Do you ever find that you can hear loud noises but can’t fully make out exact phrases when someone is speaking? Perhaps it's in a loud restaurant or even in the workplace. Or maybe you’re the one screaming and fighting to be understood. You’re not alone, as many people experience some form of hearing loss but aren’t sure how to define it or how to seek help. An estimated 25.4 million Americans over age 12 have mild hearing loss, and 12.8 million have moderate or greater hearing loss, according to Johns Hopkins.
In a long-awaited decision, the FDA announced last week that hearing aids will be available over the counter for people with mild to moderate hearing loss as soon as the fall. This decision will make them widely available at drugstores.
Having an over-the-counter option will not only help bolster the knowledge base around hearing loss more generally, but it will also dramatically lower the cost of the devices across the board, saving people an estimated $2,800 per pair according to the FDA. The devices currently can cost over $5,000, including fitting services.
Many people don’t seek out hearing aids or hearing professionals for lack of access to the devices and a lack of education around hearing loss, says Devin McCaslin, director of audiology at Michigan Medicine. He hopes this decision will change that.
“It gives people a vehicle into trying does this work or does this not,” McCaslin says, underscoring that more education is needed to make people aware of different types of hearing loss and hearing aids.
What is mild to moderate hearing loss?
The phrase “mild to moderate hearing loss” may not signal much, even though the vast majority of people with hearing loss fall under that category.
If you have mild to moderate hearing loss, you can hear people but you may not be able to fully understand them. It may sound like the words are mumbled, McCaslin says. You typically lose the detection of high frequency sounds first when hearing ability declines, so it’s harder to hear the “sh,” “th,” and “k” sounds.
“You hear all the vowels, but you can't distinguish the consonants,” McCaslin says.
Even asking people to repeat themselves may be a sign, but it may not raise any red flags for most people, says Dr. Frank Lin, director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health, who testified to Congress in support of these OTC hearing aid regulations.
Ultimately, observation alone can’t determine the range of hearing loss experienced.
“It’s a little bit difficult to expect that someone can somehow detect what degree they fall under without having a test,” says Dr. Enrique Perez, director of otology at the Mount Sinai Hospital.
What should you do when you think you might have hearing loss?
Hearing is a frequency scale, as McCaslin puts it, and everyone with some sort of hearing loss experiences different frequencies and configurations. To this point, it’s most important to seek a hearing professional and a hearing test first. This will help identify what type of hearing loss, if any, you are experiencing. The hearing professional will also be able to recommend the type of hearing aid that may work best for you.
It’s especially important to see a doctor if you have a sudden hearing loss, Lin says.
And although it’s rare, hearing loss can come from tumors, which can only be evaluated by professionals. In these cases, hearing aids will unfortunately not help.
Lin says it will probably take a year for over-the-counter hearing aids to largely swarm the market, and it makes sense for people to try them out on their own time, but not to forget that they can also consult a professional.
Which types of hearing aids will be over the counter?
Hearing aids are not a “one-size-fits-all,” McCaslin says.
There are different types of aids: the hearable aid (which is not formally a hearing aid and is for people who just want to hear better even for a specific event), over-the-counter aids, and traditional aids.
Traditional aids are for people who have more than a moderate hearing loss.
Trust known hearing aid companies with years of experience manufacturing these devices, many of which will create versions that will work over the counter, Perez says. One option won't stand out as the best, he predicts.
Many brands will come out with OTC aids, and that’s why getting a direct recommendation from someone who understands your type of hearing loss can help you find the right device.
When are they available?
You will see OTC hearing aids this fall, according to the announcement.
McCaslin believes more people will come into his practice after buying a hearing aid over the counter and question why it isn’t working properly. He says usually a few logistics need to be adjusted, depending on the person.
“Now that everyone’s got these and they don’t work quite right or there’s some sort of dissatisfaction with them, how do we then help get them back on track?” McCaslin says. He expects there to be more innovation in the hearing health care space that will customize aids to their hosts more naturally.
It will ultimately take time for the general public to be educated on their hearing and find ways to improve their overall health.
“Hearing goes beyond lifestyle,” Lin says. “There may be some real health consequences that could be hopefully helped and addressed with hearing aids,” he says, noting that hearing loss is a major risk factor for dementia, which prompted his push for OTC hearing aids to be made available.
