What is bilateral hearing loss?: The causes, symptoms, treatments, and types explained

What is Bilateral Hearing Loss?

The symptoms, causes, and what can help

Introduction    |    Degrees of hearing loss    |    Causes    |    Symptoms    |    Types    |    What can help?    |    Resources    |    Living with bilateral hearing loss    |    Conclusion

Last Hearing Aid UK Update:  16/10/2026 

Hearing loss in both ears

Bilateral hearing loss simply means your hearing is reduced in both ears. It can come about for lots of reasons, from getting older or years of loud noise to infections or something you’ve inherited. It’s often caused by damage to the tiny hair cells in the inner ear, although problems in the outer or middle ear can also affect both ears.

RNID estimates that around 18 million adults in the UK are deaf, have hearing loss or have tinnitus. Understanding the condition and getting checked early means you can find the right support sooner.

What helps depends on the type and severity of your hearing loss, but often includes hearing aids or, for more severe loss, cochlear implants. Here, we briefly discuss the symptoms, causes, what can help, types, and how to live with bilateral hearing loss.

If you've found yourself turning your head frequently to hear someone better or avoiding phone calls because you can’t quite catch what’s being said, you might be dealing with bilateral hearing loss, without even realising it.

A hearing loss in both ears is called bilateral hearing loss

This type of hearing loss commonly occurs gradually over a long period of time.  However, in some instances, it can be sudden, sometimes after exposure to very loud noise, although often there is no obvious cause. If your hearing changes suddenly in one or both ears, the NHS advises asking for an urgent GP appointment or contacting NHS 111.

How you experience and manage bilateral hearing loss will be different from the next person.  For example, the hearing loss can be symmetrical, where the loss is the same severity in both ears or asymmetrical, where the loss is unbalanced.  This means you'll hear better on one side.

Picture yourself on a busy train platform, trying to chat with a friend, or standing at the kerb unsure which direction the traffic is coming from. When both ears aren’t hearing as well as they should, everyday moments like these can feel surprisingly disorientating. That’s because working out where a sound is coming from depends on both ears hearing in balance.

If your hearing loss is asymmetric, meaning one ear is worse than the other, that sense of direction can be thrown off even more. It can make busy streets and driving feel less safe.

That’s why it’s worth speaking to your GP or an audiologist if you notice any changes. An audiologist will test your hearing, find out what type of hearing loss you have and how much, and recommend support that suits you.

Here are the degrees of hearing loss, with decibel ranges from the National Deaf Children’s Society:

• Mild (21 to 40 decibels): You can usually follow a conversation, but quiet voices, whispers or someone talking from across the room can be hard to catch.
• Moderate (41 to 70 decibels): Everyday conversation at a normal volume starts to feel like hard work, and you may find yourself asking people to repeat themselves often.
• Severe (71 to 95 decibels): You probably won’t hear speech at a normal volume at all, and even some loud sounds, like a doorbell or a phone ringing, can slip past you.
• Profound (more than 95 decibels):  With profound hearing loss, you won't be able to hear normal or loud speech and will have difficulty with even very loud sounds.

These thresholds vary slightly between organisations, so your audiologist may describe your results using slightly different bands.

People often dismiss early symptoms, blaming “selective hearing” or just thinking others are mumbling. But recognising these warning signs early can often make a big difference to how well hearing aids and other support work for you.

RNID notes that hearing loss has been linked to a higher risk of dementia. Researchers are still working out exactly why, but it’s one more reason not to ignore changes in your hearing.

Causes of bilateral hearing loss

Genetics:  Sometimes hearing loss is simply passed down. Some babies are born with reduced hearing in both ears because it’s been inherited from a parent, or from both.

Medications:  Some medicines can affect your hearing as a side effect. These are known as ototoxic drugs, and they can damage the delicate parts of the inner ear.

Common ototoxic medications include certain antibiotics (like gentamicin), chemotherapy drugs (such as cisplatin), high doses of aspirin, and some diuretics. Always talk to your GP about possible hearing side effects if you’re prescribed these medications. Don’t stop or change any medication without speaking to your doctor first.

Loud noise exposure:  If you are exposed to loud noises over a long period of time, it can cause temporary or permanent damage to your hearing.  

For example, if you’ve worked on building sites without hearing protection or regularly attended loud gigs without earplugs, your hearing could be taking more damage than you realise.

Ageing:  This is one of the most common causes of bilateral hearing loss. As we get older, our inner ear becomes less effective. This is known as presbycusis, or age-related hearing loss. This is a form of sensorineural hearing loss, which is one of the three main types of hearing loss, any of which can affect both ears.

Ear infections and earwax:  Continuous ear infections can cause blockages or structural damage to the ears, and a build-up of earwax can stop sound from reaching the inner ear properly.

Even something as simple as regular use of cotton buds can push wax deeper, making symptoms worse; another reason to leave ear care to professionals.

