More than 48 million Americans have some type of hearing loss that seriously disrupts their lives. “That includes 1 in 6 baby boomers and two-thirds of those over 70,” says Frank Lin, M.D., associate professor of otolaryngology and epidemiology at Johns Hopkins University. Experts expect that number to rise along with the gray tsunami of aging boomers.
There are two main types of hearing loss. Conductive hearing loss develops when something — congestion from a bad cold, an ear infection, a perforated eardrum — blocks sound signals from reaching the inner ear. Sometimes only one ear is affected. Hearing usually returns to normal after the problem is treated.
Far more serious is sensorineural hearing loss, which involves damage in the inner ear. It can be triggered by loud noise as well as aging. Many people gradually lose some hearing as they get older.
But that doesn’t mean there’s nothing you can do. Here are 10 unexpected causes of hearing loss and steps you can take to reverse, reduce or prevent these conditions.
Conductive hearing loss — which often can be corrected
1. Earwax buildup
This waxy substance, secreted by glands in the outer ear canal, prevents harmful substances — germs, dust and dirt — from reaching the eardrum. Too little wax and your ears are dry, itchy and a breeding ground for infection. Too much can lead to painful earaches and hearing loss, and, in some cases, tinnitus (a ringing in the ears).
What to do: Usually, wax moves naturally to the tip of the canal, where it can be safely wiped away with a washcloth. If this doesn’t happen, your doctor can remove it. Don't try to do it yourself with a cotton swab, pencil or the tip of your glasses. You may push it deeper or puncture your eardrum.
2. Perforated eardrum
Infection, explosive noise near the ear, quick changes in air pressure or poking around with a cotton swab can puncture the thin tissue (the eardrum) that separates the outer ear from the middle ear, leading to pain and temporary hearing loss.
What to do: Although a punctured eardrum usually heals on its own in about two months, it’s best to have your ear checked by an otolaryngologist — an ENT doctor, who specializes in treating the ear, nose and throat. Meanwhile, keep the ears dry; a warm, dry compress and over-the-counter (OTC) medications can help relieve pain.
3. Ear infection
Though far more common in the preschool set, ear infections because of bacteria or viruses can follow a bout with allergies or the common cold in adults, too. If the eustachian tube, which connects the ear to the throat, is blocked by swelling and inflammation, fluid buildup becomes a breeding ground for infection. The result: ear congestion, pressure, pain, fever or temporary hearing loss.
What to do: Infections usually clear in a few days. A warm compress and OTC pain medications and decongestants can help. If you have fever or severe pain, call your doctor. You may need antibiotics.
Sensorineural hearing loss — usually permanent but often preventable
4. Listening to music with earbuds
Since earbuds don’t block outside sounds, listeners often ramp up the volume for hours at a time. But these ubiquitous gadgets amplify sounds so successfully that levels can top 100 decibels, loud enough to cause damage in only 15 minutes. “Anything over 85 decibels is potentially damaging,” says Michael D. Seidman, an ear, nose and throat surgeon at Florida ENT Surgical Specialists in Celebration, Fla.
What to do: Since many new earbuds come with a volume control, toss your old ones and buy ones you can adjust. If the person sitting next to you can hear your music, it’s too loud. Music headphones are easier on the ears, but remember to keep the volume low, says Seidman, author of Save Your Hearing Now.
5. All those crazy-loud football games and rock concerts
Noise is noise, whether it comes from a rock concert, a leaf blower or a stadium full of football-crazy fans. “Even hair dryers can reach 90 decibels,” Seidman says. While a single incident of explosive sound — such as fireworks or a jackhammer — can lead to hearing loss, more often it’s caused by day-to-day exposure over an extended period. If you keep going to concerts, games and noisy restaurants, the very delicate hair cells in the inner ear become worn down, causing hearing problems. “The loss is cumulative,” Seidman says. “Once hair cells are damaged, they’re not replaceable.”
