Most of us get regular eye exams, but even when we are dealing with older friends or relatives with poor hearing, we don’t think about our own hearing … until we do. Whether you find yourself asking, “Can you repeat that?” one too many times or realizing you have developed a constant ringing/hum in your ears (we’ll get to that), hearing loss creeps up on us in ways we don’t expect. So, let’s dive into the real causes of hearing loss, what happens to our ears as we age, and why those listening breaks our parents nagged us about are actually crucial.

What Causes Hearing Loss? (Hint: It’s Not Just Loud Music)

Hearing loss happens for several reasons, and while the blaring music at parties plays a role, it’s far from the whole story. Here’s what could be happening to our hearing over time:

• Noise-Induced Hearing Loss (NIHL): Imagine your ear as a peaceful village of tiny hair cells (scientifically known as stereocilia) that are responsible for picking up sound vibrations. When you crank up the volume, especially over 85 decibels, it’s like inviting a herd of elephants to that village. The constant pounding of loud noises can destroy these delicate hair cells, and unfortunately, they don’t regenerate. Once they’re gone, they’re gone. That’s why hearing loss from loud noise is irreversible (sigh).
• Tinnitus: This is that annoying ringing or buzzing in your ears. Tinnitus doesn’t cause hearing loss, but it’s often a symptom of it, especially noise-induced hearing loss. In addition to destroying those hair cells, prolonged exposure to loud sounds can damage the auditory nerve, leading to constant phantom noise.
• Ototoxic Medications: Certain medications can damage your hearing. Antibiotics like gentamicin, some chemotherapy drugs, and even high doses of aspirin can have ototoxic effects, meaning they’re toxic to the ear.
• Infections and Illnesses: Viral infections (like measles or mumps), meningitis, and even severe ear infections can cause hearing loss by damaging the inner ear or auditory nerve. Autoimmune diseases can also attack the ear’s delicate structures.
• Earwax Build-Up: Not as dramatic as hair cell destruction, but sometimes the reason you can’t hear is as simple as wax blocking sound waves. It’s an easily treatable cause of hearing loss, but it’s a good reminder to take care of ear hygiene!

Why Is Hearing Loss Inevitable?

Given what we know about the factors that cause hearing loss, it is easy to see why our ability to hear naturally declines as we age. Hearing loss is almost as inevitable as needing reading glasses because time is not kind to the stereocilia or the auditory nerve.

As we age:

• Hair Cells Get Worn Out: You’d think evolution might have helped us out here, but those tiny hair cells in the inner ear are incredibly delicate even as our average lifespan gets longer. After decades of vibrating to the tune of everyday life—traffic, conversation, music—they start to wear out. High-frequency sounds (like birds chirping or phone beeps) are the first to go because the hair cells that pick these up are closest to the entrance of the cochlea (the part of your ear where sound waves get processed). They get the brunt of the action and wear out faster.
• Blood Flow Decreases: Like every part of your body, your ears rely on good blood circulation to function well. As you age, circulation declines, meaning your inner ear might not be getting the oxygen and nutrients it needs to keep those hair cells healthy.
• Wear and Tear on the Auditory Nerve: The nerve that sends sound signals from your ear to your brain (the auditory nerve) can also degenerate over time. This makes it harder for your brain to process sounds, even if your ears pick them up. This is why there is a link between auditory decline and cognitive decline.

Who Is Most At-Risk for Hearing Loss (besides those who seek out loud music)?

• City Dwellers: Living in a city often means being exposed to constant noise pollution—traffic, construction, public transportation, sirens, and even loud social environments. City noise typically falls in the range of 70-85 decibels (dB), which might not seem extremely loud, but over time, constant exposure to these noise levels can add up.
• Factory Workers: Factory and industrial workers are also at increased risk because of the machinery and equipment they deal with daily. Many of these environments feature sound levels well above 85 dB, which is the threshold at which noise can begin causing permanent hearing damage. Occupational hearing loss is one of the most common work-related illnesses. Many industrial settings require workers to wear hearing protection, like earplugs or sound muffling earmuffs, but long-term exposure, even with protection, can still contribute to gradual hearing loss.

How Much Noise Does It Take to Damage Hearing?

It’s not just about how loud the noise is—duration of exposure also plays a big role. Even sounds below 85 dB can cause damage if you’re exposed to them for long periods without breaks. That’s why factory workers and city dwellers, who are exposed to continuous noise, are more susceptible to hearing loss than those in quieter environments.