Additional causes include:

• A head injury that affects both ears
• Autoimmune inner ear disease (AIED), a rare condition where the immune system affects the inner ear
• Infections such as measles, mumps, or meningitis
• Ménière’s disease, which usually starts in one ear but can later affect both
• Cardiovascular conditions that may reduce blood flow to the inner ear
• Diabetes, which has been linked to hearing loss

Symptoms of bilateral hearing loss

Bilateral hearing loss doesn't always make itself obvious, especially when it develops gradually. You might not notice anything is wrong at first, which is why it can go unaddressed for longer than it should. If you do pick up on any changes in your hearing, however small, it's worth getting it checked out by an audiologist.

Here are some common signs:

• Having to rely on lipreading.
• Asking people to repeat what they have said.
• Finding it a challenge to hear within the background noise.
• Having to continuously turn up the volume.

You might also find yourself skipping busy cafes, going quiet at family dinners, or feeling worn out after seeing friends, simply because listening takes so much effort.

Types of bilateral hearing loss

Bilateral hearing loss can be one of three types: sensorineural, conductive, and mixed.  Sensorineural hearing loss happens when the tiny hair cells in your inner ear, or the nerve that carries sound to your brain, become damaged. It’s usually down to getting older or years of loud noise.

Conductive hearing loss is different. It happens in the outer or middle ear, the parts that carry sound through to the inner ear. The outer ear channels sound to the eardrum, and the tiny bones of the middle ear pass its vibrations on.

If something gets in the way, sound can’t travel through to the inner ear as well as it should. Common culprits include a build-up of earwax, a perforated eardrum or an ear infection.

Mixed hearing loss is a combination of the two, where there’s a problem in the outer or middle ear as well as the inner ear or hearing nerve.

Bilateral Hearing Loss (BHL)

What can help and living with this type of hearing loss

What can help with bilateral hearing loss?

Modern hearing aids can make a real difference for many people with bilateral hearing loss. Rather than simply making everything louder, they’re programmed to your hearing test results, so speech is clearer and listening takes less effort.

They make speech easier to follow and bring much more clarity and detail to the sounds around you, which for many people makes everyday listening feel noticeably less of a strain.

With many of today’s discreet, Bluetooth-enabled hearing aids, you can stream calls, music, and even the telly directly to your ears, ideal for keeping in touch and avoiding constant volume wars at home.

For people with severe to profound hearing loss in both ears who get little benefit from hearing aids, a cochlear implant may be considered after a specialist NHS assessment, in line with NICE guidance. These small electronic devices are surgically fitted into the inner ear and have helped a great many people access sound in a way that hearing aids alone cannot achieve.

They work by bypassing the damaged part of the inner ear and sending signals straight to the hearing nerve, which is why the NHS notes they only work if the hearing nerve itself is working. Cochlear implants are usually provided through the NHS and are not available through Hearing Aid UK.

Is bilateral hearing loss a disability?

If you live with bilateral hearing loss, you might not consider yourself disabled. However, hearing loss can count as a disability under the Equality Act 2010 if it has a substantial, long-term effect on your day-to-day activities. You may also be able to get help at work through the government’s Access to Work scheme.

This kind of support can make day-to-day life easier, whether that’s specialist equipment, assistive devices or help from a real person, so you can communicate more comfortably at home and at work.

Support might include workplace adjustments like amplified telephones or speech-to-text software, and you'll also find loop systems in many public venues like banks and cinemas. Find out more by downloading the NHS leaflet on bilateral hearing loss below.

Living with bilateral hearing loss

Bilateral hearing loss brings real challenges, but it's also an area where technology has come a long way. Technology aside, the human side of things counts for a lot too.

Supportive people, a hearing professional you feel comfortable with, and a willingness to stay engaged with life, socially, medically, and practically, all play their part. Staying proactive might sound like a small thing, but it really does make a difference to how manageable everything feels day to day.

Conclusion

Bilateral hearing loss means hearing is reduced in both ears. It can be caused by a range of things, from ageing and repeated exposure to loud noise to infections or genetics. You might notice yourself leaning on lipreading, asking people to repeat themselves, or really struggling to follow conversations in busy or noisy places.

It can be sensorineural, conductive or mixed, and there are options that can help with each. Modern hearing aids and cochlear implants can make a real difference to how clearly you hear and how well you follow conversation, and an audiologist will help you work out what suits your situation best and support you along the way.

Adjustment takes time, and there's nothing unusual about that. Getting used to hearing aids, finding communication approaches that feel natural, and regaining confidence in social situations is a gradual process, but for many people it gets easier with time and the right support.

How Hearing Aid UK can help

If you’ve noticed changes in your hearing, a free hearing test is a simple place to start. Hearing Aid UK connects you with over 200 independent, HCPC-registered audiologists across 93+ clinics, and you can have your test at a local hearing clinic or through a free home visit.

If hearing aids could help, your audiologist will fit and fine-tune them in person, with aftercare for life and a 60-day money-back guarantee, so you can try them in everyday life before deciding. We’re also Which? recommended.

Call us free on 0800 567 7621 to book your free hearing test.