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Do I need hearing aids?

If you or someone you know is experiencing signs of hearing loss, you may benefit from a hearing aid.

Medically reviewed by

Dr. Ruth Reisman


May 13, 2024

Black and white image of the back of the head of a man wearing a hearing aid. Black and white image of the back of the head of a man wearing a hearing aid.

The essentials

  • Hearing aids help people with hearing loss — They’re small medical devices that fit inside a person’s ear to amplify and separate sounds.
  • There are different kinds of hearing aids — The type that’s best for you depends on factors like the severity of your hearing loss, the size and shape of your ear, and the dexterity required to handle each.
  • See a professional to get the best hearing aid for you  — While you can buy some hearing aids over the counter, a hearing specialist will be able to recommend the best solution for your particular type of hearing loss.

Whether you’ve been diagnosed by an audiologist or you’ve only just started noticing that your hearing isn’t what it used to be, losing your hearing can be a scary experience.

It may not be physically painful, but hearing loss still has negative effects on a person’s emotional well-being, as they find normal conversations suddenly become frustratingly difficult to understand and maintain.

The FDA estimates some 30 million Americans suffer from some degree of hearing loss, but most cases are treatable through a combination of aural rehabilitation and the right hearing aid.

What are the signs of hearing loss?

While hearing loss is a common condition, it’s not always easy to identify. One of the most common causes of hearing loss in children is a condition called otitis media, an inflammation of the middle ear that’s typically caused by the buildup of fluids and, in some cases, an underlying ear infection.

An estimated 3 out of every 4 children have at least one episode of otitis media by the time they turn 3 years old.

Symptoms may include:

  • Inattentiveness
  • Lack of energy or enthusiasm
  • Unexplained irritability
  • Fever, especially in younger children and infants
  • Loss of balance
  • Misunderstanding directions
  • Pulling or scratching of the ears
  • Wanting the TV or radio louder than usual

Most cases of untreated hearing loss are considered sensorineural hearing loss, which occurs when the tiny hairs that pick up sound in the inner ear are damaged by noise exposure or an underlying disease.

Some adults may also experience conductive hearing loss, which is caused by an obstruction that stops sounds from getting through the outer or middle ear, or mixed hearing loss, where a person suffers from both sensorineural and conductive hearing loss at the same time.

Signs of hearing loss in adults include:

  •  Trouble understanding conversations in crowded, noisy settings
  • Perception of speech and other sounds as “muffled”
  • Frequently asking people to repeat themselves
  • Speaking too loudly or too softly
  • Difficulty hearing consonants
  • Ringing in the ears, known as tinnitus
  • Listening to the TV and other devices louder than others find comfortable
  • Withdrawal from conversation and social isolation

🚨Anyone who suspects they have hearing loss should seek immediate testing and treatment from an audiologist. 

How do I know if I need hearing aids?

If you’ve noticed yourself suffering from any of the signs listed above, it could be a sign that you need a hearing aid.

The first thing you should do is get your hearing checked.

Online hearing tests can be helpful for those who don’t have immediate access to health care services, but an in-person hearing assessment with an audiologist is always the most reliable way to assess the extent of your hearing loss.

During the test, the doctor will typically ask you to raise your hand or push a button every time you hear a sound. They’ll then map out your responses on a graph called an audiogram, a helpful tool used to show the severity or degree of the patient’s hearing loss.

For example, an audiogram might show that your hearing is totally fine at lower frequencies, but not with high-pitched sounds. A person with an audiogram like this would be able to hear speech, but they may have trouble hearing it clearly.

If the audiologist determines you have some degree of permanent hearing loss, they may recommend a hearing aid.

Even if they haven’t prescribed you a hearing aid, it’s worth asking to get the best treatment information for your needs.

How do I get a hearing aid?

There are two categories of hearing aids: prescription and over-the-counter. After assessing your degree of hearing loss, an audiologist may prescribe a hearing aid specifically programmed using your hearing test results.

If you don’t have a prescription, you can buy an over-the-counter hearing aid online, at big box stores in your area, or at a local pharmacy.

The types of hearing aids

There are five types of hearing aids: behind-the-ear (BTE), in-the-ear (ITE), receiver-in-the-ear (RITE), in-the-canal (ITC), and CROS/BiCROS.

Each type uses a different design, amplification technology, and additional features like wireless connectivity to assist people suffering from different types of hearing loss. The best hearing aid for you ultimately depends on factors like the severity of your hearing loss, the size and shape of your ears, the ease of handling the hearing aid device, and your own personal preferences.

Behind-the-ear (BTE) aids. These hearing aids are made up of a small plastic case that rests behind the ear connected to an earmold or earpiece by a piece of clear tubing. BTEs are sturdy, easy to clean, and easy to handle. However, they do require some manual dexterity to ensure proper insertion and placement since they’re made up of many parts.

They’re good for people with a wide range of hearing loss, from mild to severe, but they’re an especially good option for kids since they can accommodate various earmold types, which often need to be replaced as children grow.

In-the-ear (ITE) aids. These small plastic devices either fill your entire ear (full-shell) or a portion of the conchal bowl (half-shell). Doctors often recommend in-the-ear models to patients with moderate to severe hearing loss.

