By Debra Ashley,

Audiologist

People with good hearing take for granted the soft sounds of everyday life - from the pitter-patter of rain to a bird’s song or a child’s whisper.

More than 28 million people in the United States suffer from hearing loss. Nearly half are under age 65. While not always caused by aging, hearing loss affects 54 percent of the over-65 population. It’s the third most prevalent chronic health problem for elderly people, after arthritis and high blood pressure.

Hearing loss can have an enormous impact on one’s health and well-being. It can make it difficult to locate the origin of a sound, understand speech in a noisy atmosphere or contribute to a conversation. This can lead to social isolation, confusion, frustration, tension, stress and depression.

A common complaint from those suffering from hearing loss is “I can hear but I can’t understand.” This is because hearing loss leads to three kinds of communication difficulties:

Loss of sensitivity: difficulty hearing soft speech.

High-frequency loss: difficulty hearing consonants, such as the sounds “t, sh, f, p, s and th.” This can make following a conversation difficult because it’s hard to distinguish between words such as “cap” and “cat.”

Loss of focus: difficulty understanding speech in a noisy environment, even if the person speaking is louder than the background noise.

There are three kinds of hearing loss: conductive, sensorineural and mixed. Conductive hearing loss results from a problem in the outer or middle ear, such as excessive earwax, fluid behind the eardrum or an infection. This type of hearing loss is generally reversible with medical or surgical treatments.

Sensorineural hearing loss occurs when there’s a problem with the inner ear or along the auditory nerve. It can be caused by severe infections, toxic medications, genetic errors, excessive noise exposure or aging. It’s usually permanent and irreversible.

Mixed hearing loss is a mixture of conductive and sensorineural.

Because hearing generally deteriorates very gradually, the individual may not even be aware of the problem. He or she might exhibit some subtle personality shifts, ask others to repeat themselves, speak more loudly, turn up the TV or stereo, or seem more tense or angry.

If you experience one or more of the following symptoms, you should consult with a hearing specialist:

People seem to be mumbling a lot.

You have to strain to listen when spoken to.

You have difficulty hearing someone call you from another room.

Following a conversation is difficult, especially in a noisy setting.

You have to turn up the volume of the TV or stereo.

You have problems hearing clearly on the telephone.

You have problems hearing clearly at lectures, meetings or the theater.

You have begun to limit your social activities.

Family or friends mention that they have to repeat themselves often.

It’s important to seek medical help for hearing loss. Studies show that individuals who have their hearing loss treated or get hearing devices have better relationships with family and friends, higher self esteem and improved mental health.

There’s no reason to suffer in silence. Hearing loss is a real health problem with potentially serious implications, and help is available.

Debra Ashley is an audiologist at the Palo Alto Medical Foundation.