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

What is Bilateral Hearing Loss (BHL)?

What is it, what are the symptoms, causes, and treatments?

Introduction    |    Degrees of hearing loss    |    Causes    |    Symptoms    |    Types    |    Treatments    |    Resources    |    Living with bilateral hearing loss    |    Conclusion

Overview

Bilateral hearing loss refers to the reduction in hearing ability in both ears. It can be caused by factors such as ageing, exposure to loud noises, infections, or genetic conditions.  However. it is normally due to the damage of the stereocilia, which are hair-like cells in the inner ear. 

Treatments often require interventions like hearing aids or cochlear implants, depending on severity and type.  Here we briefly discuss the symptoms, causes, treatments, types, and how to live with bilateral hearing loss.

A hearing loss in both ears is called bilateral hearing loss

If you have bilateral hearing loss it means both ears are affected.  This type of hearing loss commonly occurs gradually over a long period of time.  However, in some instances, it can be sudden, such as the result of too much exposure to loud noises.

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.

This is why it is important to be seen by an audiologist if you suspect anything.  They will test your hearing, analyse the severity, diagnose the loss, and tailor treatment to your specific needs. 

Here are the degrees of hearing loss and what it means for you:

• Mild:  You may hear some speech, but softer sounds or speech from a distance will be difficult to hear.
• Moderate:  You might struggle to hear faint speech and will have difficulty with conversations at a normal volume.
• Severe: You’ll likely hear no speech during a conversation at a normal volume and will miss some loud sounds.
• Profound:  With profound hearing loss, you won't be able to hear normal or loud speech and will have difficulty with even very loud sounds unless they are extremely loud.

Causes of bilateral hearing loss

Genetics:  What causes bilateral hearing loss?  It is possible to be born with bilateral hearing loss as it can be inherited from either one or both parents.

Medications:  There are some known medications that can be a trigger for developing bilateral hearing loss, such as ototoxic drugs which can cause damage to the ears.

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.

Ageing:  Presycusis, also known as age-related hearing loss, is the most common form of sensorineural hearing loss.  This, in turn, is one of two forms of bilateral hearing loss, the other is conductive.

Ear infections and earwax:  Continuous ear infections can cause blockages or structural damage to the ears.  Similar to earwax buildup, which can also rupture the eardrum if accessive and left untreated.

Symptoms of bilateral hearing loss

What are the symptoms of bilateral hearing loss?  It can sometimes be difficult to recognise symptoms of bilateral hearing loss, especially if it is gradual.  However, if you do notice any change in your hearing, seek professional advice and support from an audiologist in your area.

Here are some common signs:

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

Types of bilateral hearing loss

There are two types of bilateral hearing loss, these are sensorineural and conductive.  In short, sensorineural hearing loss occurs when the tiny hair cells in the inner ear or the auditory nerve, which transmits sound to the brain, are damaged.

This type of hearing loss is typically caused by the natural ageing process or prolonged exposure to loud noises. 

Conductive happens in the outer or middle ear, where sound is converted into vibrations and transmitted to the inner ear. When there's a blockage or other issue in these areas, sound waves may not effectively reach the inner ear.

Causes include excessive ear wax, a ruptured eardrum, or ear infections.

Bilateral Hearing loss (BHL)

Treatments and living with this type of hearing loss

Treatments for bilateral hearing loss

Modern hearing aids provide a natural hearing experience for those with bilateral hearing loss. Unlike older models that simply amplify sound, today's hearing aids send detailed sound signals to the brain, allowing for better hearing with less effort.

They significantly improve speech understanding and enhance the clarity and detail of surrounding sounds, creating a clearer listening environment.

For more severe cases, and you have experienced profound hearing loss from birth, cochlear implants are an excellent option. These electronic devices are surgically inserted into the inner ear and are a popular solution.

They work by replacing the damaged nerves responsible for sending electrical signals to the brain.

Is bilateral hearing loss a disability?

 
If you suffer from bilateral hearing loss, you might not consider yourself disabled. However, if your hearing loss is severe or profound, you may be eligible for disability benefits and grants, depending on the extent of the damage.

These resources can assist with daily life, offering support through specialist technologies, assistive devices, and in-person help, enabling you to communicate more effectively - either at home or in the workplace.

Find out more by visiting the RNID website at www.rnid.org.uk, or download the NHS whitepaper on bilateral hearing loss by clicking on the green button further down the page.

Living with bilateral hearing loss

Living with bilateral hearing loss can be challenging, but today's technology makes it easier. Modern hearing aids and cochlear implants offer clear, detailed sound, enhancing everyday interactions.

Support from loved ones and hearing professionals are also invaluable parts of future hearing health.  While adjustments are needed, staying active, social, and engaged helps maintain a fulfilling life despite hearing challenges.