What is Asymmetric Hearing Loss (AHL)?

Q: What is the best hearing aid model for me?

In general, any audiologist will always recommend to you the hearing aid model that best suits your needs . Here is a useful checklist to make sure that is the case. Audiologist's level of knowledge: The audiologist you have seen will hopefully have a wide knowledge of all available hearing aids ; however, some will only be familiar with a small number of brands and, therefore, may not really be in a position to know which model is the best for you. It is OK to challenge their recommendation and ask them to justify why this particular brand is the one for you. Do research: Read about the hearing aid that was recommended. Does it seem like it will suit your lifestyle? Does it have more or fewer features than you need? Be aware of sales targets: Many high street retailers have specific tie-ins to a particular manufacturer/brand. The hearing aid they have suggested may still be the correct one for you, but do your research so that you know why they might have recommended it.

Q: What are the benefits of rechargeable hearing aids?

For most people, the main benefit of a rechargeable hearing aid is simple convenience. We are used to plugging in our phones and other devices overnight for them to charge up. Here are some other pros and cons: For anybody with poor dexterity or issues with their fingers, having a rechargeable aid makes a huge difference, as normal hearing aid batteries are quite small and some people find them fiddly to change. One downside is that if you forget to charge your hearing aid , then it is a problem that can't be instantly fixed. For most, a 30-minute charge will get you at least two or three hours of hearing, but if you are the type of person who is likely to forget to plug them in regularly, then you're probably better off with standard batteries. Rechargeable aids are also a little bit bigger and are only available in Behind-the-Ear models. Finally, just like with a mobile phone, the amount of charge you get on day one is not going to be the same as you get a few years down the line. Be sure to ask what the policy is with the manufacturer's warranty when it comes to replacing the battery.

Q: Are Behind-the-Ear hearing aids better than In-the-Ear hearing aids?

For most people, the answer is yes. But it's never that simple. The majority of hearing problems affect the high frequencies a lot more than the low ones. Therefore, open fitting hearing aids sound a lot more natural and ones that block your ears up can make your own voice sound like you are talking with your head in a bucket. Therefore, in-ear aids tend to be less natural. However, the true answer is we can't tell until we have had a look in your ears to assess the size of your ear canal, and until we have tested your hearing to see which frequencies are being affected. People with wider ear canals tend to have more flexibility, also there are open fitting modular CIC hearing aids now that do not block your ears. There is also the age-old rule to consider, that a hearing aid will not help you if it's sat in the drawer gathering dust. If the only hearing aid you would be happy wearing is one that people can't see, then that's what you should get. Most people can adapt to any type of hearing aid , as long as they know what to expect. Have an honest conversation with your audiologist as to what your needs are.

Q: What are channels, and how many do I need?

Generally speaking, six or more. Unless it's none at all. The number of channels a hearing aid has is often a simplistic way an audiologist will use to explain why one hearing aid is better than another, but channels are complex, and it is really not that straightforward. Here are some reasons why: Hearing aids amplify sounds of different frequencies by different amounts. Most people have lost more high frequencies than low, and therefore need more amplification in the high frequencies. The range of sounds you hear is split into frequency bands or channels, and the hearing aids are set to provide the right amount of hearing at each frequency level. Less than six channels, and this cannot be done with much accuracy, so six is the magic number. However, a six-channel aid is typically very basic with few other features and is suitable only for hearing a single speaker in a quiet room. The number of channels is not what you should be looking at; it's more the rest of the technology that comes with them. As a final note, different manufacturers have different approaches. One method is not necessarily better than any other. For example, some manufacturers have as many as 64 channels in their top aids. Most tend to have between 17 and 20. One m anufacturer has no channels at all.

Q: What's covered in a manufacturer's warranty?

Manufacturer's warranties typically last between 2-5 years, depending on the brand and model, and cover defects in materials and workmanship. This includes repairs for component failures, electronic malfunctions, and manufacturing defects, but excludes damage from misuse, accidents, or normal wear. Most manufacturers also include loss and damage insurance for the first year. We handle all warranty claims on your behalf, liaising with manufacturers and ensuring you get replacement devices quickly when needed. This comprehensive warranty coverage, combined with our lifetime aftercare, gives you complete peace of mind.

Q: How much does the hearing test cost?

