Hearing Loss Causes and Risk Factors

There are many potential causes of hearing loss, as well as risk factors that can increase your likelihood of developing it. While many people can expect some level of hearing loss as inevitable due to aging, there are other factors that are good to be aware of. Knowing what the most common risk factors are can help you avoid losing your hearing earlier or prevent greater severity of hearing loss. 

Some of the factors are internal or biological causes that are more difficult to avoid. However, some of them are more external or environmental causes over which you can have more control.

Risk Factors for Hearing Loss

First, we will address the most common risk factors you should know. These are elements that may exist in your life that are more likely to lead to hearing loss. They may not cause hearing loss right away, but they can all add up over time. As a result, you may lose your hearing earlier, or more severely, than you would otherwise. 

For some people, hearing loss can happen due to your genetics. These are people who are more likely to be born with poor hearing, or who have hearing loss much earlier in their lives than most. 

Some people may be born with deformations of the ear itself, which can affect how well you hear.

If your family has a history of having earlier and more severe hearing loss than usual, you may have this same risk factor. We recommend that people with a common family history of early hearing loss get their hearing tested earlier and more regularly. 

There are also health conditions that increase the risk of having hearing loss. Conditions like diabetes, some autoimmune disorders, cancer, and other diseases can cause nerve damage in your ears. If you are diagnosed with any disease or health condition that can affect your blood flow, nerves or brain, consult with your doctor. You can ask if your hearing may be affected by your condition. If your doctor says that a medication you take can cause hearing loss, we recommend having your hearing tested annually. This will help stop any hearing loss early and offer intervention options before it gets worse.

Another form of health condition that can cause hearing loss is due to side effects of some medications. Depending on what condition you have, some stronger medications and treatments may cause hearing loss. These can be temporary side effects that will go away once you stop taking the medication. Some, however, can cause permanent damage to your hearing.

The older you get, the more likely you are to have gradual hearing loss. Here is some basic data on how many people have hearing loss by age brackets, according to the Canadian Health Measures Survey (CHMS):

• Ages 20 to 39: 15%
• Ages 40 to 59: 40%
• Ages 60 to 79: 78%

You can see the percentage of population in each age group dramatically increases from early adulthood to senior status. This is due to a combination of things. First, you are more likely to slowly build small instances of damage to your hearing over your lifespan. Second, as you age the inner ear hair cells and nerves become less sensitive due to natural decay over time. 

When you are in your 20s, it is recommended that you get a hearing test every 10 years or so, unless you have reason to believe you have some hearing loss already. Once you reach your 50s, we recommend you get your hearing tested every two to three years. Once you have a diagnosed hearing loss, we recommend you get a full hearing test every year. 

A common risk factor for hearing loss is exposure to loud noises. Loud noise can include things like machinery, very loud music, gun shots, and so on. The longer and more often you are exposed to loud noise, the more likely you are to have hearing loss.

That is why many occupations, such as machine workers, police officers, and more are all required to get their hearing screened regularly. It is also recommended that musicians, hunters, and anyone else exposed to loud noises wear proper hearing protection.

Conductive hearing loss is the second of the two types of hearing loss. It occurs because something blocks sound from getting through your outer and middle ear and into your inner ear. The blockage can caused by a foreign objects or substances obstructing your ear canal. It can also be from an inflammation or abnormality of your ear structure.

There are several causes for conductive hearing loss, including the following.

Otitis media refers to infections in the middle ear canal. These infections are caused when bacteria or a virus enters the middle ear. As a result, such an infection is very often caused by another illness. It is common for things like the common cold, seasonal flu, or even allergies to cause increased congestion and swelling in your sinuses. This can also lead to swelling in your middle ear, and lead to an infection.

It is not uncommon for a foreign object to enter your ear canal and cause a blockage that affects your hearing. It is more common in children, who can intentionally insert objects into their ear canals, where they could become stuck. Among adults, foreign obstructions can include cotton swabs breaking and getting stuck, or insects. Foreign objects stuck in the ear canal can lead to pain and infections, which can further affect your hearing. If you suspect you have a foreign object in your ear, please see your doctor.

Tympanosclerosis is the clinical term for scarring of the eardrum. It can happen after your eardrum is injured, after a surgery, or as a result of chronic inflammation. It can lead to conductive hearing loss, but it might not. Some adults will unknowingly have scarring and experience no noticeable issues. A surgical procedure can remove some of the scarring. If that fails or if the procedure is impossible, then your hearing loss may only be managed with hearing aids.

