Hearing often deteriorates gradually, meaning that many people do not initially notice their hearing is declining. It is often friends, partners or family members who are the first to notice the changes. But when is the right time to see a hearing care professional? We explain the key warning signs, what happens during a professional hearing test, and highlight why taking action early on can make a big difference.
Key Takeaways
- If you find it difficult to follow conversations in noisy environments, we recommend booking an appointment with a hearing care professional
- Frequently asking people to repeat themselves and the feeling that others are mumbling can indicate hearing problems
- If you regularly have to turn up the volume on the TV or radio, you should have your hearing checked
- From the age of 50, regular hearing tests are recommended as a preventive measure
- Your first visit to a hearing care professional is straightforward and involves a medical history review and various hearing tests
- A prescription from an ear specialist is required for the costs to be covered by your health insurance
Early signs that a hearing test is needed
In most cases, hearing loss does not develop overnight, but gradually over months or years. This slow change means that those affected often fail to notice their hearing loss for a long time or simply ignore it. However, certain situations and behaviours can serve as warning signs and indicate that a visit to a hearing care professional would be advisable.
Difficulty understanding conversations
One of the most common early signs of incipient hearing loss is difficulty following conversations in noisy environments. Restaurants, family gatherings or public places with a lot of background noise become a challenge. Voices can no longer be clearly distinguished from ambient noise, and it becomes difficult to follow individual speakers. This phenomenon is sometimes referred to as the cocktail party effect. If such situations regularly cause stress or are avoided, a hearing check is advisable.
Frequent requests to repeat and the impression of mumbling
Anyone who finds themselves asking people to repeat themselves more and more often, or who feels that the people they are talking to are speaking unclearly, should take note. Often, it is certain high frequencies or consonants such as s, f, p or t that are no longer perceived correctly. Speech then appears as indistinct mumbling, even though the speaker is articulating clearly. The feeling of guessing words rather than understanding them can also be an indication of declining hearing.
Increased volume on the TV and radio
A typical warning sign is the constant need to turn up the volume on the television or radio. Often, those affected do not notice this themselves, whilst family members or housemates find the increased volume annoying. Anyone who regularly receives feedback that the television is set too loud should take this as an opportunity to have their hearing checked. Tips on how to improve the volume level in the room whilst watching television can also be helpful.
Social and emotional warning signs
In addition to purely acoustic signs, there are also changes in behaviour and social life that may indicate hearing problems. These warning signs are often underestimated, even though they are important indicators.
Social withdrawal and avoiding situations
A key sign that a visit to a hearing care professional is necessary is a change in social behaviour. If invitations are declined or certain situations are avoided because conversations have become too tiring, this should be taken seriously. Group conversations in restaurants or at parties become a burden, and many people affected increasingly withdraw. This social withdrawal can be a warning sign requiring early action to avoid psychological consequences such as loneliness.
Fatigue and exhaustion after conversations
An often overlooked warning sign is exhaustion following normal conversations or prolonged listening situations. When hearing is impaired, the brain must compensate for missing information. This constant effort takes energy and can lead to both physical and emotional fatigue. Anyone who notices that normal conversations are disproportionately tiring should consider making an appointment with a hearing care professional.
Social withdrawal and avoiding situations
An important indication that a visit to a hearing care professional is necessary is a change in social behaviour.
Fatigue and exhaustion after conversations
A warning sign that is often overlooked is exhaustion following normal conversations or prolonged listening situations.
Specific situations warranting a visit to a hearing care professional
There are certain situations and life circumstances in which a visit to a hearing care professional is particularly recommended. These include age-related changes as well as sudden onset of symptoms.
Regular check-ups from the age of 50
As the risk of age-related hearing loss increases with age, regular hearing tests are particularly recommended for people aged 50 and over. The hair cells in the inner ear deteriorate over the course of a lifetime and cannot be replaced. A routine check-up helps to detect changes at an early stage. Statistically speaking, people often do not receive their first hearing aid until their late 60s, although earlier intervention would be medically more sensible.
Tinnitus and ringing in the ears
Not only difficulties in understanding speech, but also constant ringing or whistling in the ears, known as tinnitus, can be a sign of early hearing loss and should be investigated. Paradoxically, hypersensitivity to loud noises can also indicate hearing impairment, as the dynamic range of hearing may be restricted. In such cases, the hearing care professional can advise whether hearing aids might also help alleviate the tinnitus.
