I can hear, just not clearly. Do I have hearing loss?

What’s the number one complaint hearing care professionals hear from their new patients with hearing loss? Ask them and they’ll likely say it’s, “I can hear, but I can’t understand.” If this is what you’re experiencing, you may have hearing loss.

Hearing loss involves not only the ears, but also the brain where sound is translated into meaningful words. Symptoms vary between people. Hearing loss comes in all degrees from mild to profound.

But most people, especially older adults, have mild-to-moderate hearing loss, especially the type that makes it harder to hear high-pitched sounds. In this case, the chief symptom may be difficulty with word understanding, especially in noisy situations.
High frequency hearing loss causes problems with hearing high-pitched sounds. It can also lead to problems understanding fast speech. Damage to the hair-like structures in your inner ear can cause this specific type of hearing loss.

Frequency is a measure of the number of vibrations a sound wave makes per second. For example, a sound measured at 4,000 Hz vibrates 4,000 times per second. The frequency, which is the pitch of a sound, is different from the intensity, which is how loud a sound feels.

For example, the note middle C on a keyboard has a frequency of roughly just below 262 Hz. If you lightly tap the key, you can produce a sound with a low intensity that’s barely audible. If you hit the key harder, you can produce a much louder sound at the same pitch.

Anybody can develop high frequency hearing loss, but it becomes more common with age. Exposure to loud sounds or high frequency sounds are common causes of ear damage in younger people.

In this article, we’re going to take a look at the symptoms and causes of high frequency hearing loss. We’ll also tell you how you can take steps to protect your ears.

Diagnosing high-frequency hearing loss

Diagnosis of high-frequency hearing loss is made after a hearing test in a sound-treated booth at a hearing clinic. A hearing instrument specialist or audiologist usually will conduct the test. The results are plotted on an audiogram. If a person has high-frequency hearing loss, your audiogram will show a slope to the right, indicating a person has trouble hearing frequencies between 2,000 and 8,000 Hz.

A person may have mild, moderate, moderately severe, severe or profound hearing loss. (See degrees of hearing loss to learn hearing loss severity is measured.) In the example below, the person has moderately severe high-frequency hearing loss that is slightly worse in the right ear.

Is it permanent?

Hearing loss is extremely common in the United States. Roughly 22 million people are exposed to dangerous levels of noise at work. Once the structures in your inner ear are damaged, it often isn’t possible to reverse hearing loss.

Hearing damage can either be classified as sensorineural hearing loss, conductive hearing loss, or a combination of the two.

Sensorineural hearing loss is the more common type. It occurs when your auditory nerve or the hair cells inside your inner ear’s cochlea become damaged. Sensorineural hearing loss is usually permanent but may be improved with hearing aids or cochlear implants.

Conductive hearing loss is less common. This type of hearing loss involves a blockage or damage to your middle ear or outer ear structures. It may be caused by built-up ear wax or a broken ear bone. In some cases, this type of hearing loss may be reversible.

If you have hearing loss, you should visit a doctor to get a proper diagnosis.

Hearing vs. understanding

When your hearing is tested, the results are plotted on an audiogram. People with high-frequency hearing loss are said to have a “sloping” hearing loss. If you have a sloping hearing loss, it means you are able to hear low-pitched sounds (such as thunder), sometimes even as clearly as someone with normal hearing. But, high-pitched sounds (such as children’s voices) need to be much louder before you can hear them.

Signs of high-frequency hearing loss

When you have a high frequency hearing loss, you may:

• struggle to follow conversations (hear but can’t understand)
• struggle to hear people on the phone
• pretend to hear when people speak to you
• nod and smile when you don’t know what’s being said
• find it hard to watch TV shows or movies even when you turn the volume up.
• mishear female and young children’s voices
• not enjoy music because it sounds distorted, especially at higher volumes.
• feel like everyone is mumbling more often
• feel exhausted from listening, known as listening fatigue

Family members, friends and work colleagues can get frustrated and feel you aren’t listening to them when they speak to you. Your spouse may accuse you of having “selective hearing.” You may accuse others of mumbling. Sometimes, you will answer questions inappropriately and miss the punch lines of jokes. Other times, you may resort to smiling and nodding when someone speaks to give the impression you are listening when in fact, you do not understand what was just said. Untreated hearing loss can take a toll on relationships, careers and your daily life.

Did you say parrot or ferret? 

In speech, the vowel sounds (A, E, I, O and U) are low in pitch while consonant sounds like S, F, Th, Sh, V, K, P and others are high in pitch. Being able to hear vowel sounds is helpful and will alert you that speech is present, but it’s the consonant sounds that give speech meaning and help you distinguish one word from another. Without being able to hear subtle differences between consonants, words like “cat” and “hat,” “parrot” and “ferret” and “show” and “throw” can be hard to differentiate. This is why so many people with age-related hearing loss or excessive noise exposure have difficulty understanding even when they know sound is present.

Why do I have high-frequency hearing loss?

High-frequency hearing loss occurs when the tiny hair-like sensory hearing cells in your cochlea (inner ear) are damaged. These hair cells, known as stereocilia, are responsible for translating the sounds your ears collect into electrical impulses, which your brain eventually interprets as recognizable sound. Learn more about how we hear.

Causes of high-frequency hearing loss

People of all ages can be affected by high-frequency hearing loss—and the reasons causing it are just as varied.

Aging

Age-related hearing loss is called presbycusis (prez-be-cue-sis). It occurs very gradually and you may not even notice it, until it’s advanced. One of the first signs is difficulty understanding speech in noisy environments. It is common among older adults. About 1 in 3 people between the ages of 65 and 74 have hearing loss. It affects half of adults over age 75.