The louder the sound, the less time it takes for damage to occur. Here’s a breakdown of common decibel levels and how long it’s safe to be exposed before damage can occur:

Safe Listening Guidelines

• 70 dB and below-Safe exposure time: No limit

           Examples: Normal conversation (60 dB), background office noise (50 dB)

• 85 dB- Safe exposure time: Up to 8 hours

          Examples: Busy city traffic, a lawnmower, or a noisy restaurant

• 90 dB- Safe exposure time: 2 hours

          Examples: Power tools, an average factory, or a subway

• 95 dB-Safe exposure time: 1 hour

          Examples: Motorcycle, car horn, or a loud bar

• 100 dB – Safe exposure time: 15 minutes

           Examples: Chainsaw, loud sports event, or jackhammer

• 105 dB-Safe exposure time: 5 minutes

           Examples: Helicopter, live rock concert, or a personal music device at max volume

• 110 dB-Safe exposure time: Less than 2 minutes

           Examples: Nightclubs, sirens, or a car stereo at max volume

• 120 dB and above- Safe exposure time: None! Immediate damage

            Examples: Ambulance sirens (120 dB), jet takeoff (140 dB), fireworks, or gunfire

While Hearing Loss Is Inevitable, the Amount of Loss Is Within Our Control

We know the sounds we hear in our future will almost certainly be a bit less clear. But there are things we can do now to minimize our hearing loss. You won’t see immediate results, but with a few simple lifestyle changes, you can make a huge difference in your quality of life later.

1. Turn Down the Volume of Everyday Life: This is the most effective way to prolong good hearing. Ear plugs, noise reduction earmuffs, and noise-canceling headphones reduce the amount of harmful noise that reaches the sensitive structures of your inner ear. Less noise means less stress on those hair cells, which can prevent them from becoming damaged over time. With noise-canceling headphones, you don’t have to turn up the volume as high to hear music or speech clearly in noisy environments. This helps you stay below the 85 dB threshold that is considered safe for prolonged listening.
2. Follow the 60/60 Rule: When listening to music or podcasts through headphones, keep the volume at no more than 60% of the maximum and limit listening to 60 minutes at a time (more on this later).
3. Give Your Ears a “Time Out:” Whether you’re at a loud concert, working with machinery, or just using earbuds for a long period, taking regular listening breaks is key. This reduces the cumulative strain on your ears, giving the hair cells time to recover. You may have noticed that after you’re exposed to loud sounds or prolonged sounds, you may notice a temporary reduction in hearing—things sound muffled. This is called a “temporary threshold shift,” where the hair cells in your ear take a break to recover from all the stimulation. Unlike what happens when you take off your eyeglasses after wearing them for a while, repeated temporary hearing shifts can lead to permanent damage.
4. Regular Exercise: Good blood circulation is essential for ear health. Regular exercise improves blood flow, which helps keep your inner ear and auditory system in good condition.
5. Quit Smoking (or Avoid Secondhand Smoke): By contrast, smoking inhibits your circulation. Poor circulation can damage your hearing by reducing blood flow to the inner ear, accelerating the natural aging process, and increasing the risk of hearing loss. Research shows that smokers are more likely to experience hearing loss, and secondhand smoke can also contribute to hearing damage.
6. Raise Your Noise Consciousness: This is 90% of the battle. Most of us go through our days not thinking about whether or not our environment is too loud. But if you feel like something is too loud or you have the urge to put your hands over your years, do something about it. Carry foam ear plugs. Change your route. Do whatever you need to do to lower the volume and reduce the impact on your ears. Each noisy onslaught you avoid will keep your hearing and your brain healthy longer.
7. Regular Hearing Checkups: If you’re frequently exposed to loud noise or notice any changes in your hearing, regular hearing checkups can help detect issues early. Audiologists can track any changes in your hearing over time and offer personalized advice on how to better protect your ears. Even if you think your sound exposure is low or normal, it is an excellent idea to get your hearing checked once every ten years, maybe every time you have a birthday that starts a new decade.

Do Hearing Aids Help Preserve Our Hearing?

Sadly, no. But they will help preserve your brain health! Hearing aids are essentially tiny sound amplifiers. They don’t restore your natural hearing, but they make sounds clearer and louder, helping you better understand speech and environmental sounds. Modern hearing aids come with advanced technology that adjusts to different noise environments and even filters out background noise, allowing you to focus on the sounds you want to hear.

Hearing aids cannot repair or regenerate the damaged cells and nerves that cause hearing loss. What they do, however, is compensate for this loss by amplifying sound, making it easier for your brain to process the signals that do come through.

