Feeling tired and cranky? It could be your ears. Irritability is one of several subtle and surprising signs of hearing loss.

About one-third of Americans between the ages of 65 and 74, and half of those over 75, live with diminished hearing. Yet less than one-fifth of people under age 70 and less than one-third over 70 are adequately treated, often because they don’t realize there’s a problem.

“Hearing loss is inevitable as people age,” says Oliver Adunka, M.D., an ear, nose, and throat specialist at The Ohio State University Wexner Medical Center. “But we can improve pretty much everyone.”

Sneaky Signs You May Miss

Thanks to a lack of awareness of age-related hearing loss, many people don’t realize it’s happening to them. Changes in hearing occur so gradually that you may not even notice them. Plus, denial and embarrassment around any age-related medical issue can keep people from seeing the doctor. On average, it takes five to seven years from when an individual has trouble hearing to when they seek assistance. Don’t let that be you.

Ask yourself if any of these signs apply:

1. Other people seem to mumble or talk too softly or too fast, especially on the phone.

“With normal hearing, you can get the gist of a conversation even with some missing words, because you fill in the blanks by using your knowledge of language. But hearing loss eliminates too many of the cues,” warns Catherine Palmer, director of audiology at the University of Pittsburgh Medical Center Integrated Health System.

2. You frequently ask others to repeat themselves, particularly in crowded settings.

“This is the ultimate reason people find a doctor,” notes Dr. Adunka.

3. You struggle when women or children speak.

“Higher pitches are lost first,” Dr. Adunka says. Lower-pitched sounds, including vowels, may remain unaffected, while consonants and higher-pitched speech become indecipherable.

4. You crank up your TV, radio, or headphones to high levels, as judged by others.

“You’re essentially using the volume control as a ‘hearing aid,’ but it’s disruptive to others,” says Palmer.

5. You’re impatient, frustrated, or totally exhausted, despite getting enough sleep and exercise.

“People don’t realize the extra effort needed to fill in the blanks in conversation,” says Palmer. The strain can drain your energy by day’s end.

6. Your thinking is sometimes fuzzy, and you hear a din inside your ears.

Persistent head sounds drown out other information, interfering with clear thinking and focus, Dr. Adunka warns.

7. You’re becoming socially isolated. 

Poor hearing can make you avoid social situations, increasing the risk of depression, social isolation, anxiety, and dementia.

What You Can Do 

If you notice any of these symptoms, see an audiologist who will test your hearing. The audiologist will build a detailed sound profile (audiogram) that maps specific deficits. A hearing aid, a highly sophisticated amplifier, can then be precisely calibrated to correct for your particular deficits. If the testing reveals any medical problems with your ears, the audiologist will refer you to an ear, nose, and throat physician (ENT). ENTs take care of medical problems related to the ears, whereas audiologists take care of the non-medical problems like age-related hearing loss (permanent hearing loss). You can also go to your primary care doctor, who will refer you to the appropriate specialist.

Hearing aid styles include:

• Behind-the-ear (BTE) devices wired to fitted earpieces
• In-the-ear (ITE) aids—these fill the inside of the ear and are very visible
• Receiver-in-the-ear (RITE) aids, which are less visible 
• Completely-in-the-canal (CIC) and invisible-in-the-canal (ITC) aids, which are entirely hidden from view
• Personal sound amplification products (PSAPs), which are non-custom solutions that may be in the style of a BTE or ITE device

When you first get a hearing aid, expect some discomfort in the beginning. You may need a few adjustments to get it just right. 

“Some people have a strong reaction to the sudden onslaught of sound,” warns Palmer. Others find their own voice initially disconcerting. The brain has adapted over time to your hearing loss, so it is essential to use the new amplification full-time (during all waking hours) so the brain can adjust to all the new sounds and this can become the new normal. After experiencing the new sounds for several weeks, fine-tuning can be done to alleviate anything that the new hearing aid user hasn’t adjusted to in terms of sound. 

Dr. Adunka suggests that you take your favorite device on a 30-day test drive before committing to the $1,000 to $5,000 average cost. These devices are rarely covered by private insurance and are not Medicare-reimbursable.

What Lies Ahead

With direct-to-consumer hearing aids poised to explode into the marketplace soon, experts remind anyone with suspected hearing loss to consult an audiologist or ENT before trying to treat themselves. “Get your hearing managed early, be patient with the adjustments, and you’ll reap years of benefit,” says Dr. Adunka.