Our hearing tests are completely free, whether at our clinics or in your home . Unlike other providers who charge £30-£100 for home visits, we believe hearing healthcare should be accessible without financial barriers. Our comprehensive assessments include examination by a registered audiologist, audiogram results, and personalised recommendations. All testing, future adjustments, and ongoing support are included at no extra cost. While NHS tests are also free, typical 6-week waiting periods often lead people to seek immediate private testing. We provide prompt, professional assessments that fit your schedule and budget.

Q: Do you offer home visits, and are they included in the price?

Yes, we offer completely free home visits throughout the UK, and this service is included in our prices with no additional charges. Home visits are particularly valuable for people with mobility issues, busy schedules, or those who simply prefer the comfort and convenience of their own environment. Our audiologists can conduct full hearing tests, fit hearing aids, and provide ongoing support in your home. This service sets us apart from many providers who either don't offer home visits or charge extra for them.

Q: Why are your hearing aids cheaper than what I'd pay on the high street?

We can offer prices up to 40% lower than high street retailers because of our business model. As a network of 200+ independent audiologists , we don't have the massive overheads of large retail chains - no expensive high street premises, no sales targets pushing audiologists to sell the most expensive options, and no costly marketing campaigns. However, we maintain the same buying power as the big chains because we purchase on behalf of our entire nationwide network. This means you get access to the same premium hearing aids with professional service, but at genuinely competitive prices.

Q: How long do I have to try the hearing aids before committing to keep them?

We offer a comprehensive 60-day money-back guarantee, which gives you twice the industry standard time to properly assess whether your hearing aids are right for you. This extended period recognises that adjusting to hearing aids takes time, and your brain needs several weeks to adapt to the amplified sounds. Unlike many providers who offer just 30 days, we believe 60 days gives you the confidence to test your hearing aids in all the situations that matter to you - from quiet conversations at home to busy restaurants and outdoor activities.

Q: Can I really buy hearing aids online without visiting a clinic first? Why can't I do this with your company?

While some companies do sell hearing aids online without professional involvement, we don't offer this service because we genuinely believe it's not in your best interests. Hearing aids aren't like buying glasses online - they require professional assessment, precise programming to your specific hearing loss pattern, and proper fitting to work effectively. Through our network of over 200 qualified independent audiologists across the UK, we ensure you receive a proper hearing test, expert guidance on the right device for your needs, and professional fitting. This approach means you're far more likely to be satisfied with your hearing aids and actually use them regularly.

What is Asymmetric Hearing Loss (AHL)?

Causes, treatments, and challenges

Last Hearing Aid UK Update: 31/03/2026

An uneven hearing loss between the ears

Asymmetric hearing loss refers to a significant difference in hearing ability between the two ears, and it can be more common than many people realise. Causes include infections, trauma, tumours, and Meniere's disease. Symptoms often include difficulty locating sounds and understanding speech in noisy environments.

Diagnosis and treatment involve audiometric tests, imaging, and tackling the root condition.

The quiet battle

Our senses play a vital role in finding our way through our daily lives. Hearing, in particular, allows us to connect with others, enjoy music, and stay alert to our surroundings. But what happens when this sense starts to falter unevenly?

This is known as asymmetric hearing loss (AHL), and it has a major impact on the number of people in the UK, often silently interfering with their lives. You might be trying to follow a conversation in a busy cafe, for example, but struggle to pick out words, not realising your hearing is uneven.

Many individuals may not report symptoms simply because they assume “just one ear is a bit worse". The other person might seem louder, but it's not their voice that's different; it’s your ear struggling to keep up. This mismatch can lead to listening fatigue, where constantly straining to hear leaves you exhausted.

In this article, we briefly explore the reasons behind uneven hearing loss between the ears and how hearing care professionals can assist with treatment.

What is asymmetric hearing loss?

Asymmetric hearing loss is when there's a noticeable difference in hearing between one ear and the other. Unlike symmetric hearing loss, where both ears are affected in a similar way, the gap between ears can vary quite a bit from person to person.

In some cases, one ear may have perfectly normal or near-normal hearing while the other has anything from a mild to a profound loss. This can actually make things trickier to spot, because the stronger ear often compensates in everyday listening, masking just how much the other ear is struggling.

For most people with hearing loss, both ears are affected to a fairly similar degree. But if a hearing test shows a significant difference between ears, your hearing care provider may refer you to an ENT specialist before looking at hearing aids. This is because uneven hearing can sometimes point to an underlying condition, and in some cases, that condition may be treatable or even reversible.

