Coping with Hearing Loss: A guide to prevention and treatment

Hearing loss can be isolating, frustrating, and embarrassing. In addition to taking away daily pleasures, it can also threaten your independence.

Age-related hearing loss affects one in three of us by age 65. That shouldn't be surprising. We’ve punished our ears with a lifetime of noise — from lawnmowers and hair dryers to car horns and loud music.

But even as technology may have accelerated hearing loss, it is also offering unprecedented help. New hearing aids — some as small as a jelly bean — are producing greater amplification with less distortion. And surgical advances are providing alternate ways of restoring hearing.

Coping with Hearing Loss: A guide to prevention and treatment gives you a useful understanding of the causes of hearing impairment as well as of the breakthroughs that are helping men and women to minimize the consequences of hearing loss.

This Special Health Report, prepared by Harvard Medical School doctors, will brief you on how hearing loss is measured. It will prepare you to work with an audiologist for an accurate diagnosis, help you determine what to look for in a hearing aid, and offer steps to take to prevent further damage.

The report will also demonstrate which medications can contribute to hearing loss, describe what to do for a burst eardrum, and reveal how treating hearing loss can protect your brain from decline and possibly even from dementia.

If you think you might need a hearing checkup, you probably do. This Special Health Report describes the causes and cures for hearing loss. You’ll learn about the latest advances in hearing aid technology and find out which kind of hearing device may be best for you. This report also contains in-depth information on the causes, diagnosis, and treatment of hearing loss. You'll learn how to prevent hearing loss and preserve the hearing you have now.

Prepared by the editors of the Harvard Health Letter with Anthony A. Prince, MD Instructor, Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School Associate Surgeon, Brigham and Women’s Hospital and Angela C. Costanzi, AuD, CCC-A Audiology Manager and Clinical Audiologist, Brigham and Women’s Hospital. (2023)

You’re having a meeting in a quiet room with a few people, and you can hear just about everything they say. Later, you’re in a noisy restaurant and someone at your table tells a joke—you know it’s a joke because everyone is laughing. You laugh, too, even though you haven’t heard enough to understand the joke. This experience is typical of people whose hearing has begun to decline, especially those whose hearing loss is age-related, noise-related, or a combination of the two.

Hearing loss usually comes on so gradually, over so many years, that it can be hard to realize that you don’t hear as well as you used to. The difference at first may not be so noticeable because people have a marvelous capacity to compensate for what they can’t hear. For example, you may fill in gaps by picking up on the facial expressions and gestures of the person talking.

Although the term “hearing loss” implies trouble hearing all sounds, this may not be the case for you, especially early on. In fact, most people start off having trouble hearing just certain sounds. People with agerelated hearing loss usually have most trouble hearing high-frequency, low-decibel sounds like a hiss, a whisper, or the “s” or “th” sounds that begin a word. In practical terms, what this means is that you can hear the vowels just fine, but consonants like “f ” and “th” give you trouble. You might not be able to tell whether someone said “fish” or “this,” “thing” or “sing.” And you may have trouble hearing over the phone or when there’s a lot of background noise. In a quiet room, you may do just fine.

As years pass, high-frequency sounds become harder to hear, even when the room is quiet. The doorbell or the telephone may ring and ring before you notice it. Lower frequency sounds can also become problematic over time. You may find yourself increasingly asking others to repeat themselves, or holding back from conversation to avoid embarrassment.

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