At what age does hearing loss usually start?

Age-related hearing loss typically becomes noticeable after 60, though the changes often begin earlier and go unnoticed. The NIDCD reports that about one in three people in the U.S. between ages 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Roughly 15% of American adults 18 and over — 37.5 million people — report some trouble hearing.

How can I test my hearing at home?

Home screeners and apps can flag a possible problem, but they cannot measure your hearing accurately or rule out a medical cause. A better home step is the NIDCD's 10-question self-check: if you answer "yes" to two or more questions, or "sometimes" to three or more, you could have hearing loss and should consider having your hearing checked. A hearing test from an audiologist remains the reliable next step.

Does hearing loss get worse if you ignore it?

Age-related hearing loss generally progresses slowly over years whether or not you address it, and ignoring it does not stop that. What ignoring it does change is daily life — the NIDCD notes that trouble hearing can make it hard to understand and follow a doctor's advice, respond to warnings, and hear phones, doorbells, and smoke alarms. A baseline hearing test also makes future changes easier to track.

Why is my hearing worse in restaurants?

Background noise competes with speech across the same pitch range, and high-frequency hearing loss removes the consonant sounds that help you separate the two. That is why a restaurant or family gathering can feel impossible while a quiet one-on-one conversation feels normal. Difficulty in noisy places is often the earliest sign people notice.

Can earwax cause hearing loss?

Yes — a buildup of earwax can block sound and cause temporary hearing loss that resolves once it is removed. Because of that, the FDA lists excessive earwax as a reason to see a doctor before buying an over-the-counter hearing aid. Have a clinician check and clear it rather than using cotton swabs or ear candles.

Signs of Hearing Loss: What to Watch For

Hearing loss usually arrives quietly. The TV creeps louder, restaurants get harder, and it starts to seem like everyone around you mumbles. Those are the classic signs. The NIDCD offers a 10-question self-check, and answering “yes” to two or more — or “sometimes” to three or more — means you could have hearing loss and should consider having your hearing checked. It is common: about one in three adults between 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. This article can help you decide whether to get tested; only a hearing test from an audiologist can tell you what is actually going on.

The Detailed Answer

Age-related hearing loss rarely announces itself. It builds over years, usually in both ears and usually in the high pitches first — which is why consonants like s, f, th and sh blur before vowels do. Speech still sounds loud enough. It just stops sounding clear. That gap between “I can hear you” and “I can’t understand you” is the single most recognizable sign.

Approximately 15% of American adults — 37.5 million people — ages 18 and over report some trouble hearing, according to the NIDCD. The numbers climb steeply with age: about one in three people in the U.S. between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing.

It matters beyond conversation. As the NIDCD puts it, having trouble hearing can make it hard to understand and follow a doctor’s advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Those practical consequences are often what finally prompts a visit.

The everyday signs people notice first

These are the patterns that come up again and again:

You turn the TV or radio up louder than other people in the room want it.
You ask people to repeat themselves, often more than once in a conversation.
It feels like people mumble or don’t speak clearly.
Restaurants, family gatherings and group meetings are much harder than one-on-one talks.
You struggle on the phone, or find yourself always using the same ear.
Women’s and children’s voices are harder to follow than men’s.
You miss the doorbell, the microwave beep, a turn signal, or birdsong.
You hear ringing, buzzing or hissing (tinnitus) in one or both ears.
Conversation leaves you tired, because following it takes real effort.
You’ve started avoiding social situations you used to enjoy.

The NIDCD self-check and its threshold

The NIDCD frames the signs not as a checklist of symptoms but as 10 questions about how hearing affects your life. Two of its questions, word for word: “Does a hearing problem cause you difficulty when listening to TV or radio?” and “Does a hearing problem cause you to feel frustrated when talking to members of your family?”

The threshold is specific. Answer “yes” to two or more of the ten questions, or “sometimes” to three or more, and in the NIDCD’s words you “could have hearing loss and should consider having your hearing checked.” That is the honest limit of any self-check, including this article: it tells you whether to get tested, not whether you have hearing loss.