How asymmetric hearing loss affects you day-to-day will depend on the degree of difference between your ears. Certain everyday situations can become particularly difficult, crossing a busy road, for instance, or trying to follow a conversation in a noisy room.

How asymmetric hearing loss impacts daily life

Asymmetric hearing loss can have a strong effect on quality of life as communication becomes challenging and sound localisation, together with clarity, is compromised.

Simple conversations can be exhausting, and social engagements may become frustrating. This often leads to social withdrawal and isolation, changing mental health, which in turn can affect mental health and self‑confidence.

Imagine trying to follow a conversation at a family gathering while sitting at a table, only to find that people on one side of you are almost inaudible. It can leave you constantly asking people to repeat themselves, which can be awkward and tiring.

One of the most significant and often underestimated challenges of asymmetric hearing loss is working out where sounds are coming from. Busy streets, crowded restaurants, noisy offices: these kinds of environments can quickly become overwhelming when your ears aren't giving you a consistent picture.

It can also raise real safety concerns. Sounds that most people pick up on automatically, such as an oncoming car or a smoke alarm, can be surprisingly easy to miss. Which is exactly why getting the right assessment and finding a solution that's tailored to you makes such a difference.

Causes Of Asymmetrical Hearing Loss

Causes of asymmetric hearing loss

There are a number of things that can cause asymmetric hearing loss, such as:

Acoustic neuroma: A non-cancerous tumour on the vestibulocochlear nerve that can affect hearing in one ear, often comes with tinnitus and imbalance.
Sudden sensorineural hearing loss (SSNHL): A type of hearing loss that arrives suddenly and almost always in one ear rather than both. Pinning down the exact cause can be difficult, though viral infections, autoimmune conditions, and circulation problems have all been linked to it.
Ménière's disease: An inner ear condition that can bring vertigo, tinnitus, and hearing loss together, and one worth taking seriously, as the hearing loss can become permanent if it isn't properly managed.
Noise exposure: Loud noise over a prolonged period doesn't always damage both ears the same; if one ear is consistently more exposed, it may bear the brunt.
Otosclerosis: A condition where abnormal bone growth in the middle ear affects hearing, and more often than not, one ear is affected more noticeably than the other.
Ear infections and trauma: Whether it's a persistent infection or a physical injury like a knock to the head, damage to one ear can result in a meaningful difference in hearing between the two sides.

It's also worth bearing in mind that age-related changes, or hearing loss that's gone unaddressed for a long time, can quietly widen the gap between ears over the years.

Related reading: What is an acoustic neuroma?

Asymmetric hearing loss

What is Asymmetric Hearing Loss?

Diagnosing and treatments

Diagnosing asymmetric hearing loss

Working out what's behind asymmetric hearing loss usually takes a proper evaluation from an audiologist or ENT specialist. There's no single test that gives you all the answers, so they'll typically look at things from a few different angles.

That starts with your hearing itself — a series of tests to measure exactly how much loss there is in each ear and what kind it is. Bone conduction testing often comes into play, helping the specialist figure out whether the issue lies in the outer/middle ear, the inner ear, or both.

If there's reason to look deeper, imaging such as an MRI or CT scan may be recommended. These can reveal structural causes that wouldn't show up in a hearing test alone — a tumour on the hearing nerve, for example.

Blood tests can help rule out any underlying conditions that might be involved, and your medical history will give your specialist a useful background. If you've had any dizziness, vertigo, or balance problems, mention these too — they can be more relevant to your hearing than you might expect.

Treatment for asymmetric hearing loss

Once asymmetric hearing loss is diagnosed, these common treatments might be recommended by an audiologist:

Hearing aids: Custom-fitted hearing aids amplify sound to make listening easier and less effortful. When it comes to asymmetric hearing loss, audiologists will often recommend fitting both ears, even if one is considerably better than the other. Having both ears aided helps maintain spatial hearing and goes some way towards offsetting the head shadow effect.

The difference this can make in day-to-day life is real. Something as simple as following a conversation while driving becomes far less of a struggle when both ears are working together.

