I think I have hearing loss because I can hear but not understand: What you need to know

I can hear but not understand

Exploring how hearing loss affects speech clarity

Overview    |    Understanding your ear's anatomy    |    Common ear problems    |    What to do when hearing loss is present    |    Conclusion

Hearing but not understanding words isn't as uncommon as you think

Some are born with a hearing impairment, whilst others develop hearing loss over time, and there are others who lose the ability more rapidly.  When you can hear but not understand words, speech might sound muffled.  In quiet environments, you might be able to catch words, but throw in a babble of noise, and you might struggle, or you might find it tricky all the time.

Whatever the scenario, this article highlights the importance of knowing why you can hear but not understand, why determining the cause is vital, and what you can do about it.

But first, let's take a brief look at your ear's anatomy

To understand any form or level of hearing loss, it's beneficial to look at the anatomy of your ears.  Losing your ability to hear can be caused by issues with either your outer, middle, or inner ear. 

An audiologist's job is to determine what the cause is, where it originates from (outer, middle, or inner), and once clear, advise on the best form of treatment.  Here is a breakdown of all three and the main problems that occur in those areas of the ear.

Related reading:  What is an audiologist?

Complications and parts of your outer ear, middle ear, and inner ear

Parts of the outer ear

This is what you can see, along with the ear canal that leads to your eardrum.

Common problems of the outer ear

Earwax can directly interfere with hearing when it builds up.  Normally, earwax naturally expels, but due to structural abnormalities, excessive use of cotton buds, and other causes, this process can be hindered.  When this happens, the wax stops the sound waves from travelling to your eardrum, resulting in muffled sound and speech.

Another outer ear problem is infection, which can also be known as swimmer's ear.  Usually painful, it targets the skin in your auditory canal, causing redness, swelling, and discharge.

Although unpleasant, an ear infection is easy to treat with drops or a course of prescribed antibiotics for those severe and prolonged cases.

Parts of the middle ear

This is the other side of your eardrum, made up of three of the tiniest bones in your body - the malleus, incus, and stapes (you might also hear these being referred to as the hammer, anvil, and stirrup).  

Common problems with the middle ear

Similar to the outer ear, fluid can build up in your middle ear and cause infection, also known as otitis media, which also muffles hearing.  Common symptoms involve pressure and fullness behind your eardrum.

If such symptoms continue, your eardrum can be at risk of rupturing.  However, generally, after being diagnosed by your GP, you can be prescribed antibiotics if not detected as viral.  If viral, the infection will usually resolve naturally within a few days and can be managed with decongestants (available at your local pharmacy) in the meantime.

Parts of the inner ear

This includes the cochlea, which turns sound vibrations into nerve impulses that then travel to your brain.  Your semicircular canals also live here; these are responsible for balance.

Common problems with the inner ear

The main issue that could present itself in the inner ear is sensorineural hearing loss, also known and abbreviated as SNHL.  This type of hearing loss is usually due to problems in either the nerve pathways (between your inner ear and your brain) or the cochlea (the snail-shaped bone in your inner ear).

Causes of SNHL could be head trauma, loud noise exposure, genetic traits, ageing, and prolonged use of certain medications.  Diagnosing SNHL requires a hearing test, which will highlight difficulties hearing soft sounds and sometimes loud ones.  This would explain why you might be able to hear, but struggle to understand (especially in loud environments).

Related reading:  Hearing aids for sensorineural hearing loss

Key points:

1. When you feel you can hear but not understand can indicate a sensorineural hearing loss.
2. The common treatment for this hearing issue is often hearing aids.
3. In rare cases, this hearing problem can be due to other complications with your brain or auditory system. 

When hearing loss is present, what can help?

If you are able to hear but unable to understand people's words, we advise that you book a hearing assessment with a professional audiologist.  They will check all parts of your ear, along with how well you hear in different frequencies, with an audiogram (hearing test).

It is then that they can diagnose if hearing loss is present and whether hearing aids can help you, your loss, and your specific needs.  In a nutshell, those who hear but don't understand find it easier to do just that by wearing hearing aids. 

This is made possible because these devices amplify specific frequencies, particularly consonant sounds, which are important for speech clarity.

Another benefit is that they also help reduce background noise, making it easier for you to focus on the sounds you want to focus on, such as speech.

I can't understand, even though I can hear.  I can handle it, though!

There are risks to ignoring hearing loss, which might surprise you, especially if you're tempted to 'get by'.  Not seeking hearing support, even if you think your hearing loss is mild, can instigate social isolation, cognitive decline, an increase in falls, general safety concerns, and poor mental health. 

Addressing hearing loss mitigates these risks and secures a better future for your well-being and hearing health.