Top 9 Questions About Hearing Loss and Tinnitus Answered by an Audiologist
Hearing loss and tinnitus are common issues that affect millions of people worldwide. My goal for this piece is to address the top 9 questions I get from patients about hearing loss, tinnitus, and hearing aids.
About the Author
My name is Dr. Tabitha Rossini. I’m an East Tennessee native who has spent my career helping people with their hearing health. I have a doctoral degree in Audiology and more than a decade of experience. Read on to find answers to the questions I get most often and learn how to take steps toward better hearing health.
Contents:
1 · How Can I Tell If I’m Experiencing Hearing Loss?
Recognizing the early signs of hearing loss is crucial for timely intervention. The most common indicators are:
Difficulty understanding speech: This often happens in noisy environments or when multiple people are speaking. You might find it hard to follow conversations at restaurants or family get-togethers.
Frequently asking for repetition: The dreaded “what?” question or asking “can you repeat that?” more often. Asking this question frustrates most people, and eventually, they just stop asking for clarification.
Turning up the volume: Are you finding you need more volume from your TV, phone, or radio than others might? Do others tell you that the volume is too loud? This is another indicator of hearing loss.
Withdrawal from conversations: When you have to ask “what?” repeatedly or struggle to hear in social situations, eventually people withdraw. This is one of the worst impacts of hearing loss, in my opinion, as it leaves people feeling isolated and often depressed.
Perceiving muffled sounds: Another indicator is when sounds seem less sharp or clear than before. This often feels like difficulty distinguishing consonants in speech.
Ringing in the ears (Tinnitus): Tinnitus gets described in many different ways, but it’s a sign associated with hearing loss.
Fatigue after social events: If you find you’re tired after social events, this is often from trying to listen and understand in social settings.
A STORY OF HEARING HEALTH—
Jack’s Journey to Better Hearing
I recall a patient named Jack who visited our clinic with his wife after a particularly challenging family event. It was his wife’s birthday party, and their home was filled with their grown children and grandchildren. As everyone sat around the table laughing and engaging in lively conversations, Jack felt increasingly isolated. He described the experience as feeling “a mile away from the room.” While he could see people’s mouths moving and hear sounds, he couldn’t understand the words—they all blended into a muffled background noise.
This wasn’t the first time Jack had struggled in social settings, and his family had gently encouraged him to get his hearing checked for a while. Feeling embarrassed and left out after the party, he finally decided it was time to take action.
During his appointment, we conducted a comprehensive hearing evaluation and determined that he was a good candidate for hearing aids. When we fitted him with the devices, the change was immediate and profound. Jack’s eyes lit up as he realized he could clearly hear and understand again.
At his follow-up visit two months later, Jack shared that he hadn’t realized how much he was missing. He attended another family gathering and was thrilled to be an active participant in conversations again.
Jack deserved to stay connected with his family and friends. Seeing him achieve that was incredibly rewarding for me. This is just one of many stories that remind me why I am passionate about audiology.
Time to Take Action?
If you experience any of these symptoms, we recommend that you schedule a hearing evaluation with a qualified audiologist. Early detection is crucial and can help prevent further hearing loss.
Learn more about signs of hearing loss from the American Speech-Language-Hearing Association (ASHA).
2 · What Are the Signs of Tinnitus?
Tinnitus is an odd word to describe a very strange and challenging condition. The root of the word tinnitus comes from a Latin word meaning “ringing, jingling, tinkle.” Unfortunately, experiencing tinnitus is not even remotely pleasant or comparable to a “jingling.”
Tinnitus is a condition in which the ear perceives sound when no external sound is present. The symptoms are a little different for everyone, but here are some common descriptors and signs:
Ringing: a ringing sound in one or both ears.
Buzzing or hissing: the perception of buzzing, hissing, whistling, clicking, or humming.
Intermittent or continuous: for some, tinnitus is always there. For others, it comes and goes.
Varied pitch and volume: the perceived sound can change in both pitch and loudness.
Tinnitus can interfere with daily activities, concentration, and rest. This often leads to irritability or anxiety. Tinnitus can affect anyone but is most common with individuals who have been exposed to loud noises or have age-related hearing loss.
If you notice these symptoms, an audiologist can help verify the diagnosis and offer some options to help manage the condition. For more information, visit the National Institute on Deafness and Other Communication Disorders (NIDCD).
3 · What Causes Tinnitus and Can It Be Treated?
Tinnitus can result from many factors. The most common ones are:
Exposure to loud noises: When our ears are exposed to loud noises, they can damage the hair cells in the inner ear. Loud music, machinery, or explosions are very common causes.
Age-related hearing loss: Unfortunately, as we age, our hearing sensitivity declines. This, too, can cause tinnitus symptoms.
