According to the World Health Organization, noise-induced hearing loss usually develops gradually, so it can remain unnoticed or ignored for a long time. The scale of the problem in Lithuania is shown by data from the Hygiene Institute: in 2025, deafness or hearing impairment was registered in 80,654 residents of the country. Compared to 2017, this number increased by almost 63 percent. However, the true extent of hearing impairments may be much greater, as some people have not yet recognized their hearing impairment or have not sought help because of it.
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We hear the voice, but not all the words
According to hearing specialist Agnė Staputienė, the first signs of weakening hearing often seem too insignificant for a person to associate them with hearing impairment.
“We turn up the TV a little louder, ask to repeat, and if we don’t hear something, we think the person is just speaking unclearly. Often, the first thing we notice is not that we don’t hear, but that we hear the sound but do not understand the meaning of the word – we have to guess it from the context,” the specialist explains.
This can happen because hearing often begins to weaken from high-frequency sounds. These include consonants important for speech clarity, such as s, š, f, t, or k. A person hears the speaker’s voice but does not distinguish some speech sounds, so they may confuse similarly sounding words – for example, hearing “butter” as “city,” or “drop” as “leaf.”
In a quiet room, talking with one person, the missing information is also helped to be restored by the context of the conversation, the speaker’s facial expression, or lip movements. Hearing difficulties become much clearer in a family gathering, conference, or work meeting where several people speak at the same time.
“In a noisy environment, it becomes harder for the brain to separate speech from other sounds because it no longer receives all the necessary acoustic information. A person may understand slow and clear speech from one speaker well but get lost in a fast group conversation. Higher-pitched voices of children and women are often harder to understand,” explains A. Staputienė.
Changes are often first noticed by close ones
Since hearing weakens gradually, a person adapts to the changes. The brain tries to restore unheard parts of the conversation based on the context and previous information. As long as this succeeds, it may seem that hearing is fine, and difficulties arise only because of the environment or unclear speakers.
According to A. Staputienė, about half of the people who come for a check-up do so encouraged by relatives or colleagues.
“Those around often notice first that the person needs everything repeated, the TV is much louder, or during a conversation, they respond not quite to what was asked. The person themselves may not think they have a problem, but after the examination, it turns out that the actual hearing threshold is worse than they felt,” says the specialist.
Among the first signs are more frequent requests to repeat, difficulties communicating on the phone, unusually loud voice of the person themselves, ringing, buzzing, or humming in the ears. Changes in communication habits can also indicate weakening hearing: conversations in larger groups become tiring, and gatherings or other noisy places are avoided.
The person themselves does not necessarily associate these difficulties with hearing. They may think the environment has become too noisy, people speak too fast, and fatigue after a meeting was caused by a long or intense conversation.
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Hearing impairments are not only a problem for older people
Age-related hearing loss is most pronounced at 60–65 years, but according to A. Staputienė, the first measurable changes can be detected already at 40–50 years.
“In check-ups, we also notice younger people whose hearing may be affected by frequent use of headphones at high volume, concerts, or noisy work environments. We would still like hearing to be checked more responsibly and earlier, without waiting for a significant deterioration,” says the specialist.
Even after noticing the first signs, people often hesitate to seek help. According to A. Staputienė, the belief that hearing impairments and hearing aids are only related to old age is still widespread. Some people think they still hear “well enough,” fear the results of the examination, possible costs, or simply postpone taking care of their health.
When to plan a check-up and when to seek urgent help?
If listening to everyday conversations requires more and more effort or at least several of the previously mentioned signs constantly recur, a hearing check-up should not be postponed.
A. Staputienė recommends checking hearing prophylactically once a year, especially for people over 60 and those who spend a lot of time in noisy environments.
However, gradual and sudden hearing deterioration should not be confused. If hearing suddenly weakens, especially in one ear, it is necessary to see a doctor as soon as possible.
“Gradual hearing loss is a reason to plan a check-up, while sudden, especially one-sided, hearing loss is a reason to seek medical help immediately,” emphasizes A. Staputienė.
A poorer hearing test result does not necessarily mean that a person will immediately need a hearing aid. Weaker hearing can be caused not only by age-related changes or long-term noise exposure but also by earwax blockage, inflammation, or another medical problem. Therefore, it is first important to determine the true cause of the deterioration.
“Familia Clinica” hearing specialists work together with otorhinolaryngologists. The doctor performs the necessary tests and determines the cause of hearing loss, and if needed, the hearing specialist selects and individually fits a hearing aid. Such cooperation helps ensure that the person receives appropriate help for their condition.
That is why it is important not to delay hearing changes until they become obvious. It is worth checking already when a person still hears environmental sounds but has to put more and more effort into understanding everyday conversations. The earlier the changes are noticed, the sooner the cause can be identified and the most suitable form of help chosen.
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