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Audiology Expert
I can hear but not understand
Exploring how hearing loss affects speech clarity
Overview | It's not that uncommon | Understanding your ear's anatomy | Common ear problems | What to do when hearing loss is present | Why you shouldn't ignore hearing loss | Summary
Overview
If you can hear sounds but struggle to understand words, especially in noisy places, it may be due to sensorineural hearing loss (SNHL) or other ear issues like wax buildup or infections.
An audiologist can identify the cause, and hearing aids often help by clarifying speech and reducing background noise.
Ignoring the problem can lead to isolation, cognitive decline, and safety risks, so early assessment is important.
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:
- When you feel you can hear but not understand can indicate a sensorineural hearing loss.
- The common treatment for this hearing issue is often hearing aids.
- 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.
Summary
Many people can hear sounds but struggle to understand words, especially in noisy environments. Hearing difficulties can stem from problems in different parts of the ear—the outer, middle, or inner ear.
Common issues include earwax build-up, infections, and sensorineural hearing loss (SNHL), which affects the inner ear or auditory nerve pathways.
Sensorineural hearing loss is often the cause of hearing without understanding. Hearing aids are a common solution, as they amplify important speech frequencies, particularly consonants, and reduce background noise to improve clarity.
Early diagnosis through hearing tests is important. Ignoring hearing loss can lead to social isolation, cognitive decline, safety risks, and poor mental health. Seeking professional support helps protect hearing health and overall well-being.
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Struggling to understand, even though you can hear?
If you're struggling to hear but can’t fully understand speech, it could be a sign of underlying hearing loss. Early detection and treatment, such as a hearing assessment from an audiologist, can help you regain clarity and improve your quality of life.
Hearing aids can make a big difference by amplifying essential speech sounds and reducing background noise. But ignoring even mild hearing loss could lead to greater risks, like social isolation or cognitive decline.
Book your hearing assessment today. We can support you either in one of our clinics in your area or at your home at no extra cost.
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FAQs
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.
If you have significant hearing loss in both ears, you should be wearing two hearing aids. Here are the audiological reasons why:
Localisation: The brain decodes information from both ears and compares and contrasts them. By analysing the minuscule time delays as well as the difference in the loudness of each sound reaching the ears, the person is able to accurately locate a sound source.
Simply put, if you have better hearing on one side than the other, you can't accurately tell what direction sounds are coming from.
Less amplification is required: A phenomenon known as “binaural summation” means that the hearing aids can be set at a lower and more natural volume setting than if you wore only one hearing aid.
Head shadow effect: High frequencies, the part of your hearing that gives clarity and meaning to speech sounds, cannot bend around your head. Only low frequencies can. Therefore, if someone is talking on your unaided side, you are likely to hear that they are speaking, but be unable to tell what they have said.
Noise reduction: The brain has its own built-in noise reduction, which is only really effective when it is receiving information from both ears. If only one ear is aided, even with the best hearing aid in the world, it will be difficult for you to hear in background noise as your brain is trying to retain all of the sounds (including background noise) rather than filtering them out.
Sound quality: We are designed to hear in stereo. Only hearing from one side sounds a lot less natural to us.
Fancy some further reading on this topic? You can read about why two hearing aids are better than one in our article, hearing aids for Both Ears, here
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.
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.
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 manufacturer has no channels at all.
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.
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.
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.
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.
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.
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