Why it happens

The NIDCD points first to the inner ear: “Changes in the inner ear that can affect hearing are common. Age-related changes in the middle ear and complex changes along the nerve pathways from the ear to the brain can also affect hearing.”

Several things can contribute, which is part of why two people the same age can hear very differently. The NIDCD lists long-term exposure to loud noise, high blood pressure, diabetes, medications that are toxic to the ear’s sensory cells (such as some chemotherapy drugs), conditions such as otosclerosis, and genetic susceptibility. Some of those — noise, blood pressure, blood sugar — are worth discussing with your doctor regardless of what a hearing test shows.

What to do if the signs sound familiar

Get your hearing tested by an audiologist. It is painless, it takes under an hour, and it produces an audiogram — a chart of what you can and cannot hear at each pitch — that turns a vague suspicion into a measurement. Nothing else, including an app or an online screener, substitutes for it.

A test also sorts out the question behind the question. Mild to moderate loss in both ears opens up more options than severe loss does, and one-sided or sudden loss points toward a medical cause that needs attention, not a device. You can read more about causes and types in our Hearing Loss guides.

What are the signs you need hearing aids?

The signs that you might benefit from hearing aids are the same everyday signs above, once they start costing you something — missed instructions at the doctor’s office, skipped gatherings, friction at home. The deciding factor is a hearing test, because the degree and pattern of loss determines what kind of device fits. Devices sold under the FDA’s over-the-counter hearing aid rules, which went into effect on October 17, 2022, are intended for adults 18 and over with perceived mild to moderate hearing loss; our OTC Hearing Aids section explains how that category works.

Can hearing loss come on suddenly?

Yes, and sudden hearing loss is treated as urgent rather than ordinary. If your hearing drops noticeably over hours or a few days, especially in one ear, contact a doctor right away — the window for treatment is short. Age-related hearing loss, by contrast, develops gradually over years and affects both ears fairly evenly.

Is ringing in the ears a sign of hearing loss?

Tinnitus — ringing, buzzing, hissing or roaring with no outside source — often accompanies hearing loss, though it can also occur on its own. It is worth mentioning at a hearing test, because the two are frequently evaluated together. Tinnitus in only one ear is on the FDA’s list of symptoms that call for a doctor’s visit before buying any device.

Why can I hear people but not understand them?

This is the hallmark of high-frequency hearing loss. Vowels carry the volume of speech and sit in the lower pitches, while consonants carry the meaning and sit in the higher ones — so when the high pitches fade, speech stays loud but turns mushy. Background noise makes it dramatically worse, which is why a busy restaurant can feel impossible while a quiet kitchen feels fine.

When to Talk to Your Doctor

Most age-related hearing loss is not an emergency. But some symptoms mean you should see a doctor or audiologist promptly instead of waiting, self-diagnosing, or buying a device. The FDA lists these as reasons to see a doctor before considering an over-the-counter hearing aid:

Blood, pus or fluid coming from the ear
Ear pain or discomfort
Excessive earwax, or a feeling that something is in the ear
Severe dizziness or problems with balance
Sudden hearing loss within the past six months
Hearing that fluctuates — better some days, worse others
Hearing loss or ringing in only one ear

Also bring it up at your regular appointments if you have diabetes, high blood pressure, a history of loud noise exposure at work, or you are taking medication that can affect the inner ear. And if the only thing you notice is that conversations have quietly gotten harder, that is reason enough to ask for a hearing test. Hearing loss is common, it is measurable, and finding out where you stand costs you nothing but an hour.

Sources:

Age-Related Hearing Loss (Presbycusis) — NIDCD — Prevalence figures, the 10-question self-check and its threshold, everyday-life impact, and the causes/contributing factors.
OTC Hearing Aids: What You Should Know — U.S. FDA — Red-flag symptoms that require seeing a doctor, and the scope of the OTC hearing aid category (adults 18+, perceived mild to moderate loss).
Hearing Aids — U.S. FDA — Comparison of OTC hearing aids, prescription hearing aids, and personal sound amplification products. (The October 17, 2022 effective date of the OTC rule is stated on the FDA’s “OTC Hearing Aids: What You Should Know” page, cited above.)