There are many different causes of hearing loss, from aging to genetic conditions to noise exposure. Determining the cause is an important step in finding the right treatment.
Close to 40 million American adults have hearing loss, making it one of the most common health concerns people face, according to the NIH.
While most causes of hearing loss are well-understood, researchers are still studying all the possible causes, methods for prevention and treatment options. In some cases, no cause can be determined.
Top causes of hearing loss
Aging
The most common type of hearing loss is known as age-related hearing loss, or presbycusis. This means the gradual loss of hearing that occurs over time. As with other body changes related to aging, hearing loss is a normal—but treatable—part of aging. You may not realize it’s happening until your symptoms become severe or someone else notices you’re having trouble.
This type of loss is permanent and usually makes it harder to hear what are known as "high-frequency" sounds, such as children's voices, birds chirping or the ringing of a telephone.
The main symptoms that indicate you may have age-related hearing loss? First, you may feel like you can hear, but not understand. You may find certain sounds annoying or too loud. You also may notice more episodes of tinnitus (ringing in the ears).
Presbycusis is a type of sensorineural hearing loss, which means it occurs from changes in the inner ear as a person ages. It also can be the result of changes in the middle ear, or along the nerve pathways leading to the brain. As you age, heart-related conditions like high blood pressure and diabetes also affect how well you hear.
Hereditary hearing loss can be conductive, sensorineural or mixed and is sometimes the result of a genetic trait passed down from a parent. There are more than 400 known genetic and rare syndromes that include hearing loss. It's likely more will be identified as genetic testing becomes even more sophisticated.
The degree of loss can vary widely from person to person, even those with the same genetic condition. For some people, hearing aids will be sufficient. For others, cochlear implants and/or learning American Sign Language will be recommended.
While many hereditary hearing losses are congenital (present at birth), some of these conditions develop slowly over time.
Noise exposure
Noise-induced hearing loss is caused by prolonged exposure to loud noise. The culmination of constant exposure to every day sounds like traffic, construction work, noisy office environments or loud music can negatively impact your hearing. While noise-induced hearing loss is generally temporary in nature, repeated overexposure to loud noise makes it harder for the ears to recover between events. The noise damages inner ear hair cells, causing hearing loss to deteriorate over time and become permanent.
Remember: Noise-induced hearing loss is largely preventable.
You can significantly lower your risk of hearing loss by limiting exposure to loud noises, using earplugs in noisy environments, and using your headphones wisely.
Illness-related hearing loss
There are numerous illnesses, autoimmune diseases and conditions that contribute to hearing loss, including:
Meniere’s disease: The cause of this disease is unknown, but symptoms usually include fluctuating hearing loss, vertigo, and tinnitus.
Otosclerosis: This disease affects the movement of the tiny bones in the middle ear causing a conductive hearing loss that is usually treated with surgery.
Drug that cause hearing loss
There are numerous drugs and medications linked to hearing loss, known as ototoxic drugs. These include:
Generally, you must take large and prolonged doses of these types of drugs to notice effects of hearing loss, but research is still being conducted to further understand the effects of specific dosages and medications.
Head trauma and tumors
Another cause for hearing loss is from tumors such as an acoustic neuroma. Tumor-related hearing loss might also include tinnitus (ringing in the ears), or you might have a sensation of fullness in one or both ears. Tumors are usually treated either medically or surgically and normal hearing may or may not be restored.
Head trauma can damage inner ear structures causing a temporary or permanent hearing loss. Any injury sustained to the head should be evaluated by a doctor immediately. The medical evaluation will likely include both a hearing and eye examination.
Less common causes and risk factors
Risk factors for hearing loss extend beyond
exposure to loud noises or getting older.
Many lifestyle choices impact hearing health.
Some risk factors for hearing loss are understandable—think aging, excessive noise exposure, or traumatic brain injury—but other risks aren’t always so obvious. Here are seven unexpected risk factors for hearing loss that may surprise you:
Sleep apnea
Several studies published in the last few years have strongly linked sleep apnea to hearing loss. Medical professionals aren’t entirely sure why those with sleep apnea are more prone to hearing loss, but they believe it’s because the condition reduces blood supply to the inner ear, an intricate system which depends on oxygen to properly process sound. It's also possible that years of loud snoring could damage hearing.
