Your First Hearing Test: What to Expect and How to Read the Results

Who Performs Hearing Tests

Most comprehensive hearing tests are done by an audiologist, a hearing specialist trained to identify and measure hearing loss and to recommend and provide treatments such as hearing aids. An otolaryngologist (ear, nose, and throat doctor, or ENT) is a physician who diagnoses and treats medical and surgical conditions of the ear. ^{[7] [6]} You might start with your primary care doctor, who can look in your ears and refer you, or you may be able to book directly with an audiologist.

If you're on Medicare, Part B covers diagnostic hearing and balance exams ordered by a provider, and you can see an audiologist once every 12 months without an order for gradual, non-acute hearing loss. You typically pay 20 percent of the Medicare-approved amount after the deductible. Original Medicare does not cover hearing aids or the exams for fitting them. ^[8]

Before the Test: History and Ear Exam

Expect questions about when you noticed changes, which ear seems worse, ringing or dizziness, noise exposure at work and in hobbies, medications, family history, and situations where hearing is hardest. It helps to jot these down beforehand, and to bring someone who knows how you're getting on day to day.

The clinician will also look into your ear canals with an otoscope. StatPearls notes that this visual exam should precede or accompany any hearing assessment, since earwax, fluid, or eardrum problems can affect results. ^[1] If wax is blocking the canal, it may need to be removed first; our guide to earwax and hearing explains why that matters.

The Main Parts of a Hearing Evaluation

Not every visit includes every test, but a comprehensive evaluation commonly includes: ^{[1] [7]}

• Pure-tone audiometry (air conduction). You sit in a sound-treated booth wearing headphones and press a button, raise a hand, or say "yes" each time you hear a beep, even a very faint one. Tones are played at different pitches, typically spanning roughly 125 or 250 Hz up to 8,000 Hz, to find the softest level you can hear at each. ^[10] This tests the whole hearing pathway. ^[2]
• Bone conduction. A small vibrating headband placed behind the ear sends sound directly to the inner ear, bypassing the outer and middle ear. A gap between air and bone conduction results suggests a conductive problem, such as fluid or a stiff middle-ear bone, rather than inner-ear damage. ^[1]
• Speech audiometry. You repeat words at different volumes. This measures the speech recognition threshold (the softest level at which you can identify speech) and a word recognition score (how clearly you understand words at a comfortable volume). Results also help guide hearing aid settings. ^[3]
• Tympanometry. A soft probe in the ear canal briefly changes air pressure to check how well the eardrum and middle ear move. Acoustic reflex testing, often done at the same time, checks a tiny muscle reflex in the middle ear. ^[1]
• Otoacoustic emissions (OAEs). A healthy cochlea actually produces faint sounds of its own. A probe measures them as a marker of outer hair cell function. ^[4]

None of these tests hurt. The main challenge is concentration, since you're listening for the faintest sounds you can detect, and it's normal to feel unsure whether you heard something. Respond anyway; the audiologist accounts for that.

How to Read Your Audiogram

Results are plotted on a chart called an audiogram. Pitch (frequency) runs from low on the left to high on the right. Loudness (in decibels hearing level, dB HL) runs from soft at the top to loud at the bottom. Each mark shows the softest sound you heard at that pitch, so the lower the marks sit on the chart, the more hearing loss. Right and left ears are usually shown with different symbols or colors.

Degrees of hearing loss are commonly described like this, based on one widely used classification: ^[9]

• Normal: up to 25 dB
• Mild: 26 to 40 dB (soft speech and speech from a distance or in noise become harder)
• Moderate: 41 to 55 dB (regular conversation is difficult, even up close)
• Moderately severe: 56 to 70 dB
• Severe: 71 to 90 dB
• Profound: 91 dB or more

The shape matters as much as the numbers. A line that slopes downward toward the high pitches in both ears is typical of age-related loss, while a dip around 3,000 to 6,000 Hz can suggest noise damage. Our comparison of age-related vs. noise-induced hearing loss explains those patterns. A clear difference between the two ears, or word recognition much poorer than expected, may prompt further testing to rule out problems behind the inner ear. ^[1]

When Should You Get Tested?

For adults without symptoms, official screening guidance is cautious. In 2021 the U.S. Preventive Services Task Force concluded that the evidence was insufficient to weigh the benefits and harms of routine hearing screening in adults 50 and older without symptoms. That isn't a recommendation against testing; it means the evidence for population-wide screening is incomplete. ^[5] Cleveland Clinic notes that many adults may not need a hearing evaluation until their 50s or 60s, but that people who work in very noisy environments should be tested yearly. ^[7]

Practically, a test makes sense if you notice any signs of hearing difficulty, if family members comment on it, if you work or play around loud noise, or simply as a baseline around your 50s or 60s so later changes are easy to spot. Get checked promptly, not routinely, if hearing drops suddenly in one or both ears; that's a medical emergency covered in our guide to sudden hearing loss. Online and app-based hearing checks can be a useful first step, but StatPearls cautions that they shouldn't be considered equivalent to comprehensive diagnostic audiometry. ^[1]

After the Test: Next Steps

Ask for a copy of your audiogram and have the audiologist walk you through it. Depending on the results, next steps may include monitoring with a repeat test, hearing protection advice, a referral to an ENT doctor for medical evaluation, or hearing aids. For mild to moderate loss without red-flag symptoms, over-the-counter hearing aids are now an option; see our guide to OTC hearing aids.

Whatever the result, the everyday habits that protect hearing still apply: limiting noise exposure, not smoking, and looking after heart health.

After Your Hearing Test, Add a Daily Routine

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