What Causes Hearing Loss?

Hearing loss has many possible causes. Understanding what caused your hearing loss — or what puts you at risk — can help you make informed decisions about prevention, treatment, and monitoring. The World Health Organization (WHO) estimates that over 1.5 billion people worldwide live with some degree of hearing loss, and more than 430 million require rehabilitation services.¹

Age-related hearing loss (presbycusis)

Presbycusis is the gradual loss of hearing that occurs as part of the natural aging process. It is the most common cause of hearing loss in adults. The NIDCD reports that approximately one in three people between the ages of 65 and 74 has hearing loss, rising to nearly half of those 75 and older.²

Age-related hearing loss typically affects both ears equally and develops slowly over time. It is sensorineural in nature — caused by cumulative changes to the hair cells and structures of the inner ear — and is generally not reversible. Hearing aids are the primary treatment.

Noise-induced hearing loss (NIHL)

Noise-induced hearing loss is caused by damage to the hair cells of the inner ear from exposure to loud sounds. It is one of the most common and preventable causes of hearing loss. NIHL can result from a single extremely loud event (acoustic trauma) or from repeated exposure to sounds above 85 decibels over time.

Common sources of damaging noise include occupational environments (construction, manufacturing, military service), recreational activities (concerts, motorcycles, firearms), and personal audio devices at high volumes.

Learn more about noise-induced hearing loss and prevention →

Ototoxic medications

Some medications can damage the inner ear, causing hearing loss, tinnitus, or balance problems. These are called ototoxic medications. Examples include:

• •Certain aminoglycoside antibiotics (e.g., gentamicin, streptomycin)
• •Some chemotherapy drugs (e.g., cisplatin, carboplatin)
• •High doses of loop diuretics (e.g., furosemide)
• •High doses of aspirin or quinine

If you are prescribed a medication known to be ototoxic, discuss monitoring with your doctor. Do not stop taking prescribed medications without medical guidance.

Infections

Several infections can cause hearing loss:

• •Otitis media (middle ear infection) — a common cause of conductive hearing loss, particularly in children
• •Viral infections including mumps, measles, meningitis, and cytomegalovirus (CMV)
• •Labyrinthitis — inflammation of the inner ear, often following a viral illness
• •Syphilis — can cause sensorineural hearing loss if untreated

Earwax and physical blockages

Earwax (cerumen) buildup is a common and easily treatable cause of conductive hearing loss. When earwax accumulates and blocks the ear canal, it can muffle sound. Other physical causes include foreign objects in the ear canal and abnormal growths.

Structural and middle ear problems

Conditions affecting the outer or middle ear can cause conductive hearing loss:

• •Otosclerosis — abnormal bone growth in the middle ear that restricts the movement of the stapes bone
• •Perforated eardrum — a hole or tear in the eardrum
• •Cholesteatoma — an abnormal skin growth in the middle ear
• •Malformation of the outer or middle ear (atresia)

Genetic and hereditary factors

Genetic factors account for approximately 50 to 60 percent of hearing loss in newborns and a significant proportion of adult-onset hearing loss.³ Hearing loss can be inherited in several patterns and may be present at birth (congenital) or develop later in life (late-onset). Some genetic syndromes — including Usher syndrome, Waardenburg syndrome, and Pendred syndrome — include hearing loss as a feature.

Medical conditions associated with hearing loss

Several systemic health conditions are associated with an increased risk of hearing loss:

• •Diabetes — associated with both sensorineural and conductive hearing loss
• •Cardiovascular disease — reduced blood flow to the inner ear may contribute to hearing loss
• •Autoimmune conditions — including autoimmune inner ear disease (AIED)
• •Meniere's disease — a disorder of the inner ear causing episodes of vertigo, tinnitus, and fluctuating hearing loss
• •Acoustic neuroma (vestibular schwannoma) — a benign tumor on the auditory nerve

Head and ear trauma

Physical injury to the head or ear can cause hearing loss. Traumatic brain injury (TBI), skull fractures, and barotrauma (pressure injury from diving or flying) can all affect hearing. Blast injuries — common in military service — can cause both conductive and sensorineural hearing loss.

Frequently asked questions

Sources

1. 1. World Health Organization (WHO). Deafness and Hearing Loss. who.int. Accessed September 2026.
2. 2. National Institute on Deafness and Other Communication Disorders (NIDCD). Quick Statistics About Hearing. nidcd.nih.gov. Accessed September 2026.
3. 3. Smith RJH, et al. Deafness and Hereditary Hearing Loss Overview. GeneReviews. NCBI Bookshelf. Updated 2023.