Ear infections or blockages: Some people produce more wax than others. If wax builds up too much over time, it can change the pressure inside the ear.
Medications: Some drugs, like high doses of aspirin, antibiotics, or chemotherapy agents, can cause tinnitus.
Underlying health conditions: Cardiovascular disease, Meniere’s disease, or temporomandibular joint (TMJ) disorders can also cause tinnitus.
Tinnitus is a frustrating condition. There is no definitive cure, but different treatments can help manage the symptoms:
Sound therapy: External noises can mask or alter the perception of tinnitus. White noise machines can help and some hearing aids have tinnitus features.
Cognitive behavioral therapy: CBT is a psychological approach to help manage the emotional and psychological impact of tinnitus.
Medication adjustments: It’s possible that reviewing and adjusting prescriptions can help reduce the symptoms of tinnitus.
Tinnitus retraining therapy (TRT): This approach combines sound therapy and counseling to help the patient get used to tinnitus symptoms.
A STORY OF HEARING HEALTH—
A Patient’s Journey with Tinnitus and Hearing Aids
I recall a patient who visited our clinic with persistent ringing in her ears. Over the past few years, the ringing had gotten worse and it was beginning to affect her ability to fall asleep. While she could sometimes ignore it, overall the tinnitus was causing her considerable anxiety.
What’s interesting is that when this patient first visited, her main focus was on tinnitus, not hearing loss. This is very common. Many patients are more troubled by ringing or whooshing than by subtle changes in their hearing.
We conducted a comprehensive hearing test and discovered that she had high-frequency hearing loss—meaning she had difficulty hearing higher-pitched sounds. I explained to her that tinnitus is often a symptom of this type of hearing loss. To address the ringing effectively, we needed to treat the underlying hearing loss.
I fitted her with hearing aids specifically programmed for her hearing profile. Immediately, she noticed an improvement in her hearing that she hadn’t realized was missing. It was quite an “ear-opening” experience for her. Again, I see this often. Many patients aren’t fully aware of the extent of their hearing loss until they experience the difference hearing aids can make.
When she returned for her follow-up appointment a few weeks later, she shared some encouraging updates. She found that conversations were much easier. While the ringing was still present, it was much less noticeable. And she felt happier overall with less “blank space” filled by the tinnitus.
It’s important to note: hearing aids are not a cure for tinnitus. But there’s about a 60% to 65% chance that they can help reduce the effects. By amplifying external sounds, hearing aids reduce the contrast between environmental noise and tinnitus, making the ringing less noticeable. This patient’s experience is quite typical. Hearing aids often help mitigate tinnitus by improving hearing and reducing the focus on the internal ringing.
If you struggle with tinnitus, an audiologist or ENT specialist can help to develop a personalized treatment plan.
4 · Will Hearing Loss Get Worse If Untreated?
Unfortunately, hearing loss can get worse over time if left untreated. Plus, when you let your hearing health deteriorate, other health issues can arise:
Further deterioration: Your auditory system can weaken because it’s lacking stimulation. This leads to further decline in speech understanding and comprehension.
Cognitive decline: Studies show that memory problems worsen and mental sharpness declines as hearing health deteriorates. There are strong links to dementia because of this.
Social isolation: Mental health can take a serious toll as worsening hearing leads to withdrawal from social situations and interactions due to the struggles to communicate.
Emotional impact: Worsening hearing health can increase feelings of frustration, anxiety, or depression.
When you detect hearing loss early and intervene with hearing aids or other treatments, it can slow down or prevent these effects. You can read more about the impact of untreated hearing loss from the Hearing Loss Association of America.
5 · What If Hearing Aids Don’t Work for Me?
In some less common cases, traditional hearing aids aren’t as effective. When this happens, there are other options:
Advanced hearing devices: Cochlear implants can help those with severe hearing loss. This device bypasses portions of the ear and directly stimulates the auditory nerve.
Bone-anchored hearing systems: This approach can work for those with conductive or mixed hearing loss. It’s also used for those with single-sided deafness.
Assistive listening devices: There are also tools and devices that amplify specific sounds or reduce background noise.
Aural rehabilitation: There are therapies available to help improve listening skills, speech reading, and other strategies to improve communication.
If traditional hearing devices aren’t effective, in some cases it makes sense to get a medical evaluation to investigate any underlying medical conditions that could be treatable. Your audiologist should be open to discussing alternative solutions to find the best option for your hearing health.
A STORY OF HEARING HEALTH—
How a Hearing Aid Changed Joe’s World
When it comes to hearing transformation, we love to tell the story about a client named Joe. Joe was homebound, confined to his bed, and fighting a losing battle with dementia. He was isolated in every sense of the word. Physically, he lived in the furthest room in the house. He had to rely on others to come for any interaction. Emotionally, he was distant, sad, irritable, and unresponsive. His hearing loss was so severe it made the isolation worse.