Microtia and Anotia are both rare types of birth defects where the external ear has not formed properly. With Anotia, the external part of the ear is completely missing. With Microtia, there is an external ear but it has not formed completely so it still affects the child’s hearing. How it affects the child’s hearing will vary depending on the severity of the condition. Surgery may be possible to reconstruct the external ear, but not until the child is older. 

A ruptured eardrum is a type of ear-related trauma that can cause infections and hearing loss. Here are the more common causes of an eardrum rupture: 

• Head trauma
• Sudden loud sounds/acoustic trauma
• Imbalance of air pressure between your ear and external environment (e.g., air travel)

Typically, a ruptured eardrum can heal itself over a few weeks, which can also restore your hearing to its previous levels. More severe ruptures may require surgery to repair, and any hearing loss may be permanent. 

Eustachian tubes run from your middle ears to your upper throat. They equalize the pressure in your ear, and drain fluid from your middle ear. These tubes are small, and as a result can be easily blocked. Blockages can lead to hearing loss, as well as pain or discomfort. When a blockage occurs, it is called eustachian tube dysfunction (ETD). The most common causes of ETD are blockages from sinus infections, allergies, common colds, and altitude changes. The blockages and hearing loss are most often temporary.

Otosclerosis refers to abnormal bone fusion inside your ear. It is most common among young adults. It occurs when three small bones within the middle ear fuse with the surrounding bone. These bones vibrate when sound waves enter the ear canal in order to transmit them to the inner ear. When they fuse with surrounding bones, sound waves are less efficiently transmitted to your inner ear. This results in mild to severe hearing loss. There is no clear cause of otosclerosis, but genetics are believed to play a role. There are two ways to treat this condition, depending on its specific nature and severity: surgery and hearing aids. 

Other conditions that lead to abnormal growths protruding into your ears and ear canals can also lead to hearing loss. Tumors are the most common type of growth. These tumors are not necessarily cancerous, and can be benign. Acoustic neuroma is an example of such a tumor that specifically develops on your hearing nerves, which causes hearing loss. Medical management is the best treatment for this condition.

Ossicular chain discontinuity is the clinical term where your middle ear bones become separated. Hearing loss and tinnitus are both common symptoms of this condition. It can be treated with surgery, and if some of the hearing loss is permanent you can explore using hearing aids.


There are many risk factors and causes for hearing loss. Some are minor and temporary, where treating the underlying cause can restore your hearing to its previous levels. Some are more serious, and can lead to permanent hearing loss. Some cannot be avoided, such as trauma from accidents or illnesses causing hearing loss, but some can be prevented with proper ear protection, healthy habits, and consulting with your doctor or a hearing care specialist.

You might be interested in...

• Hearing Loss Treatments
• Hearing Loss Symptoms
• Types of Hearing Loss
• Hearing Services
• Hearing Aids

¹ Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and Hearing Impairment in the United States: Audiometric Evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149:1-10.

*National Health and Nutrition Examination Survey, 1999 to 2004. 5,140 (3,316 males; 2,624 females) noninstitionalzied adults age 20 to 69 years who had audiometric testing. Hearing impairment was assessed from the pre tone average of thresholds over low or mid-frequencies (500, 1000, and 2000 Hz) and high frequencies (3000, 4000, 6000, and 8000 Hz) and was defined as mild or greater severity (pure tone average >25 decibels hearing level [dB HL]) and moderate or greater severity (pure tone average >40 dB HL). Hearing impairment was more prevalent among adults with diabetes. Age-adjusted prevalence of low- or mid-frequency hearing impairment of mild or greater severity on the worse ear was 21.3% (95% CI, 15.0% to 27.5%) among 399 adults with diabetes compared with 9.4% (CI, 8.2% to 10.5%) among 4741 adults without diabetes. Similarly, age-adjusted prevalence of high-frequency hearing impairment of mild or greater severity in the worse ear was 54.1% (CI, 45.9% to 62.3%) among those with diabetes compared to 32.0% (CI, 30.5% to 33.5%) among those without diabetes. The association between diabetes and hearing impairment was independent of known risk factors for hearing impairment, such as noise exposure, ototoxic medication use, and smoking (adjusted odds ratios for low- or mid-frequency and high-frequency hearing impairment were 1.82 [CI, 1.27 to 2.60] and 2.16 [CI, 1.47 to 3.18], respectively). The diagnosis of diabetes was based on self-report. The investigators could not distinguish between type q and type 2 diabetes. Noise exposure was based on participant recall.¹