Single-sided hearing loss and orientation problems
Hearing with both ears is important for spatial hearing and orientation. If you have difficulty locating sound sources, or feel that your hearing is poorer in one ear, it is advisable to seek a prompt assessment. Only by fitting both ears can spatial awareness and the brain’s ability to distinguish important sounds from unimportant ones be maintained.
Possible consequences of untreated hearing loss
Hearing loss affects not only the ear but can have far-reaching consequences across various areas of life. Being aware of these potential consequences can strengthen the motivation to consult a hearing care professional at an early stage.
Link to cognitive changes
Scientific studies point to a possible link between untreated hearing loss and cognitive impairment. When hearing is impaired, the brain must expend more resources to process what is heard. This constant additional strain can, in the long term, tie up cognitive capacity. Furthermore, the social isolation associated with hearing loss can represent a further risk factor. Further information is available in the guide on hearing loss and dementia.
Avoiding auditory deprivation
A rarely considered but important aspect is what is known as ‘auditory dishabituation’. If the brain does not receive sufficient auditory stimuli over a prolonged period, it can effectively ‘unlearn’ how to understand speech. The longer a visit to the hearing care professional is delayed, the more difficult it may become later on to re-train the brain to process speech. Taking action early prevents this deterioration and improves the chances of success with subsequent treatment.
The first appointment with the hearing care professional
Many people put off visiting the hearing care professional because they are unsure of what to expect. However, the process is straightforward and painless. An overview of the individual steps can help alleviate any apprehension.
Medical history and ear canal examination
The first appointment begins with a detailed medical history, during which your lifestyle and individual hearing needs are discussed. The hearing care professional will ask about situations in which hearing problems occur, your working environment and personal habits. This is followed by an examination of the ear canal using an otoscope to rule out physical obstructions such as earwax or other abnormalities. This examination is painless and takes only a few minutes.
Tone and speech audiometry
The actual hearing test involves various measurement procedures. In tone audiometry, sounds at different frequencies and volumes are played through headphones. The person being tested indicates when they first hear a sound. In speech audiometry, words or numbers are played back and must be repeated. This helps determine how well speech is understood in a quiet environment and in the presence of background noise. The entire procedure takes around 30 to 45 minutes and forms the basis for the individual consultation.
Consultation and next steps
After the hearing test, the hearing care professional discusses the results and explains whether and to what extent there is hearing loss. If necessary, various treatment options are presented, ranging from hearing aids to other hearing aids. Many hearing care professionals offer the option of testing hearing aids in everyday life on a no-obligation basis before a final decision is made. For the costs to be covered by health insurance, a prescription from an ENT specialist is subsequently required.
Hearing care professional or ENT specialist as the first point of contact
There is often uncertainty as to whether one should consult a hearing care professional or an ENT specialist first if hearing problems are suspected. Both approaches are possible and have their merits.
The low-threshold approach with a hearing care professional
A no-obligation hearing test with a hearing care professional is often the simplest first step. Many hearing care professionals offer free hearing tests that can be taken without a referral. The hearing care professional can provide an initial assessment and, if necessary, recommend a visit to an ENT specialist. If the suspicion of hearing loss requiring treatment is confirmed, a prescription from an ENT specialist is essential for the costs to be covered by health insurance.
The medical route via an ENT specialist
In the event of sudden hearing loss, earache or other symptoms, you should first consult an ENT specialist to rule out any medical causes. The ENT specialist will carry out a comprehensive examination and can determine whether the hearing loss is treatable or whether hearing aids would be appropriate. The medical diagnosis forms the basis for prescribing hearing aids and for the health insurance to cover the costs.
What happens after the first hearing test
A visit to the hearing care professional should not be seen as a one-off event, but may mark the start of a longer process. Several appointments are common, particularly when fitting hearing aids.
Fine-tuning and the settling-in period
Once a hearing aid has been fitted, the initial appointment is followed by further sessions for fine-tuning. After a trial period in everyday life, the settings are adjusted, for example if one’s own voice sounds unfamiliar or certain noises are found to be distracting. This phase is important to ensure acceptance of the devices and to maximise hearing success. The brain needs to get used to the new acoustic information, which can take several weeks.
Regular check-ups and maintenance
Even after the initial fitting, it is advisable to visit the hearing care professional regularly. Professional cleaning and maintenance of the devices ensures their lifespan, which is typically five to seven years. In addition, hearing should be retested at regular intervals to identify any changes and readjust the hearing aids accordingly. A good hearing care professional offers these services and annual check-ups as part of the care package.