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About 15% of American adults have some degree of hearing loss. Your chance of having hearing loss increases with age. Almost half of all people older than 75 experience hearing loss.

Many people with poor hearing don’t get an assessment. Instead, they may turn up the volume on the television or ask people to repeat themselves.

Only one in three people above age 70 who could benefit from hearing aids use them, research shows. Among younger adults, the uptake is even lower, at one in six.

Hearing aids can improve people’s social life, work performance, and even brain health.

Do I Need Hearing Aids?

The Hearing Health Foundation suggests you get a hearing check if three or more of the following apply to you:

• Friends or family often get annoyed because you didn’t hear something correctly.
• People often sound like they are mumbling or aren’t speaking clearly.
• People say you turn the TV volume up too high.
• You find it hard to follow conversations with two or more other people.
• You frequently ask people to repeat themselves.
• You frequently misunderstand what others are saying.
• You have to strain to understand conversations.
• You have trouble hearing over the telephone.
• You have trouble hearing when there is a lot of background noise (like traffic, or music at a restaurant).
• You have trouble understanding people who speak softly.

The first step is to make sure there isn’t a medical reason for your hearing loss. Your doctor may check for an ear infection, wax build-up, or other causes of hearing loss.

If you don’t have an easily fixable medical cause for your hearing loss, your doctor will refer you to an audiologist. They can measure the degree of hearing loss. They can also set up hearing aids for your specific level of hearing loss.

What Causes Hearing Loss?

There are two types of hearing loss: conductive and sensorineural hearing loss. Conductive hearing loss happens because of fluid build-up in the ear. It’s usually due to infection, but it can also happen from growths in the ear or physical abnormalities.

Sensorineural hearing loss happens when the hair cells get damaged. The hair cells pick up vibrations in the ear and turn that into electrical signals that travel to the brain.

Sensorineural hearing loss can happen from:

• Being exposed to loud noises.
• Certain medications that damage the hair cells in the ears, like some types of chemotherapy.
• Genetic causes (this is often the reason for hearing loss in young children).
• Getting older, as hair cells sustain more damage over the years.
• Trauma or explosion that damages the inner ear.
• Viral, bacterial, or other infections.

How loud sounds are and how long you’re exposed to loud sounds affect hearing loss. For example, a leaf blower at about 85 DB can damage the inner ear cells after two hours if protection isn’t worn. A television or stereo at max volume (about 110 DB) can damage the ears after five minutes.

How Is Hearing Loss Treated?

Conductive hearing loss is typically reversible. Doctors can resolve fluid build-up with surgery or medication.

Sensorineural hearing loss is permanent. Hearing aids can help improve this type of hearing loss by making sounds louder in the ear. This increases the vibrations in the ear making it more likely that the hair cells will pick up and detect sounds.

Other technologies can help too. For example, some assistive devices can direct sounds from a phone or TV to a hearing aid.

How Bad Does Your Hearing Have to Be to Get a Hearing Aid?

Doctors measure hearing loss by how loud sounds need to be before a person can hear them. Loudness is measured in decibels. For instance, people with mild hearing loss need sounds to be at least 26 to 40 decibels before they can hear them.

The categories break down as follows:

• Mild hearing loss – 26 to 40 decibels
• Moderate – 41 to 60 decibels
• Severe – 61 to 80 decibels
• Profound – 81 decibels and above

To put these numbers in context, a whisper is about 30 decibels, so some people with mild hearing loss might not hear whispering. Normal conversations are about 60 decibels, but people who speak more quietly speak below 60 decibels.

Doctors recommend hearing aids for people with moderate to severe hearing loss, but hearing aids can also help people with mild hearing loss.

People with mild hearing loss who engage with many people in noisy setting for their job may perform better with hearing aids. Sound engineers or musicians may also want to optimize their hearing even if they only have mild hearing loss.

For those with profound hearing loss, hearing aids may help people hear some words.Unfortunately, sometimes the damage to the hair cells can be so extensive/severe that hearing aids that make sounds louder don’t help.

High-frequency hearing loss

In many cases, people lose the ability to hear higher pitches, or frequencies, of sound. For example, they may be able to hear low-pitch sounds at 40 decibels, but not high-pitch sounds at 40 decibels.

People with this type of hearing loss have trouble hearing some consonants that people tend to say at a higher pitch. This includes letters like s, h, f, and th.

High-frequency hearing loss is still classified as mild to profound. The audiologist will tell you if your trouble hearing is pitch-dependent. Hearing aids can help with high-frequency hearing loss, but they may not work if it is severe or profound.

Are Hearing Aids Really Necessary?

Many people think they don’t need hearing aids because they can manage without them. But hearing aids can improve your life in many ways — and can also prevent hearing loss.

People with hearing damage might turn up the volume too loud on speakers or headphones to make up for hearing loss. This can cause more damage to the hair cells in the inner ear, and worsen hearing. (Hearing aids don’t cause further damage because they don’t increase sound beyond a certain level).

A hearing aid can also make social times more enjoyable. You don’t have to strain to understand what people are saying or try to figure out what someone said from the context. This will help you to stay present in the moment and connect with others.

In the office, you’ll be less likely to miss important information from your colleagues. This also applies to situations where you’re receiving health care, government services, and other day-to-day tasks.

Most importantly, hearing aids can help prevent cognitive decline. Studies show people with hearing loss who used hearing aids had less memory loss and other thinking problems. This could be because hearing conversations lead people to engage in ideas and connect with others more. Using the brain in these ways helps to stave off dementia.

The best way to see if hearing aids help you is to try them. You may not notice an improvement for a few weeks, as it takes time to get used to hearing aids. For more, check out our tips on getting used to a hearing aid.