When Joe’s family suggested he try a hearing aid, he fought against it. To be frank, fitting him with a hearing device was incredibly difficult. Then, he immediately dismissed the aid as not being effective. But, even on day one, we did notice a small change. He was able to have basic conversations without anyone needing to shout.
Over the next few weeks, Joe’s demeanor changed. He became less irritable and more engaged with the people around him. And over the next few months, he was completely changed. In fact, when his hearing aid needed some adjustment, he showed significant anxiousness to have it back as quickly as possible. This was a great signal that he was finding benefit and dependence on his hearing, and thus his connection to those around him.
Six months later, Joe’s hearing aid needed an extensive repair. Without the hearing aid, Joe quickly regressed, slipping back into a frustrated mode and isolated state. His family noticed an immediate drop in his engagement and were shocked by how critical the hearing aid had become to his quality of life.
Today, Joe wears his hearing aid daily. The man who was once irritable and dismissive of any hearing device now sees it as a lifeline to his world. His ability to communicate and connect with those around him has been transformed. For Joe, the hearing aid wasn’t just a tool, but a bridge back to humanity.
6 · Will Hearing Aids Make My Hearing Worse Over Time?
Thankfully, no! When hearing devices are properly fitted and used regularly, not only will they not worsen your hearing, but they will work to help protect it. Here’s how:
When your auditory pathways are kept active, it helps maintain your ability to understand speech and reduce the strain of listening.
Hearing aids prevent a concept known as ‘auditory deprivation,’ in which the brain loses the ability to process sound because your auditory pathways are not being used.
This is why we get so excited about hearing health. It can make all the difference in your life. We recommend you have your hearing aids fitted by a professional and get regular check-ups to make sure they are programmed correctly and functioning well.
7 · Are There Risks Associated with Using Hearing Aids?
Hearing aids are generally very safe, but there are some very minor risks associated with their use.
Ears can sometimes get irritated and the wearer can experience discomfort. This happens from improper fit, allergic reactions to the hearing aid material, or moisture build-up. In all cases, there are solutions to explore.
When hearing aids are not fitted correctly or if there is earwax blockage, they can sometimes produce a slight feedback noise, like a microphone squeal. Again, this can be remedied.
If hearing devices aren’t regularly cleaned, bacteria can build up and lead to ear infections.
In rare cases, if a hearing device is poorly adjusted, over-amplification can occur. This can lead to hearing damage but should never happen with properly fit and tuned hearing devices from a professional.
We minimize these risks by:
Making sure you have a proper fit and programming by our licensed audiologists.
Teaching you how to clean and service the hearing aids appropriately.
Teaching you how to insert, remove, and take care of your hearing aids.
If you experience any discomfort or other issues with your hearing devices, please contact us so we can help.
8 · Can Loud Noises Cause Permanent Hearing Damage?
Yes. Exposure to loud noises can lead to noise-induced hearing loss. We call this NIHL for short. Here’s what that looks like:
The loud sounds can destroy tiny hair cells in your inner ear. These hair cells are essential for hearing.
Once damaged, these hair cells cannot regenerate or grow back. This is what causes permanent hearing loss.
Some of the most common situations for NIHL are loud events like concerts or sporting events, loud machinery like construction equipment or power tools, or listening to music at high volumes through headphones.
Here’s what you can do to be safe:
Wear ear protection in noisy situations
Follow the 60/60 rule. When using headphones, listen at no more than 60% volume for no more than 60 minutes at a time.
Get your hearing checked regularly if you’re exposed to loud noises.
9 · How Can I Manage Background Noise with Hearing Aids?
This is one of the most common concerns with hearing devices. Fortunately, hearing aids have really advanced in the last decade.
Modern hearing aids offer highly specialized algorithms that reduce background noise in smart ways. They’re designed with technology that adapts to focus on the sounds of speech and not the background. When you work with an audiologist, we can help create custom settings for your hearing aids that fit different environments.
If you think your current devices don’t have these capabilities, schedule an appointment and we’ll discuss further adjustments or an upgrade to give you the best hearing options possible.
Take Charge of Your Hearing Health Today
If you can’t tell, we believe hearing health is key to a quality life. Early detection and intervention are the best tools to manage and protect the hearing you have. If you suspect hearing issues, schedule a comprehensive evaluation with our top-notch, experienced audiologists. We want to give you personalized care and solutions that fit you best so you can reconnect with the sounds you love.
Contact us today to book an appointment and take your next step toward better hearing.
