mild: Unable to hear sounds below 21-40 dB
  • Moderate: Unable to hear sounds below 41-55 dB
  • Moderate to severe: Unable to hear sounds below 56-70 dB
  • Severe: Unable to hear sounds below 71-90 dB
  • Profound: Unable to hear sounds below 91 dB

Hearing devices, implants and other treatments

Depending on the cause of your hearing loss, there may or may not be a cure for it. However, hearing loss can usually be treated. Common treatments include:

Protect your ears and prevent hearing loss

A certain amount of hearing loss is a normal part of the aging process. However, you can slow this process and preserve your hearing for as long as possible by taking a few measures to protect your ears:

  • Reduce your exposure to loud noises, or take frequent breaks when in typically noisy areas, like concerts, clubs or parties
  • Wear hearing protection gear, like earplugs or regulated earmuffs, when around loud noises
  • Don’t listen to music too loudly, especially when using earbuds or headphones

If you or a loved one may be experiencing hearing loss, start by scheduling an appointment with a primary care doctor or clinician. They have experience diagnosing and treating hundreds of conditions, and they can refer you to an audiologist for a hearing test or an ENT if an underlying condition is suspected.