A Guide to Conductive Hearing Loss

Causes of Conductive Hearing Loss

Earwax acts as a barrier to protect ears from infection. It helps by trapping bacteria, dust, and other contaminants in its sticky web before it reaches the cochlea in the inner ear, which is the organ that helps us hear.

Earwax buildup can be too much of a good thing, however, as it’s the most common cause of conductive hearing loss. Wearing hearing aids, using cotton swabs for cleaning ears, and ear surgeries can cause excessive wax buildup, so it’s important for older adults to keep an eye out to protect their hearing from those common risk factors.

Expert Insights

From Dr. Ruth Reisman, Audiologist

One of the biggest misconceptions patients have is that they need to clean their ears regularly with cotton swabs. In reality, the ear is self-cleaning, and swabs often push wax deeper, creating blockages. We often advise safe management options and professional removal when necessary.

Here are some other causes of conductive hearing loss:

• Swimmer’s ear (external otitis)
• Fluid in the middle ear due to colds or allergies
• Poor Eustachian tube function (The Eustachian tube connects your middle ear and your nose.)
• Benign tumors blocking the outer or middle ear
• A hole in the eardrum
• A malformed outer or middle ear3

Signs of Conductive Hearing Loss

Conductive hearing loss can happen gradually, so it can be easy to miss the signs. With conductive hearing loss, sounds typically seem quieter rather than distorted, like someone turned down the volume on your life.

General signals that you might be experiencing hearing loss can vary, but some typical hearing loss signs include:

• You often think others are mumbling and ask people to repeat themselves.
• Sounds are muffled.
• You’re turning up the volume on the TV louder than usual.
• You might start speaking too softly or too loudly.
• You’re experiencing listening fatigue and might start avoiding social situations.

People experiencing conductive hearing loss might also notice:

• A feeling of fullness or stuffiness in their ears
• Pain or tenderness in ears
• Dizziness4
• Difficulty hearing soft sounds
• Liquid draining from ear

If the cause of conductive hearing loss is related to Eustachian tube malfunction, your own voice might sound louder than usual, which is called “autophony.” This happens because bone conduction of your voice remains normal but air conduction in the ear is impaired.5

Conductive Hearing Loss Diagnosis

The first step in figuring out what could be causing conductive hearing loss is an examination by your primary care provider. Your doctor might be able to see an obstruction or problem in your outer ear, eardrum, or middle ear.

They might also refer you to an ear, nose, and throat doctor (an otolaryngologist) or an audiologist for further hearing tests. These tests could include:

• Acoustic reflex test: This looks at your ear’s automatic response to loud sounds.
• Pure tone test: You’ll listen to tones of different pitches and loudness. This air conduction and bone conduction test is considered the gold standard test for conductive hearing loss.6
• Speech and word recognition tests: This tests how well you hear words at different volumes.
• Tuning fork tests: Called Rinne and Weber tests, tuning fork tests help determine which type of hearing loss you have.7 These tests help determine if hearing loss is conductive, indicating a problem with the outer or middle ear, or sensorineural, indicating an inner ear or nerve problem.

Audiologist Dr. Ruth Reisman demonstrates taking a hearing evaluation

Treatments for Conductive Hearing Loss

Treatment will depend on the cause of conductive hearing loss. Excessive earwax — the most common cause — can be helped with wax removal techniques, which might involve suction and irrigation treatments. Medications such as antibiotics might be prescribed if the hearing loss is caused by an infection. And if there’s a hole in your eardrum, for example, that could require surgery to fix.

Expert Insights

From Dr. Ruth Reisman, Audiologist

Even though conductive hearing loss is usually treatable, its impact on communication, social interaction, and well-being can be significant if left unaddressed. Untreated hearing loss can lead to frustration, social withdrawal, and even cognitive decline over time, so timely evaluation and treatment are critical.

If the hearing loss is persistent, an audiologist might discuss hearing aid options with you. Bone conduction hearing aids work particularly well for conductive hearing loss. We’ve tested many hearing aids that may be suitable with conductive hearing loss. Our resident audiologist, Dr. Ruth Reisman, also has years of experience treating conductive hearing loss. To learn more about hearing aids, check out our guides to the best hearing aids for seniors in 2025 and best cheap hearing aids.

Dr. Reisman wearing Starkey hearing aids, one of the many popular brands available to those with hearing loss.

Preventing Conductive Hearing Loss

Not all conductive hearing loss is preventable, but you can take simple steps to reduce your risk. Protect your ears from water during swimming and bathing, especially if you're prone to infections. Use well-fitted earplugs or a swim cap, and dry your ears after swimming.

Chronic inflammation can affect eustachian tube function, so see your doctor about persistent colds and allergies that can cause inflammation. Stay up-to-date with vaccinations, particularly flu shots, as upper respiratory infections can lead to ear complications.

And of course, avoid cleaning ears with cotton swabs, which can push wax further in and increase your risk of infections and blockages.

The Bottom Line

Conductive hearing loss is among the most treatable forms of hearing impairment, and early treatment leads to better outcomes. So don’t put off seeking medical attention if you’re noticing changes in your hearing.

Problems with hearing can be frustrating and exhausting, and as a result, people might start isolating themselves. Isolation can erode your overall well-being, relationships, and independence. But paying attention to any changes in your ability to hear will help you maintain not only your hearing health, but strong ties to your loved ones and community as well.

If you’re ready to get tested for hearing loss, watch our video below. Dr. Brad Ingrao explains the importance of hearing evaluations.