Degrees of Hearing Loss: Mild to Profound, and How to Read an Audiogram
by Crystal Hearing Solutions
The degrees of hearing loss, also called the levels of hearing loss, describe how loud a sound has to be before you can hear it. From least to most severe, they are mild, moderate, moderately severe, severe, profound and complete hearing loss. This guide explains each degree, what it means day to day, and how to read an audiogram.
Charts and test reports draw these lines in slightly different places, so your own report may give the same result a different name. Here we use one scale throughout: the grades of the World Health Organization (WHO), from its World Report on Hearing (2021).
Quick Answer: The Degrees of Hearing Loss
On the World Health Organization’s scale, your degree of hearing loss is set by the hearing level of your better ear, in decibels (dB HL): normal hearing below 20 dB, mild 20 to 34 dB, moderate 35 to 49 dB, moderately severe 50 to 64 dB, severe 65 to 79 dB, profound 80 to 94 dB and complete 95 dB or more. The higher the number, the louder a sound must be before you hear it. Your audiogram also shows the type of loss: conductive, sensorineural or mixed.
The Levels of Hearing Loss: Mild, Moderate, Severe and Profound
Here is the WHO scale, with its descriptions for most adults. Your hearing level is the average of your results at 500, 1,000, 2,000 and 4,000 Hz in your better ear, and each grade ends where the next begins.
| Degree | Better ear (dB HL) | What it is like |
|---|---|---|
| Normal hearing | Below 20 dB | No problem hearing sounds, and little or none in noise |
| Mild | 20 to 34 dB | Conversation is fine in quiet but may be hard to hear in noise |
| Moderate | 35 to 49 dB | Conversation may be hard to hear in quiet, and is hard to follow in noise |
| Moderately severe | 50 to 64 dB | Conversation is hard to hear, though raised voices are fine. Most speech in noise is hard to follow |
| Severe | 65 to 79 dB | Most conversation is missed, and even raised voices may be hard to understand |
| Profound | 80 to 94 dB | Even raised voices are extremely hard to hear |
| Complete or total | 95 dB or more | Speech and most everyday sounds are not heard |
A grade rests on one average, so it never tells the whole story. An average can hide a steep loss at high pitches, where soft sounds such as s, f and th sit. That is why your audiologist reads the whole audiogram, and often checks how clearly you understand words, before recommending anything.
How to Read an Audiogram
Your audiogram comes from an audiogram test, also called pure tone audiometry. You hear beeps at different pitches through headphones and respond each time you hear one, however faint. Each mark on the chart is the softest beep you heard at that pitch.
- Across the chart is pitch. Low pitches are on the left and high pitches on the right, usually from 250 to 8,000 Hz.
- Down the chart is loudness. The lower a mark sits, the louder that pitch had to be before you heard it, so lower marks mean more hearing loss.
- O marks your right ear and X your left, often in red and blue. These are air conduction results, heard through the headphones. Triangles or squares, if you see them, mean the same test was done with a masking noise in the other ear, so that ear could not join in.
- Bone conduction marks (often < and >, or [ and ] when masked) are measured with a small vibrator behind the ear, which sends sound straight to the inner ear. If they sit well above the air conduction marks for the same ear, part of the problem lies in the outer or middle ear.
- The shape tells a story. Age-related loss usually slopes down to the right, because high pitches go first. Noise damage often shows a dip around 4,000 Hz.
Many reports also include results from a speech audiometry test, which shows how clearly you understand words rather than beeps. Once you wear hearing aids, an aided audiogram, measured through loudspeakers with your hearing aids on, shows how much they help. Your audiologist may add other checks too, and our guide to the different hearing tests explains each one.
The Type of Hearing Loss: Conductive, Sensorineural or Mixed
The degree tells you how much hearing is reduced. The type tells you where the problem is, and who should treat it.
| Type | Where the problem is | Common causes | Usually managed with |
|---|---|---|---|
| Conductive | Outer or middle ear | Wax, fluid behind the eardrum, infection, a hole in the eardrum, otosclerosis | Medical care from an ENT doctor, often medicine or surgery |
| Sensorineural | Inner ear or hearing nerve | Ageing, loud noise, genes, some medicines | Hearing aids, or a cochlear implant for some severe or profound losses |
| Mixed | Both | A mix of the above | ENT care first, then hearing aids if needed |
Sensorineural hearing loss is the most common kind of permanent hearing loss. A conductive loss is a matter for an ENT doctor, and it can often be treated. See an ENT doctor too if hearing loss comes with ear pain, discharge or dizziness. If your hearing drops suddenly, in one ear or both, treat it as urgent and see an ENT specialist the same day.
What Your Result Means for Hearing Aids
Hearing aids can help at most degrees. What changes is how much power you need and how precise the fitting must be:
- Mild: soft voices and speech in busy places slip away, and hearing aids help in exactly those moments.
- Moderate and moderately severe: everyday conversation takes effort, and hearing aids are usually recommended.
- Severe: you need powerful hearing aids and a careful fitting.
- Profound and complete: powerful hearing aids help some people. If they give too little clarity, an ENT specialist can assess whether a cochlear implant would help.
Your degree also narrows down which types of hearing aids suit you. The smallest in-canal styles have less room for power, so they suit milder losses, while severe and profound losses usually need a more powerful behind-the-ear model. Whatever your degree, the fitting matters: Real Ear Measurement (REM), available for fittings at every one of our clinics, uses a thin probe microphone to check what your hearing aid delivers inside your ear.
The surest way to know what hearing aids can do for you is to wear them in daily life, which is why we offer a free 7-day hearing aid trial.
Frequently Asked Questions
On the World Health Organization’s 2021 scale, normal hearing is a hearing level below 20 dB in your better ear. At that level most adults have no problem hearing sounds in a quiet room, and little or no problem in noise.
It depends on the type. A conductive loss, from wax, fluid or an infection, can often be treated by an ENT doctor. Sensorineural hearing loss is usually permanent, and it is most often managed with hearing aids.
It depends on how much the loss gets in your way. With mild hearing loss you may hear well in quiet but miss soft voices, and speech in busy places such as meetings or family gatherings. If that sounds familiar, a free 7-day trial shows whether hearing aids make those moments easier.
Yes. Your audiogram records each ear separately, and the two can differ, so each hearing aid is set to its own ear’s result. The WHO grade goes by your better ear, and when one ear hears normally (below 20 dB) and the other has a loss of 35 dB or more, the WHO calls it unilateral hearing loss. If one ear is clearly worse than the other, see an ENT doctor before choosing hearing aids.
It can. Age-related hearing loss tends to change slowly over the years, so a repeat hearing test shows whether your degree has changed, and hearing aids can usually be reprogrammed to match. A sudden drop in hearing is different: see an ENT specialist the same day.
Find Out Your Degree of Hearing Loss
Knowing your degree and type of hearing loss is the first step to hearing better. Book a hearing test at any of our 11 clinics across Mumbai, Thane and Navi Mumbai, and our RCI-certified audiologists will take you through your audiogram in plain words. If hearing aids can help, you can start with our free 7-day trial.