Like many other conditions, hearing loss affects people in different ways. Factors that can influence hearing loss symptoms include your age, type of hearing loss, underlying cause, and its severity. Here are a few common signs of hearing loss:

• Inability to hear speech clearly including problems understanding all the words
• Frequently saying “what” in response to conversations with others
• Watching peoples’ mouths closely when they’re talking to make it easier to understand the words
• Feeling tired at the end of the day from straining to hear
• Ringing in your ears (tinnitus)
• Avoiding social situations due to difficulty following conversations in noisy settings (e.g. restaurants and parties)
• Pretending to hear what people say because you’re reluctant or embarrassed to ask them to repeat themselves

Symptoms can be fleeting in the early stages, which means you’ll likely hear better in some situations than others. If you’ve noticed that you need to raise your voice when talking to certain people or they seem to be ignoring you, they’re probably not doing this on purpose. It’s more likely that they’re experiencing some degree of hearing loss. This can be so gradual that the person affected doesn’t notice, but loved ones often do and may be bothered by it. Age-related hearing loss, known medically as presbycusis, typically causes sounds to be muffled or unclear, making it hard to understand what people are saying. In fact, it’s common for the affected person to tell their loved ones they’re mumbling when they’re actually speaking clearly. 

In the early stages of hearing loss, your brain is able to compensate. It’s common not to notice when your hearing loss is mild, but loved ones and close friends may point this out. An easy, nontechnical way to describe mild, moderate, severe, and profound hearing loss symptoms is by the kind of sounds a person may have difficulty hearing at each stage.

• Mild: Soft voices, soft consonant sounds, rustling leaves, normal breathing, ticking watch, whispers; comparable to somebody with normal hearing placing fingers in their ears.
• Moderate: Consonant and vowel sounds, baby crying, conversational speech; may still be able to hear, but find it more difficult to understand what’s being said.
• Severe: Vacuums, hair dryers, ringing telephone, television, doorbell; speech is inaudible without hearing aids.
• Profound: Airplanes, helicopters, firecrackers, fire alarms, and sirens cannot be heard without hearing aids

Sensorineural hearing loss, the most common type, involves damage to the inner ear or the nerve pathways from the inner ear to the brain. This type of hearing loss reduces your ability to hear faint sounds. Even when speech is loud enough for you to hear, the words may sound distorted or muffled. Other common signs include not hearing the doorbell ring and turning up the volume on your television or radio.

Conductive hearing loss involves blockage or damage in the outer ear, ear canal, or middle ear, making it difficult for sounds to pass from your outer ear to your middle ear. Everyday sounds will likely seem softer and your hearing will be better in one ear than the other. It may be harder for you to talk on the phone because both the quality and clarity of sound are diminished. Physically, conductive hearing loss may be accompanied by a feeling of pressure in your ears or a strange odor coming from the ear canal if your hearing loss is caused by wax-build-up, infections, or certain diseases.

Loud noises can damage the tiny hair-like structures (stereocilia) that sit on top of hair cells in your inner ear. This type of hearing loss is rarely painful and symptoms can be subtle and fluctuating. Common symptoms include vague feelings of pressure or fullness in your ears, speech that sounds muffled or distant, and tinnitus when you’re in quiet settings. NIHL symptoms may clear up within hours, days, or weeks after the noise exposure ends. In fact, you might think the problem is gone. In many cases, some cells have been damaged permanently, but an adequate number of healthy ones allow you to hear normally. Keep in mind repeated noise exposure can cause more cells to be damaged, resulting in permanent hearing loss.

A wide variety of illnesses and disorders can cause hearing loss, and surprisingly, so can more than 200 medications.

Below is a summary of select disease-specific hearing loss symptoms:

1. Acoustic neuroma: Also called vestibular schwannoma, this uncommon benign (non-cancerous) growth affects the eighth cranial nerve. Responsible for hearing and balance, this nerve runs from your inner ear to the brain. Although symptoms vary considerably, about 90% of people develop hearing loss before other issues such as tinnitus, dizziness, or imbalance.
   
   
2. Meniere’s disease: This disorder is caused by fluid buildup in compartments of the inner ear called the labyrinth. The most debilitating symptom is severe dizziness (vertigo). Many people also experience tinnitus, the sensation of blocked or muffled hearing, and a feeling of fullness or congestion, typically in one ear. An estimated 60% of people either get better on their own or manage their symptoms with dietary modifications, medications, or hearing aid devices.
   
   
3. Traumatic head injury: Hearing loss related to a traumatic head injury typically results from damage to the tiny bones in the middle ear or a fracture of the inner ear. Due to its sudden and violent nature, a traumatic head injury may cause damage to any point within the auditory pathway, from the outer ear to the auditory cortex in the brain. This can result in the same symptoms as sensorineural and/or conductive hearing loss, balance issues related to the inner ear, and tinnitus. Even if the ear structure itself isn’t damaged, hearing loss can still occur due to impairments in the way sound is processed by the brain.