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What Causes Hearing Loss?

What causes hearing loss? It is normal to experience some hearing loss as you age and around 50% of people over 65 years of age have age-related hearing loss, known as presbycusis.

In this article, I will discuss types of hearing loss and their causes and what you can do to reduce your risk of developing preventable hearing loss. This is especially important to know as most types of hearing loss can’t be reversed, though ENT specialists like myself can take steps to improve your hearing.

What is hearing loss

There is a difference between hearing loss and deafness. When we use the term “hearing loss”, we usually refer to the degree to which hearing is impaired rather than complete deafness, which is the inability to hear distinguishable sounds or the complete inability to hear anything (which is more rare).

How to recognise hearing loss

You may have hearing loss if you:

  • have difficulty understanding words, especially in a noisy environment, like in a crowd.
  • are frequently asking people to speak more slowly or loudly.
  • need to turn the volume up on the television or radio, especially when others complain it’s too loud.
  • have trouble hearing consonants.

What causes hearing loss

Damage to the inner ear

You can hear because the cochlea in the inner ear sends sound signals to your brain. The ageing process and exposure to loud noise can cause wear and tear on the hairs or nerve cells in the cochlea, which interferes with the efficient transmission of the electrical signals and that’s when you experience hearing loss. You will tend to find that high pitched sounds are muffled and notice that it becomes more difficult for you to follow conversations against a noisy background.

Earwax build-up

If you have a build-up of earwax, which can happen over time, this can block your ear canal and stop sound waves entering the inner ear. Having the earwax removed by an ENT specialist can help restore your hearing.

Ear infection, abnormal bone growths, tumours.

Any of these in the outer or middle ear can cause hearing loss.

Ruptured eardrum (tympanic membrane perforation)

This is a hole in your ear drum, which can happen suddenly with a loud blast of noise, with sudden changes in pressure, when you have an ear infection, and if the drum is pierced by a foreign object such as a cotton bud pressed too far into the ear canal.

This is a hole in your ear drum, which can happen suddenly with a loud blast of noise, with sudden changes in pressure, when you have an ear infection, and if the drum is pierced by a foreign object such as a cotton bud pressed too far into the ear canal.

Are you at risk of hearing loss?

Understanding what causes hearing loss and when you are susceptible will help you avoid preventable hearing loss.


Your inner ear structures degenerate as you age. While this can’t be prevented, your hearing can be helped with specialist treatment.


If someone in your family suffers from hearing loss due to ageing, you may have inherited the genes that make you susceptible to the same.


If you work in a noisy environment, you risk damaging your inner ear. Such jobs include construction and manufacturing where you work with loud machinery.


Exposure to explosive noises can cause immediate, permanent hearing loss. Examples include standing near jet engines and firearms being discharged. Exposure to loud noise over a long period of time can also progressively damage hearing. Habitually listening to music on headphones at a high volume for more than 20 minutes at a time can also cause hearing loss. Some devices provide volume and time notifications to limit exposure.

Some illnesses

Illnesses that result in high fever, such as meningitis, may damage the cochlea, leading to hearing loss.

Some medications

Certain chemotherapy drugs can damage the inner ear as well as the gentamicin antibiotic and sildenafil (Viagra). High doses of aspirin, other pain relievers, antimalarial drugs and loop diuretics can cause temporary damage to hearing, including tinnitus.

How can you lower your risk of hearing loss?

There are steps you can take to lower your risk of developing preventable, noise-induced hearing loss and to stop the progress of age-related hearing loss.

Limit your exposure

Be aware of the length of time you are exposed to loud noise and limit your exposure by controlling the amount of time and take regular breaks. Keep volume levels within the safe range when listening to music and limit the length of time you listen to music through earphones at higher levels to no more than 20 minutes per session.

Cover your ears

Wear appropriate protective ear coverings such as earplugs when involved in work or recreational activities that include exposure to loud noise.

Get your hearing tested regularly

This is especially important if you work in noisy environments. Having tests will help monitor your condition and prevent further hearing loss.

When to see an ENT specialist

If you develop any of the signs of hearing loss, book a hearing test with your doctor. Consider having your hearing tested on a regular basis after you reach 40 as age-related hearing loss is gradual and you may not notice it yourself.

If you experience sudden loss of hearing, particularly in one ear, seek medical attention immediately.

Dr Rebecca Heywood

ENT specialist Dr Rebecca Heywood is a British ENT surgeon (otorhinolaryngologist) specialising in ear and hearing disorders and hearing implants. She currently practices at Advanced ENT Centre at Gleneagles Medical Centre in Singapore and works as a visiting consultant at Nuffield Medical, Royal Healthcare, Raffles Hospital, Thompson Medical Centre and Sengkang General Hospital.

Location & Hours

Nuffield ENT

Nuffield Medical Centre

501 Orchard Road

#05-15 Wheelock Place

Singapore 238880

Monday - Friday | 9 am - 6 pm

Saturday | 9 am - 1 pm

Closed on Sundays and Public Holidays

Tel: +65 6950 2869 / 8805 0324

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