Hearing aids

Expert reviewer, Mr Anil Banerjee, Ear, Nose and Throat Consultant
Next review due March 2023

Hearing aids are electronic devices that you wear in or behind your ear. They make sounds louder and clearer so you can hear them more comfortably. You may need a hearing aid if you have trouble hearing, especially if you find it hard to communicate.

Why you might need a hearing aid

You can have trouble hearing properly for many different reasons. Hearing loss can be caused by a problem with your inner, middle or outer ear or by the way sound signals travel to your brain.

A hearing aid may help you if:

  • your hearing loss is getting worse as you get older – this may be caused by damage to the hair cells in your inner ears
  • sound can’t pass easily from your outer ear to your inner ear – this may be caused by a blocked outer ear or a problem with your middle ear such as a build-up of fluid (glue ear)
  • your auditory nerve is damaged, which means sound signals don’t travel to your brain – this may be caused by an infection or injury

A hearing aid may also help if you have tinnitus (buzzing or ringing in your ears). If you can hear background sounds more clearly, you’re less likely to notice the sounds coming from inside your ears.

Benefits of hearing aids

Many people who need hearing aids don’t wear them. This may be because they think hearing aids don’t work well or are uncomfortable, difficult to use and too noticeable. But hearing aids have improved in sound quality and accuracy over the years. Modern hearing aids can also be very discreet and easy to use. So, if you’ve tried to use hearing aids in the past and found they didn’t work, it’s worth trying them again.

A hearing aid won’t restore your normal hearing. But it can make certain sounds louder and clearer, helping you to communicate more easily with family, friends and work colleagues. If you have hearing loss, wearing a hearing aid can improve your quality of life.

Having a hearing test

If you think there’s a problem with your hearing, you could start with a telephone or online hearing check. Some high street pharmacies and opticians offer free NHS hearing check-ups too.

If your hearing suddenly gets worse or one ear seems worse than the other, speak to your GP. They may refer you to an audiologist (a healthcare professional who specialises in hearing problems). Or they may suggest you see an ENT specialist (a doctor who specialises in ear, nose and throat conditions). This is more likely to happen if you have sudden hearing loss, tinnitus or pain in your ear.

Your audiologist will ask you questions about your hearing and check your ears. They’ll then test your hearing to see if they can find a cause for your hearing loss and decide if a hearing aid will help.

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How do hearing aids work?

Hearing aids are small devices that you wear in or behind your ear. They’re made up of a microphone, amplifier and speaker. The microphone picks up sound and converts this into electrical signals that are sent to the amplifier. The amplifier makes the sounds louder and sends them to your ear through the speaker. With behind-the-ear hearing aids, the microphone, amplifier and speaker are attached to an ear mould that fits around your ear. With an in-the-ear hearing aid, these are part of the ear mould itself.

Hearing aids make all noises louder, including background noise. But most of them can be programmed to distinguish between the sounds you’re trying to hear (such as voices) and background noise. Hearing aids won’t make your hearing perfect, but they’ll help you hear everyday sounds more clearly.

Types of hearing aids

Hearing aids are available in analogue and digital versions. Analogue and digital hearing aids work in different ways. Most hearing aids are now digital, whether they’re available on the NHS or privately.

Digital hearing aids

Digital hearing aids work like a mini-computer. They can be programmed to suit your individual hearing loss and make the sounds you hear as clear as possible. You can even programme them to suit different environments, such as a quiet living room or a crowded restaurant. This reduces background noise and makes listening to conversations much more comfortable.

Analogue hearing aids

Analogue hearing aids are the cheapest type of hearing aid. They increase all noises, including background noise. Your audiologist will set the quality of sound you hear when your hearing aid is fitted. This can’t be changed at all. But you can change the volume yourself, turning it up or down when you need to.

Wearing a hearing aid

Hearing aids come in various shapes and sizes. The main types of hearing aid sit in or behind your ear. Not all types are suitable for everyone. Your audiologist will show you different hearing aids and help you choose the best type to suit your needs.

  • Behind-the-ear hearing aids have a plastic case that sits behind your ear and an ear mould that fits into your outer ear. An open fit, behind-the-ear hearing aid has a soft earpiece instead of an ear mould. This can make sounds more natural. But you’ll only be able to use an open fit hearing aid if you have mild-to-moderate hearing loss.
  • In-the-ear hearing aids fit completely inside your outer ear. They’re usually less noticeable than behind-the-ear hearing aids, but may not be right for you if your hearing loss is very bad.
  • Completely-in-canal hearing aids are smaller and less noticeable than other styles of hearing aid. They’re almost totally hidden inside your ear canal. This can make them fiddly to use.

If you have conductive hearing loss, you may benefit from a bone conduction hearing aid. This is when sound can’t pass easily from your outer ear to your inner ear. You may also need to wear one of these if you can’t wear one of the more common types of hearing aid. This could be because you’ve had surgery, your ear has an unusual shape or you’ve not reacted well to other types of hearing aid. Bone conduction hearing aids work by passing vibrations through your skull directly to your inner ear.

If you have poor eyesight or find it hard to use small controls, a hearing aid that you wear on your body may be helpful. This type of hearing aid has a small box that you can put in your pocket or attach to your clothes. The box is connected to a plastic ear mould by a wire.