What to do: Carry earplugs everywhere. Pick up disposable foam plugs or have some custom-fit. Never stuff cotton balls in your ears, as that can lead to impacted wax and infection. Give your ears a break: Whenever you’re in a noisy venue, find a quiet place to rest your ears for a few minutes. Invest in a pair of noise-canceling headphones to use when mowing the lawn or doing other noisy chores. And consider easing up on the hard-rock concerts.
6. Tipping the scale
Being overweight — especially if those extra pounds are around your belly — is also a risk factor. In 2013, researchers at Boston’s Brigham and Women’s Hospital followed more than 68,000 women in the Harvard Nurses’ Health Study II and found that those who had more body fat and larger waists reported more hearing problems than those of normal weight.
What to do: Get moving. Researchers found that walking for as little as two hours a week cut the risk of hearing loss by 15 percent compared with those who walked less than one hour per week. “We suspect that obesity affects blood flow to the inner ear, compromising hearing, while physical activity may improve blood flow and help protect the ear,” says lead researcher Sharon G. Curhan, M.D., of Brigham and Women’s Hospital.
If you have diabetes, you’re twice as likely to develop hearing loss as people with normal blood sugar levels. Those with prediabetes face a 30 percent greater risk. High glucose levels are risk factors for heart disease, and researchers suspect that the same destructive action is at work on the nerves and blood vessels in the inner ear.
What to do: If you have diabetes, see an ear, nose and throat doctor or audiologist for a hearing screening. To combat glucose overload, be sure to exercise regularly. Also, cut back on highly processed foods, opting instead for fish, vegetables, fruit and whole grains.
8. Sleep apnea
A study of 13,967 people released in 2014 by the Albany Medical Center in New York found that those with sleep apnea — a stop-and-start breathing disorder — also had an increased risk of hearing impairment. While the connection between sleep apnea and heart disease has been known, this is the first time a link was also made to hearing loss.
What to do: Suspect sleep apnea? See your primary care physician, who may refer you to a sleep specialist. Various lifestyle changes and medical devices that help keep airways open help treat the condition. Make sure to also get your hearing checked by a professional.
9. Not wearing a hearing aid when you need one
Although not wearing a hearing aid won’t cause hearing loss, there is some evidence that wearing an aid when you need one may help protect the hearing you have left. Unfortunately, two-thirds (or more) of adults 50 and older who might benefit from hearing aids don’t use them. “Most delay several years before accepting they have a problem and doing something about it,” says Brad Stach, an audiologist at the Henry Ford Health System in Michigan. Some people may not realize they have a problem. Others believe that waiting won’t cause any harm; still others are simply embarrassed to admit they can’t hear well. But if you don’t wear a hearing aid when you need one, or only wear it some of the time, you can lose the ability to process sounds.
What to do: “Your brain devotes a lot of resources toward hearing well,” says Lin. “When words are garbled, it has to work harder to hear at the expense of other functions.” Not wearing a hearing aid is also a safety concern, because hearing loss has been linked to falls, social isolation, depression and even dementia. So remind yourself that needing help with hearing is no different than needing glasses to read. Ask your doctor to check your hearing regularly and, if necessary, refer you to an ENT or audiologist who can diagnose the extent of hearing loss and suggest aids or other devices that can help.
More than 200 drugs, ranging from over-the-counter medications to chemotherapy, can damage hearing, according to the American Speech-Language-Hearing Association. A 2016 study of more than 54,000 women ages 48 to 73 by Brigham and Women’s Hospital reported that those who used ibuprofen or acetaminophen for six or more years were at higher risk for hearing loss.
What to do: Be proactive. Ask your health provider about possible long-term effects of any medication — including common OTC drugs — on your hearing. If there is a concern, monitor your hearing during the course of treatment. And if you notice problems, speak to your doctor immediately.
This story was updated March 24, 2017, by freelance writer Cathie Gandel, who specializes in health and hearing topics.