By L. Anne Carrington, Contributing writer

Perhaps it was present at birth. Perhaps it had been the result of a poorly treated or even an untreated ear infection or other ailment. Perhaps it's just getting older.

Whatever the case may be, at some point in their lives, someone or their loved ones have suffered from hearing loss, and living in a world of silence or near-silence is one that can be difficult to adjust to, but the transition can be easier with a few changes, depending on the person's approach to this impairment.

Sometimes hearing problems can make the affected person feel embarrassed and isolated, and sometimes their aloofness can be mistaken for withdrawing because they can't follow a conversation in group settings, such as a family gathering or a dinner at a restaurant.

It's also been a mistaken assumption for friends and family of a hearing-impaired person that has not sought treatment (or even either isn't aware they have a problem or are in denial) to think the person with hearing loss is confused, uncaring, or difficult, when the problem may be that he or she is just hard of hearing.

There are two points to remember: Minor decreases in hearing are common after age 20, and problems with hearing usually come on gradually, and rarely end in complete deafness. With proper diagnosis and treatment, many with hearing loss can go on to lead normal, productive lives.

Signs Of Hearing Loss

Perhaps either you or a loved one has either done or are doing one of the following. If at least three of these happens to be the case, it is recommended that you see a doctor:

- Have trouble hearing over the telephone without an amplifier feature.

- Find it hard to follow conversations when two or more people are talking.

- Need to turn up the TV volume so loud that others complain.

- Have a problem hearing because of background noise.

- Sense that others seem to mumble.

- Can't understand when women and children speak to you.

What Can I Expect At A Doctor's Appointment?

Sometimes a diagnosis can be made by one's own personal physician, but in most cases, the person may be referred either to an otolaryngologist, a specialist in the ear, nose, and throat, who will take a medical history, do an exam, and ask for any family history of hearing problems, or a referral may be made to an audiologist, a professional trained to measure hearing using an audiometer to test a patient's ability to hear sounds of different pitch and loudness. These tests are painless (earphones are placed over the head before the test). Audiologists can also determine if a hearing device is needed and select the best hearing aids for the patient's needs.

Types, Causes Of Hearing Loss

There are many causes of hearing loss. Hearing loss can be divided into two main categories:

Conductive hearing loss (CHL) occurs because of a mechanical problem in the outer or middle ear. This could be caused by the three tiny bones of the ear not conducting sound properly or fluid in the middle ear.

Sensorineural hearing loss (SNHL) results most often occurs when the tiny hair cells (nerve endings) that transmit sound through the ear are injured, diseased, or have prematurely died.

While conductive hearing loss can be reversed, sensorineural hearing loss is usually permanent.

Presbycusis is commonly age-related hearing loss. It becomes more common in people as they get older. People with this kind of hearing loss may have a hard time hearing what others are saying or may be unable to stand loud sounds. This type of hearing loss may also be caused by loud noise, heredity, head injury, infection, illness, certain prescription drugs, and circulation problems such as high blood pressure. This type can vary from person to person and it is also common that it can be different levels of this hearing loss type in each ear.

Tinnitus, better known as ringing in the ears, accompanies many forms of hearing loss, including those that sometimes come with aging. This could be caused by loud noise (e.g. rock concerts), side effects of medications, allergies.

Tinnitus can come and go, it can stop completely, or it can be permanent, but some medications are available to treat this problem, along with a hearing aid to make it easier for those affected by tinnitus to hear the sounds they need to hear by making them louder. Avoiding things such as loud noise, smoking, and alcohol may also help the problem.

Ear infections are the most common cause of temporary hearing loss. Fluid may stay in the ear following an ear infection. Fluid in the ears can go without being noticed or cause some significant hearing loss.