Understand Your Audiogram

An audiogram is a graph that shows how well you hear at different pitches (frequencies). It's the result of a hearing test performed by an audiologist. The chart plots the softest sounds you can detect at each frequency, giving a visual picture of your hearing ability.

O (circles) mark your right ear and X (crosses) your left, conventionally drawn in red and blue respectively. But those two are only part of the set, and knowing the rest is what lets you actually read a clinic report. O and X specifically mean unmasked air conduction — tested through headphones. When the audiologist has to mask the other ear with noise, air conduction switches to a triangle for the right ear and a square for the left. Bone conduction (the small vibrator behind your ear) uses carets — < for right, > for left — or square brackets [ and ] when masked. An arrow hanging off any symbol means there was no response even at the audiometer's maximum output. One caveat: this is the ASHA convention used in the US, not a worldwide standard — other countries publish variants.

It depends who you ask, and the honest answer is that professionals genuinely disagree. This tool uses 25 dB or better, a common US working cutoff. The WHO's 2021 report sets a stricter bar at under 20 dB. And the Clark scale that ASHA publishes is stricter still, labelling −10 to 15 dB as normal and 16–25 dB as "slight" loss — ASHA notes outright that not all professionals agree on where normal ends. More importantly, a normal audiogram does not guarantee easy listening. The WHO puts it directly: the ability to detect pure tones through earphones in a quiet room "is not, in itself, a reliable indicator of hearing disability," and should not be used to measure difficulty understanding speech in background noise — which is the complaint most people actually have.

PTA averages your thresholds across the frequencies that matter most for speech, giving one number per ear. This tool uses 500, 1000, 2000, and 4000 Hz — the same four the WHO uses to define the hearing threshold behind its 2021 grades. Be aware that "PTA" is genuinely ambiguous in practice: the classic three-frequency version uses 500, 1000, and 2000 Hz (it's used to cross-check your speech reception threshold), while otologic outcome reporting often uses 500, 1000, 2000, and 3000 Hz. So the number on your clinic report may differ from the one here without either being wrong — check which frequencies were averaged before comparing.

Yes, hearing loss can progress over time, especially with continued noise exposure, aging, or certain medical conditions. That's why regular hearing tests are important — they help you track changes and take action early. Protecting your ears from loud sounds and getting treatment when needed can help preserve the hearing you have.

There's no official schedule, and it's worth being honest about that rather than inventing an interval. ASHA states plainly that there is no single agreed-upon adult hearing screening schedule, and the US Preventive Services Task Force gives screening in asymptomatic adults 50 and over a Grade I — meaning the evidence is insufficient to weigh the benefits against the harms. What actually triggers a test is symptoms and exposure: get one if you notice a change, if speech in noise has gotten harder, if you have tinnitus or a difference between ears, or if hearing drops suddenly (that last one is urgent). If you work in noise, OSHA requires your employer to provide annual audiograms. A baseline test while things feel fine is still genuinely useful, because it gives every later test something to compare against.

A full audiogram distinguishes three types. Sensorineural loss comes from the inner ear or hearing nerve and is the most common. Conductive loss means sound is blocked on the way in — earwax, fluid, or a problem with the eardrum or middle-ear bones — and is often treatable. Mixed is both together. Audiologists tell them apart by comparing air conduction (through headphones — the O and X marks) against bone conduction (a vibrator behind the ear, marked with carets < and >, or brackets when masked). The difference between the two lines is the air-bone gap, and there's a number attached to it that most explainers leave out: a gap of more than 15 dB at a frequency indicates a conductive component, while a purely sensorineural loss shows no gap greater than 10 dB. This is the single most useful thing on the chart, because a conductive gap often points to something treatable.

Yes, and the numbers line up neatly — Apple's test reports the same six frequencies this tool collects (250, 500, 1000, 2000, 4000, and 8000 Hz). Open the Health app, find your hearing test results, and enter those thresholds above. One point of accuracy worth getting right, since it's widely reported wrong: the hearing test itself is a registered 510(k)-exempt Class II device, not an FDA-cleared diagnostic. What the FDA authorized in September 2024, through the De Novo pathway, was the separate Hearing Aid feature the test feeds, for adults 18 and over with perceived mild to moderate hearing loss. So treat the result as a solid consumer screening — a full evaluation with an audiologist is still the gold standard.