What causes hearing loss and what you can do about it right now

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group

Published: July 20, 2025Updated: July 20, 2025

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Key Takeaways

Hearing loss can stem from three broad groups of problems: damage to the inner-ear hair cells from aging or loud noise, blockage or disease of the middle or outer ear, and nerve or brain disorders that interrupt sound signals. Less common but important causes include certain medicines, diabetes, autoimmune disease, and sudden viral infection. Pinpointing the exact cause early greatly improves the chance of preventing further loss or even reversing it.

What medical problems most commonly reduce hearing today?

Up to 90 % of adult hearing loss falls into sensorineural loss—injury to the delicate hair cells in the cochlea or the auditory nerve. Conductive loss from wax or ear-drum trouble is the next biggest category, while mixed loss involves both. As Sina Hartung, MMSC-BMI, notes, “Identifying the exact type on day one directs everything from testing to treatment.”

Age-related cochlear wear (presbycusis) dominates after 60Natural cell aging plus lifetime noise exposure makes high-frequency sounds fade first, affecting 1 in 3 people older than 65.
Repeated loud-sound exposure injures hair cellsAny sound exceeding 85 dB—power tools, concerts, even some gyms—can cause permanent loss after just 8 hours of daily exposure.
Earwax blockage is a reversible causeImpacted cerumen accounts for roughly 12 % of primary-care complaints of sudden hearing drop and is fixed with simple removal.
Chronic middle-ear infection scars the eardrumOtitis media with effusion can stiffen the ossicles, cutting sound transmission by 20–30 dB.
Genetic and autoimmune inner-ear disease is rare but severeConditions such as Ménière’s disease or Cogan syndrome produce fluctuating, often progressive loss.
Diabetes and hypertension accelerate inner-ear damageThe NIDCD notes that chronic conditions such as high blood pressure and diabetes are linked to a greater risk of hearing impairment, likely through micro-vascular changes that starve delicate cochlear hair cells. (NIDCD)
Certain medications are directly ototoxicMedlinePlus lists chemotherapy drugs, some aminoglycoside antibiotics, loop diuretics and high-dose aspirin among medicines that can injure the cochlea or auditory nerve, causing sudden or progressive sensorineural loss. (MedlinePlus)

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Which hearing changes are emergencies that warrant same-day care?

Some patterns signal potentially reversible but time-sensitive problems. The team at Eureka Health warns that “24 to 48 hours can decide whether sudden deafness remains permanent or not.”

Sudden loss in one ear over minutes to hoursMay indicate viral neuritis or vascular occlusion; oral steroids within 72 hours restore hearing in 38–65 % of cases.
Severe ear pain with drainageCould be malignant otitis externa, a fast-spreading infection mainly in diabetics; hospitalization and IV antibiotics are often needed.
New ringing plus balance trouble after head injuryRaises concern for temporal-bone fracture; urgent CT imaging is required.
Hearing drop with facial weaknessSuggests Ramsay Hunt syndrome (VZV reactivation); antiviral therapy works best when started within three days.
Pulsatile whooshing soundMay reflect vascular tumor or aneurysm and needs ENT or neurosurgical evaluation immediately.
Sudden sensorineural hearing loss strikes only 1–6 people per 5,000 each yearIts relative rarity can delay recognition, yet every case requires immediate evaluation to preserve hearing. (AssocAudiol)
Roughly 4,000 new U.S. cases of sudden deafness are reported annuallyNIDCD figures underscore that thousands face this ear emergency each year despite its uncommon incidence. (Swedish)

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Who is most at risk for hearing loss and why?

Risk depends on genetics, lifestyle, and co-existing health issues. According to Sina Hartung, MMSC-BMI, “Two people can attend the same concert; the smoker with uncontrolled diabetes is far more likely to lose hearing later.”

Older adults with cardiovascular diseaseReduced cochlear blood flow from hypertension or atherosclerosis accelerates hair-cell death by up to 30 %.
Workers in construction, aviation, and agricultureOccupational Safety data show 22 million U.S. workers are exposed to hazardous noise each year.
People taking ototoxic drugsLoop diuretics, aminoglycosides, and high-dose aspirin collectively cause about 4 % of new permanent losses.
Poorly controlled diabetes or thyroid diseaseMicrovascular changes and metabolic imbalance double the risk of mild-to-moderate sensorineural loss.
Family history of early deafnessMutations in genes like GJB2 (connexin 26) explain 50 % of congenital non-syndromic losses.
Recreational noise drives over half of all U.S. noise-induced casesCDC analyses estimate 40 million adults aged 20–69 already have noise-induced hearing loss, and more than 50 % of those injuries came from music venues, power tools, or other non-work activities rather than job-site exposure. (CDC)

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What concrete steps can I take today to protect or improve my hearing?

Simple measures reduce further damage and sometimes restore partial hearing. The team at Eureka Health says, “Small habits—like keeping volume at 60 %—add up to years of preserved hearing.”