If your hearing loss is very bad and isn’t helped by a hearing aid, you may be recommended to have a cochlear implant. This is an electronic device made up of several parts that are surgically inserted into different areas of your ear. This includes your inner ear and under the skin behind your ear.

Caring for a hearing aid

Your audiologist will show you how to look after your hearing aid so it works well and lasts for as long as possible. Your hearing aid should come with instructions about how to use and clean it. You may find the following tips helpful too.

  • If you have a behind-the-ear hearing aid, remove and wash the ear mould in warm soapy water every night. Don’t wash the hearing aid itself.
  • If you have an in-the-ear hearing aid, clean it regularly with a soft, dry cloth, making sure to remove any earwax that’s built up on it. Never use a damp cloth or any fluid to clean it.
  • When you're not wearing your hearing aid, store it in a cool dry place, away from heat, strong light and moisture.
  • Change your hearing aid batteries as soon as they stop working.
  • Check your hearing aid tubing for cracks or hardening. It may need to be replaced every three to six months.

Living with a hearing aid

Wearing a hearing aid shouldn’t make you feel embarrassed. Think of it as no different from wearing glasses or contact lenses if you can’t see clearly. Lots of people of all ages wear hearing aids for many different reasons.

It may take you a while to get used to wearing a hearing aid. You’ll need to gradually build up wearing it, so you get used to different sounds, places and situations. Sounds may seem different or odd at first, and background noise may seem too loud.

You’ll also need to learn to:

  • put in and take out your hearing aid comfortably
  • use the volume controls and other settings
  • use different settings for different environments
  • replace your hearing aid batteries – carry spare batteries with you at all times

You may find it hard to use normal telephones with your hearing aid. Your hearing aid may make a squealing sound when you put your ear near the phone. Most hearing aids have a loop setting to use with listening equipment, such as induction loops and hearing aid compatible telephones. Loop systems and devices take sound directly to your hearing aid and cut out background noise. Many hearing aids will also link up to Bluetooth-compatible devices, such as TVs and laptops.

Wearing hearing aids doesn’t mean you’ll be able to hear perfectly. It may help if you ask your family and friends to:

  • speak clearly and at a normal pace (not too fast or too slow)
  • talk a bit more loudly than usual, but don’t shout
  • reduce any background noise such as the radio
  • face you when they talk to you
  • use hand gestures and movements (e.g. nod/shake their head), especially if you’re in a noisy environment

Some people with a hearing aid find that wax builds up or becomes impacted in the ear canal. This can cause symptoms, such as discomfort or hearing loss because of the blockage. If you think you’ve got a build-up of ear wax, you can have this removed.

If you have any problems with using your hearing aid, ask your audiologist for advice.

Frequently asked questions

  • It’s important to keep your hearing aid dry. This is because water can damage the electronic parts and the battery. You'll need to remove your hearing aid when you go swimming and store it safely in a waterproof container. You’ll also need to remove it or be careful to keep it dry when you have a bath or shower. Swimming pools have bad acoustics, which means your hearing aid will make background noise louder than usual. So even if you wear your hearing aid when you’re out of the water, you may not be able to hear everything clearly.

    It’s important to tell the lifeguard or swimming teacher if you have any level of hearing loss. You may not hear them blow their whistle or shout in an emergency. It’s vital you make them aware so they can help keep you safe.

  • This will depend on whether you have hearing loss in one or both of your ears and whether or not hearing aids will help.

    If your hearing loss is in both ears, it may help you to have a hearing aid in each ear. Two hearing aids can help you follow conversations when there’s background noise and help you tell which direction sound is coming from. Your audiologist will show you how to identify each hearing aid. They usually have colour markers (red for your right ear and blue for your left ear).

  • It can take a few months to feel comfortable wearing your hearing aid, so you’ll need to be patient. Wear your hearing aid regularly and build up how long you wear it for each day. If it feels comfortable, wear it for as long as you can. Learning how the settings work will also help you get used to using it. Your audiologist can show you how to use your hearing aid and look after it properly. For more information, see our sections Living with a hearing aid and Caring for a hearing aid above.

    While you’re getting used to your new hearing aid, you may have the following problems.

    • Your hearing aid may feel uncomfortable at first. Ask your audiologist how long to wear it for each day so you can get used to it.
    • Your voice may sound too loud. Most people get used to this after wearing their hearing aid for a while.
    • You may get feedback, such as whistling or squealing, from your hearing aid. This may be because your hearing aid has earwax in it or there’s a problem that needs to be fixed.
    • You may hear more background noise. This is because your hearing aid won’t completely separate the sounds you want to hear from the ones that you don’t want to hear. Sometimes adjustments can be made for this.

    You should be offered a follow-up appointment with your audiologist about six to 12 weeks after you’ve had your hearing aid fitted. This is to check your hearing aid is fitted properly and you’re not having any problems. If you have problems before your follow-up appointment, don’t wait – contact your audiologist for advice.

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  • Reviewed by Michelle Harrison, Specialist Health Editor, Bupa UK Health Content Team, and Victoria Goldman, Freelance Health Editor, March 2020
    Expert reviewer, Mr Anil Banerjee, Ear, Nose and Throat Consultant
    Next review due March 2023