If you have no hearing loss, it may seem hard to believe that someone can become hard of hearing without noticing. However, most people are unaware of early hearing loss. For adults, age related hearing loss is a slow, gradual process and our brains compensate for decreased sound levels. You might find yourself turning up the volume on TV or not enjoying social activities without realizing the cause. Children born with hearing loss have never experienced normal hearing, so their loss and how they hear is their “normal hearing.” 

In both cases, it’s often friends and relatives of those with hearing loss who notice the problem first.

If you’ve experienced any of the following, you may need to look into hearing loss treatment:

• You have trouble hearing phone calls or have increased the phone’s volume to maximum.
• You frequently have difficulty following conversations when people talk at the same time.
• Family members or neighbors complain about the volume of your music or television.
• You feel physically or emotionally drained after conversations.
• You experience headaches after conversations.
• You have difficulty hearing conversations in noisy environments.
• You frequently say “what?” during conversations and ask people to repeat themselves.
• People seem to mumble more than they once did
• You frequently misunderstand what people say.
• You have difficulty hearing children or women, who tend to speak at a higher pitch than men.
• You find yourself withdrawing from social occasions
• You experience anger and frustration while trying to follow conversations.

Hearing loss treatment begins with a hearing test, or audiogram. An audiogram tests how well you hear sounds of varying frequencies or pitches. The test is measured in decibels and the test results are called your hearing threshold level.  Depending on your results, you’ll fall into one of the following categories:

• -10-25 decibels: Normal hearing.
• 26-40 decibels: Mild hearing loss.
• 41-55 decibels: Moderate loss.
• 56-70 decibels: Moderate/severe hearing loss.
• 71-90 decibels: Severe hearing loss.
• 91-100 decibels: Profound hearing loss.

During an audiogram you wear headphones and listen to sounds sent to one ear at a time. You signal when you hear a sound. For comparison, a whisper is approximately 20 decibels, while a loud music concert is between 80-120 decibels.

Speech audiometry is used to measure how well you can perceive and repeat spoken words. Another test, acoustic immittance uses a probe and gentle air pressure to measure eardrum movement and air pressure equalization in your middle ear and eustachian tube.  

Hearing loss treatments include hearing aids, cochlear implants, surgery, and medication. The type of treatment that’s best for you will depend on the cause of your hearing loss. Hearing loss is divided into three broad categories: sensorineural, conductive, and mixed.

1. Sensorineural hearing loss: This is permanent hearing loss due to damage to the inner ear, auditory nerve, or inner ear hair cells. Presbycusis, or age-related hearing loss, falls into this category.
   
   
2. Conductive hearing loss: This results from problems with the outer or middle ear, such as perforated eardrums, excessive earwax, or fluid in the middle ear. Conductive hearing loss can often be cured through medical or surgical interventions.
   
   
3. Mixed hearing loss: This is a combination of conductive and sensorineural hearing problems.