Hearing aids make it easier to engage in conversations and follow along in noisy environments, reducing the frustration that comes with hearing loss. They help keep your brain engaged by allowing it to process sound and language, which can be critical in preventing cognitive decline. When your brain has to “work harder” to interpret muffled or faint sounds, it can lead to fatigue and even cognitive strain. By making sounds clearer, hearing aids help reduce this mental load. There is a close correlation between hearing loss and loss of cognition.

If hearing loss is left untreated for a long time, your brain can gradually lose the ability to process certain sounds. This is called auditory deprivation. The longer your brain goes without hearing certain frequencies, the harder it becomes to interpret those sounds, even if you eventually get hearing aids. Hearing aids can help prevent further cognitive decline by keeping the brain engaged with sound, but they are most effective when used early. It’s the old truism, “use it or lose it.”

One More Thing About Your Listening Devices …

Most of us spend an increasing amount of time listening to music on personal devices, through headphones and ear buds. And now that we’ve raised your consciousness about damaging sound levels, you probably want to be sure you are not pumping those damaging levels straight into your ears.

It can be tricky to know exactly how loud the sound from your headphones is in terms of decibels (dB), especially because most devices don’t display decibel levels directly. However, there are several ways you can get a good idea as to whether the volume you’re listening to is higher than a safe 70 dB ad adjust accordingly.

• Check Your Device Volume Settings. Most listening devices (like smartphones or tablets) offer volume indicators (bars, numbers, or percentages) but don’t show decibel levels. As we mentioned earlier, 60% volume on most devices typically produces sound around 70-80 dB. Anything above 60% volume is likely to exceed the safe listening threshold of 70 dB. Try to keep the volume below 60% as a general guideline for safe listening levels.
• Use a Sound Level Meter App. There are apps available that can estimate the decibel level of the sound playing through your headphones by using your phone’s microphone. While they won’t be perfectly accurate, they can give you a rough idea of the sound level. Some popular ones include Decibel X, Sound Meter, and NIOSH Sound Level Meter, but there are several.

Here’s how to use them with your headphones:

1. Play music or any sound at your usual volume level through your headphones.
2. Hold one of the ear cups or earbuds near your phone’s microphone (not directly on it, but close enough to pick up the sound).
3. The app will give you a dB reading, which can help you gauge how loud the sound is. Use the information above to determine how long you can listen at that level.

• Check for Distortion or Discomfort. A simple rule is if you start to feel discomfort in your ears or experience distortion in the sound quality, the volume is likely too high. Your ears might feel “full” or even slightly painful, and those are warning signs. Sounds at safe levels shouldn’t feel physically uncomfortable.
• Try the “Arm’s Length” Test. A good trick is the arm’s length rule: If someone sitting next to you at arm’s length can hear what you’re listening to through your headphones, the volume is likely too high. This is a clear sign that your headphone volume is over 70 dB.
• Use Headphones with Built-In Volume Limits. Some headphones, especially those marketed for children, have volume limiters that prevent the sound from going over 85 dB. These are great for ensuring that your listening levels stay within a safer range. Some models even allow you to set a custom decibel cap lower than 85 dB.
• Use Device Warnings. Some smartphones and audio devices will provide warnings when you raise the volume to unsafe levels. This is particularly common on iPhones and Android devices. If you see a warning message about potential hearing damage, that’s a sign the volume is above 70 dB, and you should consider turning it down.
• Use Volume Limiting Features on Your Device (Pro Tip). Many devices allow you to set a maximum volume limit to avoid going above a certain level.

On an iPhone:

1. Go to Settings > Sounds & Haptics > Headphone Safety and turn on Reduce Loud Sounds.
2. You can set a maximum decibel level for your headphones, with an option to cap it at 70 dB.

There are a variety of different Android devices but generally you can find the volume limiter this way:

1. Open the Settings app on your Android device.
2. Scroll down and select “Sounds” or “Sound & Vibration” (depending on your device).
3. Look for an option labeled “Headphone Safety”, “Volume Limiter”, or “Hearing Protection”. On some devices, this might be under a section called “Additional Settings” or “Advanced”.
4. Toggle the option to enable a volume limit or hearing protection feature.

The Bottom Line on Hearing Loss

Hearing loss is inevitable as we age. Hearing damage is cumulative—the longer you’re exposed to a loud noise, the more likely you are to damage your hearing, even if the noise isn’t extremely loud. The key is to reduce exposure time and, whenever possible, reduce the noise level.

Protecting your ears is way easier than trying to regain lost hearing, mostly because hearing loss is irreversible. Taking care of your hearing now means you’ll be able to enjoy conversations, music, and the sound of birds chirping for years to come. So, whether you’re 25 or 65, it’s never too early — or too late — to turn down the volume, take listening breaks, and give your ears the care they deserve.