Since ITE aids are larger than most in-the-canal hearing aids, they may also be easier to handle for people with dexterity issues.

Receiver-in-the-ear (RITE) aids. These are similar to BTE devices, since the body of most RITE aids sits behind the ear. However, as their name suggests, receiver-in-the-ear hearing aids are unique in that they feature a thin receiver wire that runs from the body over the outer ear and into the canal.

A soft tip at the end of the wire sits inside the canal without sealing it, which many claim offers a more natural sound than other hearing aids. RITE aids are good for several different degrees of hearing loss, from mild to severe, but like BTEs, they require some dexterity to ensure proper insertion and placement.

In-the-canal aids (ITC). These tiny devices fit more deeply into your ear canal than in-the-ear (ITE)  hearing aids, which makes them less visible but more difficult to handle.

The small size of ITC aids also makes them harder to clean than most BTC or ITC aids. Models that fit completely in the canal are known as completely-in-the-canal (CIC) aids.

ITC aids are best for people with mild to moderate hearing loss, and their discreet location inside the canal makes them particularly good for use with a telephone.

CROS/BiCROS aids. If you have normal or near-normal hearing in one ear and very little to none in the other, your audiologist may recommend a CROS/BiCROS hearing aid.

CROS (Contralateral Routing Of Signals) hearing aids offer no sound amplification and route all sound to the side with better hearing ability, while BiCROS (Bilateral Contralateral Routing of Signals) aids send amplified sounds to the poorer ear to make up for the hearing loss.

These types of hearing aids are especially helpful when someone’s talking on a person’s poorer hearing side.

Over-the-counter hearing aids vs. prescription hearing aids

While all hearing aids offer some degree of sound amplification, no two models are exactly alike. Understanding the differences between prescription and over-the-counter (OTC) hearing aids will help you make the best, most informed decision for your particular hearing needs.

Who will benefit from prescription hearing aids?

Prescription hearing aids can benefit people with all degrees of hearing loss, from mild to severe. Unlike over-the-counter hearing aids, prescription hearing aids can also be used to treat people of all ages, including children. Since prescription hearing aids are obtained through an audiologist, the level of amplification they provide can be tailored to your specific hearing loss. Additionally, prescription hearing aids tend to include better warranties than OTC devices, covering patients whenever adjustments or maintenance are needed.

Who will benefit from OTC hearing aids?

Over-the-counter hearing aids are marketed towards people over the age of 18 who perceive themselves to have mild hearing loss but haven’t been officially diagnosed. The main benefit of OTC hearing aids is their affordability — since there are so many on the market, the average cost of an OTC hearing aid tends to be drastically lower than that of most prescription models.

However, since doctors aren’t able to tailor them to each patient’s needs, people who use OTC hearing aids are required to perform “self-fittings” with the help of built-in presets or an accompanying smartphone app.

Since there’s no set regulation for services or warranties on over-the-counter hearing aids, wearers often have a hard time getting help from the manufacturer when a problem occurs.

🚨If you have any ear complications besides perceived hearing loss, an OTC hearing aid is not recommended for you. See an audiologist for immediate testing and treatment. 

Hearing loss can be a frightening, unnerving, and isolating experience —  but the good news is that it is possible to return to a normal life if the right steps are taken. See a doctor as soon as you notice anything abnormal about your hearing and ask if a hearing aid might be right for you.

It can be a tough adjustment while you’re still getting used to wearing it, but you’ll find that your mental health, social interactions, and overall quality of life drastically improve with the help of your new hearing aid.

Frequently asked questions

What are the signs you need a hearing aid?

You may need a hearing aid:

  • if you have difficulty understanding people when they talk, especially in crowded, noisy settings
  • if speech and other sounds seem muffled to you
  • if you frequently ask others to repeat what they have said
  • if you often find yourself speaking too loudly or too quietly for the place you are in
  • if you listen the television or radio at a louder volume than others.

See an audiologist for proper testing.

What level of hearing loss requires a hearing aid?

Normal hearing falls in the range of 0 to 25 decibels (dB). People whose hearing falls between 26 and 70 dB have mild to moderate hearing loss and can get the most benefit from wearing a hearing aid.

Is it worth getting hearing aids?

Yes. While the average cost of hearing aids can be pricey at around $2,000 to $5,000, the help they provide can drastically improve your quality of life.

People who wear hearing aids have a decreased risk of developing mental health problems like depression and cognitive decline,  and they often find that they’re able to be more present in their day-to-day interactions with others.

What is average hearing loss by age?

According to the National Institute on Deafness and Other Communications Disorders (NIDCD), about two percent of adults aged 45 to 54 suffer from moderate to severe hearing loss.

The rate increases to 8.5 percent for adults aged 55 to 64, nearly 25 percent of those aged 65 to 74, and 50 percent of those who are 75 and older.

Will my hearing get worse if I don’t wear a hearing aid?

Hearing loss is most common in older people, and it can gradually get worse over time, whether you wear hearing aids or not.

Your ability to hear won’t necessarily get worse just because you don’t wear a hearing aid, but chances are your ability to understand speech and consonant sounds will get worse faster than it would if you did wear them.