You've noticed you're asking people to repeat themselves more often. The TV volume keeps creeping up. Restaurant conversations feel exhausting. Now you're wondering: why is this happening to me? Understanding what causes hearing loss helps you make sense of your experience and, in some cases, protect the hearing you still have.
Noise Exposure: The Preventable Cause
Noise-induced hearing loss is one of the most common causes—and the only one that's completely preventable. Loud sounds damage the tiny hair cells in your inner ear that convert sound waves into signals your brain understands. Once damaged, these cells don't regenerate.
What counts as "too loud"? Sound is measured in decibels (dB). Normal conversation is about 60 dB. Prolonged exposure above 85 dB (like heavy traffic or a lawn mower) can cause damage. Above 100 dB (concerts, power tools, motorcycles), damage happens faster—sometimes in minutes rather than hours.
Noise exposure can be sudden (an explosion or extremely loud event) or cumulative (years of working in a noisy environment, attending concerts, or using power tools without protection). Many people with noise-induced hearing loss have trouble hearing high-pitched sounds first, making it difficult to understand speech, especially in noisy places.
You Can Still Protect Your Hearing
If noise contributed to your hearing loss, protecting your remaining hearing matters. Use earplugs or noise-canceling headphones in loud environments. Keep personal listening devices at 60% volume or lower. Give your ears rest breaks after loud exposure. These habits won't reverse existing damage, but they prevent additional loss.
Age-Related Hearing Loss (Presbycusis)
Presbycusis is the gradual hearing loss that happens as we age, typically starting in our 50s and 60s. It's caused by natural changes in the inner ear—those same hair cells breaking down over time, blood flow to the ear decreasing, and changes in the nerves that send sound signals to the brain.
Age-related hearing loss typically affects both ears equally and progresses gradually. High-frequency sounds go first, which is why older adults often say, "I can hear you, but I can't understand you"—they're hearing the low-frequency sounds of speech but missing the high-frequency consonants (like s, f, th, sh) that make words clear.
The good news: While you can't stop aging, you can address age-related hearing loss effectively with hearing aids or other devices. Many people wait years before seeking help, but earlier intervention often leads to better outcomes because your brain stays practiced at processing sound.
Medical Conditions and Medications
Several health conditions can affect hearing, either temporarily or permanently:
- Ear infections can cause temporary hearing loss that usually resolves with treatment, though repeated infections (especially in childhood) can cause lasting damage
- Cardiovascular disease, diabetes, and high blood pressure reduce blood flow to the delicate structures of the inner ear
- Autoimmune diseases like rheumatoid arthritis or lupus can attack the inner ear
- Ménière's disease causes episodes of vertigo along with fluctuating hearing loss and tinnitus
- Otosclerosis involves abnormal bone growth in the middle ear that prevents sound transmission
Certain medications—called ototoxic drugs—can damage hearing. Common culprits include some antibiotics (especially gentamicin and others in the aminoglycoside family), chemotherapy drugs (like cisplatin), high doses of aspirin, and some diuretics. If you're taking any of these medications and notice changes in your hearing or develop ringing in your ears, tell your doctor right away.
Other Common Causes
Earwax buildup is surprisingly common and causes temporary hearing loss that resolves once the wax is removed. Never try to remove impacted earwax yourself with cotton swabs—you'll usually push it deeper. See your doctor for safe removal.
Head injuries can damage the ear structures, skull bones, or hearing nerves. If you've experienced head trauma—even months or years ago—and notice hearing changes, mention this to your audiologist.
Genetic factors account for about half of all hearing loss in children and play a role in adult hearing loss too. Some genetic hearing losses are present at birth, while others develop later in life. If multiple family members have hearing loss, genetics might be a factor.
Acoustic neuromas (benign tumors on the hearing nerve) are rare but can cause gradual hearing loss in one ear, often with tinnitus and balance problems. Asymmetric hearing loss—where one ear is significantly worse than the other—always warrants further medical evaluation.
Most People Have Multiple Causes
It's common for hearing loss to have several contributing factors. You might have some age-related changes plus years of noise exposure plus genetic predisposition. Your audiologist can often identify patterns in your hearing test that point to likely causes, which helps guide treatment decisions.
Common Questions
The Bottom Line
Most hearing loss is caused by a mix of factors—age, noise, health conditions, genetics, and sometimes medication. You can't control all of them, but you can still protect the hearing you have and get help for the hearing you've lost.
A hearing evaluation doesn't just tell you "how bad" your hearing is; it helps clarify what's likely causing the problem and what can be done about it. Knowing the why behind your hearing changes makes it easier to take the next step toward treatment.
Next Steps: From Causes to Action
Understanding the cause of your hearing loss is just the first step. Now, learn how hearing loss is classified and what to expect at your first audiology visit.