I can hear, just not clearly. Do I have hearing loss?
Editor’s note: The answer to this frequently asked question was published on Healthy Hearing on April 17, 2013. Due to its popularity, we’ve added to and updated the information to publish again today.
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 wonder if you have a hearing loss.
Hearing loss is complicated because it involves not only the ears, but also the brain where sound is translated into meaningful words. It can manifest in many different ways with symptoms that vary between individuals. Hearing loss comes in all degrees from mild to profound. When you think of hearing loss, severe hearing loss or deafness probably comes to mind. But mild, moderate and high frequency hearing losses are actually much more common. And, with these types of hearing losses, the only symptom may be difficulty with word understanding, especially in situations where there is competing noise.
Hearing vs. understanding
When your hearing is tested, the results are plotted on an audiogram. People with high frequency hearing losses 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, those below 1000 Hz, very well, sometimes even as well as someone with normal hearing. But, the high-pitched sounds above 1000 Hz need to be much louder before you can hear them. While not always the case, high frequency hearing loss is often the cause of feeling like you can hear but can’t understand.
In speech, 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 high frequency hearing losses brought about by natural aging (presbycusis) or excessive noise exposure have difficulty understanding even when they know sound is present.
If you have a high frequency hearing loss, you may notice problems understanding speech even in a relatively quiet environment, but when background noise is present or several people are talking at once, it can become nearly impossible to follow a conversation. People with hearing loss that has gone untreated for a number of years sometimes begin to avoid lively social situations or public places they once enjoyed because interacting with others is too difficult.
When you have a high frequency hearing loss, you may have trouble:
- following conversations in quiet and noisy places (hear but can’t understand).
- talking on the phone.
- understanding your favorite TV shows or movies even when you turn the volume up.
- understanding female and young children’s voices because they tend to be higher in pitch.
- enjoying music because it sounds distorted, especially at higher volumes.
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.
Hear what you've been missing
Often, the best solution for high frequency hearing loss is properly fit hearing aids that 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. Help is available through any of our consumer-reviewed hearing health providers, so make the call today.