Excessive drinking
People who regularly drink above recommended amounts have more to worry about than developing chronic diseases like heart disease, high blood pressure and stroke. Heavy drinking damages the central auditory cortex, increasing the amount of time it takes your brain to process sound, studies show. Excessive drinking among young adults also can lead to problems processing lower frequency sound. Even one overindulgent night can create balance problems: That’s because alcohol is absorbed into the fluid of the inner ear, which monitors balance, even after it is no longer present in the blood and brain.
Iron deficiency
After analyzing the medical records of more than 305,000 adults, researchers at the University of Pennsylvania discovered a relationship between iron-deficient anemia (IDA) and hearing loss. People with IDA were twice as likely to have hearing loss than those without the blood disorder. Although the researchers stopped short of saying iron deficiency causes hearing loss, they did acknowledge the mineral’s critical role in providing a healthy blood supply to the delicate hair cells of the inner ear, which are responsible for processing sound.
Mumps
This common childhood disease is known for causing painful swelling of the salivary glands on both sides of the face but in extreme cases, the mumps can also cause swelling of the membranes that surround the brain and hearing loss. How does mumps affect your hearing? Medical professionals suspect the highly contagious viral disease damages the cochlea, located inside your ear. Although research shows only 1-4% of those infected with the mumps experience hearing loss, the exact rate is unknown. Immunizing children against the disease is the best way to prevent getting sick.
Chronic stress
Almost everyone experiences short bouts of intense stress at some point in their life, but sufferers of chronic acute stress are at risk of hearing problems. In the case of hearing, it’s most likely a circulation problem. During periods of acute stress, the body diverts oxygen to its muscles so you can react more quickly if necessary. Most of the time, the body returns to normal when the danger has passed; however, in cases of acute stress, the body doesn’t receive that message. That means other parts of the body, such as the hearing mechanisms of the inner ear, can be damaged from lack of proper oxygen and blood circulation.
Vaping
While the jury is still out on vaping as an alternative to cigarette smoking, one thing remains true—smoking, nicotine and vaping aren't good for your hearing. Nicotine is an addictive chemical that restricts blood flow to all parts of your body, including your inner ear where delicate stereocilia which interprets and transmits sound from your outer ear to your brain are located. Smoking is well-known to be bad for hearing. Even e-cigarettes without nicotine might be hazardous to your hearing health. The mixture of flavorings, colorings and other additives which give the e-cigarette its flavor contain a substance called propylene glycol, an alcohol-based solvent that has proven to be harmful to ears when used topically.
COVID-19
While the coronavirus is far more likely to cause breathing problems, it can occasionally infect the auditory system, studies show, leading to temporary hearing loss and tinnitus from COVID. There are increasing anecdotal reports that the more recent Delta variant is more likely to cause earaches than other mutations of the virus. This is likely because Delta causes more upper respiratory symptoms, doctors say, putting more pressure on the ears and potentially causing ear infections.
Viagra and erectile dysfunction drugs
If you’re enjoying a renewed quality of life courtesy of a “little blue pill” make sure you’re monitoring your hearing health closely, too. Men who take Viagra and other PDE-5 inhibitors are twice as likely to have hearing loss and may experience sudden hearing loss in one or both ears. Viagra is only one of many medications considered ototoxic, or harmful to your hearing health. Your best bet before taking any medication is to ask your physician to explain all potential side effects, including those which may affect your hearing.
There are so many potential causes of hearing loss. Hearing healthcare professionals are trained to use many diagnostic tests to help get to the bottom of your concerns. Once they determine the cause, they can find the best course of treatment.
If you have hearing loss and are unsure of the cause, visit a qualified clinic near you from our consumer-reviewed directory.
Joy Victory, managing editor, Healthy Hearing
Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public.
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Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public.
