Most people have some sort of hearing loss as they age.

The amount of hearing loss depends on lifestyle, genetics and noise exposure over your lifetime.

Just as tanning and sunburns have been proved to cause skin cancer years after the exposure, loud noise exposure can cause hearing loss later in life, says Dr. Carol Bauer, associate professor of surgery at the Southern Illinois University School of Medicine’s division of ear, nose and throat.

“It is difficult to know at what point the damage occurs,” Bauer says. And, like cancer, some people may be more prone to ear damage because of genetics.

Firing guns at close range, listening to loud music over long periods of time and operating factory or farm equipment without ear protection all could have an impact on hearing later in life, she says.

Prolonged ringing in the ears after an exposure to loud sounds can be an indication that there was some damage done to the ears, Bauer says. “When the ringing is continuous and won’t go away, there is nearly always inner ear damage.”

Bauer says there are two types of hearing loss. Conductive loss is caused by fluid behind the eardrum, “arthritis” of ear bones or a hole in the eardrum. Sensorineural hearing loss is caused by noise damage, aging, toxic chemicals and infections.

The signs of hearing loss can be subtle, says Kendra Watts, an audiologist at SIU’s center for hearing imbalance.

Family members often notice the problem first when they have to repeat information, Watts says. Needing to turn the television louder than normal and missing the punch lines to a joke also can be indications that there is a problem.

Hearing usually isn’t lost all at once, Watts says. At first, you may begin to miss high-frequency sounds at the end of words such as s, th, f, ch and sh. For example you may have difficulty discriminating between “cat” and “cap.”

“It can be a big frustration to people,” Watts says.

For the person who is not hearing those sounds, it seems like the person talking has marbles in his mouth as the high-frequency words are filtered out. If you think family members are mumbling all the time, your hearing may be the problem. You may also notice that you have a hard time following conversations in a crowded room or a noisy restaurant.

Hearing loss affects everyone differently, Watts says. Two people can have the same amount of hearing loss, but one person may be frustrated and seek help and the other may say it doesn’t bother them. Other health issues, such as diabetes, can be a factor.

The first step in seeking help is to see your family doctor, who can make a referral to an audiologist for testing or an ear, nose and throat specialist. Bauer says most family practice physicians are not equipped to do the in-depth testing required to investigate hearing loss. A battery of hearing tests is needed to check all the functions of the ear.

The solutions to hearing loss vary, Bauer and Watts say. Some people may find it helpful to see the faces of those they are conversing with, so as to utilize visual cues for better understanding. Others may consider hearing aids or surgery such as a cochlear implant to improve hearing.

“Hearing aids can help at almost every level of hearing loss,” Watts says. Today’s hearing aids, especially ones that are placed behind the ear, are much more comfortable than they were years ago.

“We always encourage an open mind,” Watts says.

As more hearing loss occurs, the more difficult it is to train the brain to utilize the signals. “The sooner you get the hearing aid, the better you will be in the long run,” Watts says.

Hearing aids can be expensive, between $1,500 and $5,400, according to Watts. Most health insurance policies and Medicare do not cover the cost.

“Our goal is to have the benefits outweigh the costs,” Watts says.