If you think you are having difficulty hearing, the first thing you need to do is visit your GP (family doctor).

The first step

If you have difficulty hearing you may have a wax build-up or an infection that has temporarily affected your hearing and can be treated by your GP. You may need further medical investigation and treatment so it is a good idea to see your GP first, even if you are thinking of buying a hearing aid privately.

Your GP will look in your ears using a special instrument (otoscope) to check for obvious problems and may carry out simple tests with a tuning fork. Or you may be able to have your hearing tested by listening to sounds through headphones in the surgery. But usually they will refer you to an audiology clinic or the ear, nose and throat (ENT) department of your local hospital to have hearing tests and to see if a hearing aid will help.

Hearing tests in the audiology clinic

The audiologist will test your hearing using an 'audiometer', which produces sounds of differing frequencies (pitch) and levels of loudness. These are like low, middle and high musical notes played at different volumes.

The audiologist will ask you to listen through a set of headphones and indicate each time you hear a sound. He or she will record the softest sound you can hear at each frequency, which is known as your hearing 'threshold'. One ear is tested and then the other.

The audiologist might also make the sounds louder to find out the level when they become uncomfortably loud for you to listen to. This gives important information and can help with setting up your hearing aid.

A second test involves putting on a headband with a vibrating pad, which transmits sounds through the bones of your skull to your inner ear. When these results are compared with the headphone test, it shows up any problems you might have with your eardrum or middle ear. For more information see our "Ears and ear problems" leaflet.

The hearing test results are shown on a chart called an audiogram and the audiologist will explain what it shows and discuss whether hearing aids are likely to help you, or if you could have some other treatment. Occasionally, you will be offered further tests.