Harvard Health Letters

“What?” How often do you have to ask this question during conversations? If the answer is often, you could have a hearing problem.

Nearly a third of adults ages 65 to 74 and almost 50 percent of those age 75 or older have at least some degree of hearing loss, according to the National Institutes of Health. First to go are the high-frequency sounds – the “s” and “th” sounds in words. Later, lower-frequency sounds become muffled, too.

Hearing loss is an inevitable part of getting older, says Dr. David Vernick, assistant clinical professor of otology and laryngology at Harvard Medical School. With hearing aids and other treatments available, you don’t have to settle for silence. We’re willing to sacrifice conversations, concerts and phone calls rather than wear a hearing aid. According to one survey, just 14 percent of adults who need hearing aids wear them.

When to get screened

The time to get screened is when you – or someone close to you – notices a problem with your hearing.

You might have a hearing problem if you:

• Have trouble following conversations or picking up voices in noisy rooms.

• Have to turn up loud your TV or radio to hear it.

• Need to read lips or strain to hear.

• Hear a ringing, hissing or roaring sound in your ears; these are signs of tinnitus, which can be a symptom of hearing loss.


If any of these issues has been bothering you, visit your primary care provider. The doctor will first check for problems that can prevent sound waves from reaching the inner ear, such as earwax build-up, fluid in the ear or a punctured eardrum. These are causes of conductive hearing loss, which can usually be reversed with treatment.

If none of these problems is to blame, you’ll have a hearing test done. If you can’t hear some sounds, you might have sensorineural hearing loss – damage to the inner ear or auditory nerve. At that point, your doctor will send you to an otolaryngologist – a doctor who treats problems related to the ears, nose and throat – or an audiologist, a specialist who screens for hearing problems and helps fit patients for hearing aids.


The solution to most age-related hearing loss is to wear a hearing aid. Today’s hearing aids are much smaller and higher-tech than their predecessors. Many hide inside the ear canal or behind the ear, making them almost invisible.

Modern hearing aids are also digital and adaptable. They can adjust automatically as you go from one environment to another. Many hearing aids even come equipped with Bluetooth technology, “so they can go wirelessly to the phone or TV, or into a theater,” Vernick says.

Your audiologist will recommend a particular type of hearing aid based on the results of your hearing test and your typical listening situations. Try on different models until you find one that will be comfortable and small enough for you to wear on a daily basis.

An alternative to a traditional hearing aid is an implantable one. The advantages to implanted hearing aids are that you never have to take them out, even in the bath or shower.

However, these devices require surgery, which always carries risk, and they’re still being studied.

Cochlear implants – small, surgically implanted electronic devices – are also available, but they’re only for people with very severe or total hearing loss.

If you’re not ready for an aid, set yourself up for better hearing by taking these steps:

• Try to have conversations in quiet environments.

• Look into assistive devices, such as a personal amplifier to boost sound and reduce background noise.

• See your doctor as soon as possible, so you can get your hearing problem diagnosed and be a part of the conversation again.