Noise

You can suffer hearing damage from both high frequency sounds and overly loud sounds. Frequently using headphones at a loud volume can cause permanent hearing loss. The damage can occur as the result of a one-time, loud exposure to noise, such as a gunshot or explosion, or can occur over time with constant exposure to noise louder than 85 decibels.

Genetics

Check your family history. If your relatives developed high-frequency hearing loss, you may be genetically predisposed to developing it as well.

Medications

Medications that can cause hearing impairments by harming the inner ear or auditory nerve are referred to as ototoxic, meaning they are harmful to your hearing health. Nonsteroidal anti-inflammatory drugs (NSAIDs), some antibiotics, and some cancer treatment medications are among potential ototoxic medications.

Diseases

Meniere’s disease, which affects the inner ear, often occurs between the ages of 30-50 and may include fluctuating hearing loss, tinnitus and vertigo or intense dizziness. In severe cases, though, it typically causes low-frequency hearing loss.

In children, chronic otitis media (commonly known as a middle ear infection) can lead to hearing loss if it’s untreated.

Infections of the middle ear have the potential to cause a buildup of fluid and temporary hearing loss. Permanent damage to your eardrum or other middle ear structures might occur in cases of serious infection.

Tumors

Tumors called acoustic neuromas can press on your auditory nerve and cause hearing loss and tinnitus on one side.

Managing high frequency hearing loss

High frequency sensorineural hearing loss is usually permanent and is commonly caused by damage to the hair cells in your cochlea. A hearing aid that targets high frequency sounds may be the best option if your hearing loss is serious enough to impair your life.

Technological improvement in the past 25 years has led to the creation of hearing aids that can better match your specific type of hearing loss. Modern hearing devices often even have Bluetooth technology to sync with phones and tablets.

Typically, the best type of hearing aid for high-frequency hearing loss is what’s known as a receiver-in-the-ear (RITE) with a dome that sits in the ear canal. This style has an open fit so it doesn’t muffle the low-frequency sounds that you still hear naturally. It can be programmed to amplify only the frequencies you struggle to hear.

While some people want to wear devices that are invisible (known as “invisible-in-the-canal” or “completely in the canal” hearing aids), they often don’t work well for this type of hearing loss, because they block low-frequency sounds.

For any hearing aids, keep in mind it may take time to get used to them, especially if you have had untreated hearing loss for a long time.

Health risks of hearing loss

It’s important to address high-frequency hearing loss as its effects extend far beyond struggling to hear. When children have high-frequency hearing loss, it can impede speech and language development, affecting their ability to excel in school. In older adults, untreated hearing loss is associated with a higher risk of dementia, social isolation, depression and injury-causing falls.

Preventing high-frequency hearing loss

High-frequency hearing loss isn’t reversible, but in some cases, it is preventable. One of the best prevention techniques is to protect your hearing against exposure to noise–especially noise louder than 85 decibels. Keep the volume turned down on your personal electronic devices and wear hearing protection like earplugs whenever you anticipate being in a noisy environment, such as at the shooting range, when riding snowmobiles, or when attending a live concert or sporting event.

Inexpensive ear plugs are available at the local drugstore for occasional use. If you regularly engage in very noisy hobbies, consider investing in specialized hearing protection such as noise-cancelling headphones or custom-made earmolds, which can be purchased through many hearing healthcare professionals.

Here are some ways to protect your hearing.

• Minimize your exposure to loud noises.
• Use earplugs or earmuffs when exposed to loud noises.
• Keep your earbud and headphone volume on the low side.
• Take breaks away from the TV or radio.
• Get regular hearing tests to catch hearing problems early.

Pass a hearing test but still feel like you can’t hear?

If you’ve taken a hearing test and were told your hearing is fine, don’t give up trying to get answers just yet. Your ears may be fine—but your auditory nerve or your brain may have problems processing sounds or other sensory input. For example:

Hidden hearing loss

Hidden hearing loss is defined as hearing loss that’s not detectable on standard hearing tests, which zero in on problems within the ear. Hidden hearing loss is not a problem with the ears—instead, it originates in the brain.

Auditory processing disorders (APD)

For some people, hearing but not understanding may signal an auditory processing disorder (APD). This means the nervous system—not the ears—struggles to make sense of the sounds coming in from the ears. APD is often diagnosed in children, but it also can be diagnosed in adults.

Attention deficit disorder (ADD)

Attention deficit hyperactivity disorder (ADHD) also can make it hard to understand—in the sense that the brain can’t quite keep up with all incoming sensory inputs, including and sometimes especially noise. If you have undiagnosed and untreated ADD, you may pass a hearing test just fine, yet feel like you can’t understand people, or struggle to follow conversations.

In either case, a hearing aid may help a person with APD or ADD focus on the conversation they want to hear most, allowing them to amplify the voice of their preferred speaker (such as a professor). It’s worth noting that some kids or adults may have ADD or autism and an auditory processing disorder.

Don’t accept difficult hearing

If your hearing test reveals hearing loss, hearing aids can amplify the high pitches you’ve been missing without amplifying low-pitched sounds. Once you begin wearing hearing aids, you will notice improvement with understanding speech and you may even notice you’re hearing sounds that have long been forgotten. For instance, some new hearing aid wearers are pleasantly surprised to hear the soft chirping of songbirds for the first time in years. You will once again be able to hear that beeping sound your microwave makes, your car’s turn signal and your phone ringing.

If you can hear, but can’t understand, you’re not alone. This is what hearing care professionals hear almost every day from their patients, and they are highly skilled at getting to the root of the problem, listening to your concerns and finding a solution that meets your needs. Don’t give up on enjoying conversations at work, home and play. Find a hearing center near you with our directory and make the call today.

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