1. Aging
   If you’re 65 and older, maybe you’ve experienced difficulty having conversations with your friends and family, understanding your doctor’s advice, or hearing the doorbell ring. Perhaps you’re also cranking up the volume on your television or radio. If you’re experiencing difficulty coming to terms with age-related hearing loss, that’s a common reaction and completely understandable. The term for sensorineural hearing loss related to aging is presbycusis. Sensory presbycusis is the most common subtype, with high-frequency hearing loss most often impacting both of your ears equally. This type of hearing loss occurs gradually over time, so you may not even realize you can’t hear well. 
   
   
2. Blood vessel diseases
   Many disorders of the vascular system can impact the blood circulation of your inner ear. This can cause fluctuating or permanent hearing loss. 
   
   
3. Autoimmune diseases 
   Most patients with Sjögren’s syndrome have mucosal dryness, which can result in ear lesions and severe sensorineural hearing loss. Other autoimmune disorders such as systemic lupus erythematosus and rheumatoid arthritis less commonly cause this problem.
   
   
4. Viral infections
   Hearing loss related to viruses can be congenital or acquired, unilateral (one side), or bilateral (both sides). Most virus-induced hearing loss is sensorineural, although certain viruses may cause conductive and mixed hearing loss. Meningitis, mumps, scarlet fever, measles, rubella, herpes simplex 2, HIV, and West Nile have been linked to hearing loss. Prior to widespread vaccination, measles accounted for 5–10% of profound hearing loss cases in the U.S. With the recent measles outbreak, related hearing loss cases may escalate.
   
   
5. Traumatic brain injuries
   Due to its sudden and violent nature, head trauma may lead to hearing loss as well as vestibular (balance) and central auditory problems. Hearing loss related to a head injury can be sensorineural or conductive.
   
   
6. Noise-induced
   Hearing loss caused by exposure to loud noise is common, affecting about 10–40 million adults in the U.S. younger than age 70. Whether you were exposed to extremely loud noise once or repeatedly over a long period of time, it can damage your sensitive ear structures.
   
   
7. Meniere’s disease
   In addition to extreme dizziness, this disease can cause tinnitus (ringing in your ears), the sensation of blocked or muffled hearing, and a feeling of congestion, fullness, or pressure in the affected ear. If your inner ear fills with excessive fluid, this can damage the delicate hair cells of the inner ear, resulting in permanent hearing loss.
   
   
8. Benign and malignant tumors
   Acoustic neuromas (vestibular schwannomas) are benign tumors of the eighth cranial nerve that can cause hearing loss. An estimated 20% of adults with these tumors experience some hearing loss. Additional tumors that may cause hearing loss include paragangliomas and endolymphatic sac tumors.
   
   
9. A side effect of specific medications
   According to the American Speech-Language-Hearing Association, more than 200 different medications have hearing-related side effects. The most common ones include aspirin in very high doses, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, aminoglycosides, amoxicillin (the most widely prescribed antibiotic), certain chemotherapy drugs, and loop diuretics.

The most common symptoms impact clarity of sound and loudness. Symptoms can be physical and behavioral: 

• Muffling of speech and other sounds
• Difficulty understanding words, especially in a crowd or with background noise
• Trouble hearing specific consonant sounds (e.g. “s” or “th”) 
• Needing to frequently ask others to speak slower, more clearly, and louder
• Needing to turn up the volume on the television, radio, or computer
• Withdrawing from conversations
• Avoiding certain social settings

1. Impaired Eustachian tube function
   If you’re experiencing muffled or reduced hearing, your Eustachian tube may be blocked. The Eustachian tube links the back of your nose to the middle ear. Eustachian dysfunction may occur when the mucosal tube lining swells up or the tube doesn’t open or close properly.
   
   
2. Fluid in the middle ear related to colds or allergies
   Allergies can cause swelling, pressure, and fluid buildup in the tube that runs from your ears to your nose and throat, or even completely block it. When this happens, you may experience reduced hearing temporarily.
   
   
3. Ear infection, or otitis media
   This common inflammation of the middle ear can be sparked by an infection or drainage into your middle ear. If you swim, you’ve probably gotten water in your ears, but luckily, it usually drains out without causing an ear infection. This condition is the most common cause of intermittent, mild-to-moderate acquired hearing loss in infants and young children.
   
   
4. Otosclerosis
   An abnormal growth of the bone of the middle ear, this disorder prevents proper functioning of the structures in your ear.
   
   
5. Ruptured eardrum
   Inflammation or an infection in the middle ear, a blow to the ear, a head injury, or insertion of a cotton swab too far into the ear canal can lead to this condition, medically known as tympanic membrane perforation. However, to put it in simple terms, this literally means you have a hole in your eardrum. If it gets infected, hearing loss can worsen.
   
   
6. Benign tumors
   Although they are nonmalignant, lesions that affect the middle ear can lead to hearing loss. These types of rare tumors are called paraganglioma.
   
   
7. Earwax (cerumen) in the ear canal
   Although it’s a little off-putting, earwax is a highly useful substance because it protects and cleanses your ear canal. But a problem can occur if you produce too much earwax. Excessive wax can prevent sound from traveling from your outer ear to your inner ear. As you get older, earwax can become harder and more prone to building up in your ear canal. You may be tempted to remove earwax from your ears with cotton swabs but doing so can damage your ear canal. It’s important that you consult a doctor for treatment. This involves placing medication in the ear canal to soften the wax, irrigating the ear canal with water, or using special tools to remove the blocked wax.
   
   
8. Infection in the ear canal (external otitis)
   An acute infection of the ear canal skin, this can cause your ear canal to swell up and close, resulting in hearing loss.
   
   
9. Middle ear malformation
   A wide range of birth defects can affect a baby’s ears before birth. When the middle ear is impacted, hearing loss can occur.

These are the symptoms you might experience when you have conductive hearing loss:

• Everyday sounds are perceived as softer
• Better hearing in one ear than the other
• Difficulty hearing discussions (e.g. on the phone)
• The quality of sound is less clear or sharp
• High and low sounds are reduced
• Feeling of pressure in one or both ears
• A foul odor coming from the ear canal