Cochlear implants: In cases of severe to profound hearing loss, cochlear implants may be an option. These electronic devices bypass damaged parts of the ear and directly stimulate the auditory nerve.
Medications and surgery: For conditions like SSNHL or Meniere’s disease, medication may support symptom management. Surgery might be necessary for cases involving tumours or structural issues.
Routine check-ups: Because asymmetric hearing loss may evolve, ongoing follow-up is often advised to track changes and re-evaluate treatment.

Related reading: Hearing aids vs cochlear implants

Fitting hearing aids for asymmetric hearing loss

Your treatment options will depend on the cause and severity of your hearing loss. Usually, hearing aids, bone-anchored hearing devices, or cochlear implants are recommended.

Fitting hearing aids for AHL can be a more involved process. You may find that at first, the balance between both ears feels strange. This is normal, especially when one ear has much better residual hearing than the other.

Getting the hearing aid settings right can take a little time, and your audiologist may need to make a few adjustments along the way. Try to be patient with the process; giving your brain time to adapt to hearing things differently really does make a difference.

This type of hearing loss can be more complex, and finding the right solution could entail some trial and error. It can sometimes take several appointments before you reach a “sweet spot” in the programming.

The aim is to balance the sound reaching each ear as much as possible, though the bigger the difference between ears, the more complex it can be to achieve.

Modern hearing aids can often be adjusted by an audiologist to accommodate the differences between your ears. However, if the hearing loss is severe in one ear or if one ear is completely normal, bone-anchored hearing devices might be a better option.

If you are fitted with hearing aids, remember to be patient while you are adjusting to them. You may need additional adjustments to achieve the right balance for your specific hearing needs, and it might take your brain a bit longer to integrate the amplified sounds.

Using a hearing-aid programme with directional microphones and noise reduction can help compensate for the “weaker” ear, especially in difficult settings.

The effort will pay off, and the health benefits of using hearing aids to treat asymmetrical hearing loss will improve your ability to localise sounds. Better spatial hearing not just assists with conversation, it also supports safety in daily life (e.g. judging where sound is coming from).

Living with symmetric hearing loss

Adapting to life with asymmetric hearing loss requires different approaches. Below are some strategies that can help:

Communication tactics: Positioning yourself so the better-hearing ear is towards the sound source, using visual cues, and reducing background noise can improve communication.

For example, in a meeting at work, sitting so that the better ear is facing the speaker will help ensure you hear them clearly. Also, you might gently ask family or colleagues to face you when speaking, which can help quite a lot.

Assistive listening devices: Devices like FM systems and loop systems may improve sound quality in specific environments. It's also worth exploring remote microphones or Bluetooth receivers, which can help with one-ear amplification.
Support networks: Joining support groups or seeking counselling may deliver emotional support and practical advice. Connecting with others who understand the frustration of uneven hearing can make a world of difference to your mental well-being.

You can also download the white paper on Asymmetric hearing loss from the Royal Australian College of General Practitioners by clicking on the green button further down the page.

Safety planning: Since it can be harder to tell which direction sounds are coming from, it's worth taking a little extra care when crossing roads, driving, or moving through busy areas. At home, visual warning systems — like flashing fire alarms — are worth considering if you feel they'd be useful.
Self-monitoring: Try keeping a note of situations where you find listening particularly tough, including when and where they happen. It might feel like a small thing, but this kind of detail can really help your audiologist fine-tune your treatment and get the balance between ears just right.

Conclusion

Asymmetric hearing loss doesn't always get the attention it deserves, but for people who have it, it can have a big effect on their daily lives. The good news is that there is a lot that can be done, and getting a specialist involved sooner rather than later really does make a difference.

The right support and technology can make an enormous difference, both practically and in terms of feeling less alone with it. Many people with asymmetric hearing loss find that modern hearing aids give them back a real sense of control, and that things do get easier with time and the right help.

One final thing worth mentioning: keeping up with regular check-ins with your audiologist or ENT is important. Hearing profiles can change, and so can the technology available to help, so it's not a case of being seen once and that being that.

Asymmetric hearing loss conclusion

Asymmetric hearing loss doesn't always get the attention it deserves, but for those living with it, the effects on everyday life are very real. The good news is that with the right support, the right technology, and a specialist in your corner, it doesn't have to define your experience.

If you or someone you know has been struggling with hearing difficulties, it's worth getting it checked out — the sooner, the better. Modern hearing aids and assistive devices have come a long way, and many people with AHL find they're able to regain confidence and feel much more in control of how they hear the world around them.

Common FAQs about hearing aids and hearing loss