Use 32-dB-rated earplugs at concerts and while mowingEach 3-dB reduction halves damaging sound energy reaching inner-ear cells.
Follow the 60 / 60 rule for headphonesListen at no more than 60 % max volume for 60 minutes, then rest ears for at least 10 minutes.
Schedule an annual audiogram after age 50Early detection allows timely fitting of aids, which slows social isolation and cognitive decline by 30 %.
Manage chronic diseases aggressivelyKeeping A1c under 7 % or blood pressure under 130/80 mmHg preserves cochlear blood supply.
Quit smoking and limit alcoholSmokers have a 1.7-fold higher risk of high-frequency loss; heavy drinkers face nutritional deficits that worsen nerve health.
Leave earwax removal to safer methodsSkip cotton swabs; WebMD warns they can push wax deeper and injure the canal—use an irrigation kit or see a clinician instead. (WebMD)
Coach teens on sound safety earlyAbout 15 % of 11–19-year-olds already have noise-induced loss, according to Michigan Medicine, so set volume limits and hand out earplugs at concerts and games. (MichMed)

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Which tests and treatments do doctors use for hearing problems?

Accurate diagnosis begins with objective measurements. As Sina Hartung, MMSC-BMI, explains, “An audiogram is the EKG of the ear—without it, we’re guessing.”

Pure-tone audiometry maps frequency-specific lossReveals the classic sloping high-frequency curve of age-related loss and guides hearing-aid programming.
Tympanometry checks middle-ear pressure and fluidA flat curve suggests effusion; treating with a short myringotomy restores hearing in 80 % of cases.
Otoacoustic emissions verify hair-cell function in newbornsNewborn screening now catches 98 % of congenital deafness in the U.S.
High-resolution MRI of the internal auditory canalNeeded when asymmetric loss or tinnitus raises concern for acoustic neuroma.
Modern treatments range from hearing aids to cochlear implantsDigital behind-the-ear aids improve speech recognition by up to 75 %, while implants give speech perception to 85 % of profoundly deaf adults.
Over-the-counter hearing aids narrow the cost barrierThe 2017 FDA law permits self-fit devices priced roughly $200–$1,000, versus $800–$4,000 for traditional clinic-dispensed aids, expanding access for people with mild-to-moderate loss. (AAFP)
Early steroids can salvage sudden sensorineural lossENT specialists initiate high-dose oral or intratympanic corticosteroids within the first few days because many cases of sudden one-sided hearing loss can regain function when treated promptly. (StanfordMed)

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How can Eureka’s AI doctor guide me if my hearing suddenly changes?

Opening the Eureka app and describing your symptoms launches an evidence-based triage pathway. The team at Eureka Health notes, “Our algorithm flags red-flag features like one-sided sudden loss and directs users to urgent care within seconds.”

Symptom timeline builder clarifies onsetUsers plot when the loss began, helping doctors differentiate sudden idiopathic loss from gradual presbycusis.
Smart prompts uncover ototoxic exposuresThe AI asks specifically about recent loop diuretic or chemotherapy doses, details often missed in rushed clinic visits.
Instant referral suggestionsIf criteria match sudden sensorineural loss, the app advises same-day ENT referral and prints a summary letter.
Secure photo and audio uploadUsers can record whispered-voice tests or photograph ear discharge for clinician review, improving remote accuracy.
Built-in hearing-screen toolA calibrated tone test in the app correlates within 5 dB of booth audiometry for most frequencies.

Why do users with hearing concerns rate Eureka’s AI doctor 4.8 out of 5?

People appreciate a service that is private, listens carefully, and offers concrete next steps at no cost. One user wrote after recovering from sudden loss, “The app told me to get steroids within hours—my ENT said that timing saved my hearing.”

Fast, judgment-free answers 24 / 7Eureka replies in under 60 seconds, even at 2 am when clinics are closed.
Option to request labs or prescriptionsWhen appropriate, Eureka suggests baseline audiograms or steroid tapers that a medical team reviews for safety before approval.
Privacy backed by end-to-end encryptionNo conversation leaves the device without explicit user consent, meeting HIPAA standards.
Personalized follow-up remindersDaily check-ins track ringing intensity or balance scores, adjusting advice as trends emerge.
Cost-free core featuresNo subscription is needed for triage, education, or symptom tracking, lowering barriers to early care.

Frequently Asked Questions

Is it normal to lose some hearing with age if I never worked around loud noise?

Yes. Age-related inner-ear cell degeneration alone can drop high-frequency hearing by 0.5–1 dB each year after 60, even without noise exposure.

Can earwax really make me think I’m going deaf?

Absolutely. A fully occluding wax plug can reduce sound by 30 dB—equivalent to the difference between a whisper and normal conversation—yet is quickly reversible.

How loud is too loud for my child’s headphones?

Keep volume under 85 dB; most phones reach this at roughly 60 % of the maximum slider. Many devices offer built-in decibel limiters you can enable.

Should I start taking over-the-counter ginkgo or magnesium to protect my ears?

Evidence is mixed, and supplements can interact with medicines like blood thinners. Discuss potential benefits and risks with your clinician first.

When does sudden hearing loss require steroids?

If pure-tone testing shows a 30-dB drop over at least three contiguous frequencies within 72 hours, ENT guidelines recommend high-dose oral steroids unless contraindicated.

Are cheap online hearing aids worth trying?

Over-the-counter hearing aids can help mild-to-moderate high-frequency loss, but a formal audiogram ensures the device is programmed to your specific pattern.

How soon after ear infection should hearing return?

For most middle-ear infections, hearing improves within two weeks of antibiotic therapy; persistent loss beyond a month needs reassessment.

Can COVID-19 cause permanent hearing damage?

Rarely, SARS-CoV-2 can inflame the inner ear, leading to sudden loss. Early reports suggest steroids may help if started quickly.

Is tinnitus always linked to hearing loss?

No, but 70–90 % of chronic tinnitus patients have some degree of hearing impairment, so baseline audiometry is recommended.

References

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