How to Read Your Audiogram (Hearing Test Results)

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Why this matters to me personally: The first time I was handed an audiogram, I had no idea what I was looking at. My audiologist explained it quickly and moved on. I left with a piece of paper I couldn't read and a $4,000 quote I wasn't ready for. This is the plain-language explanation I wish I'd had that day.

📋 In this guide

What is an audiogram?
The two axes — frequency and volume
What the symbols mean (X's, O's, and more)
Degrees of hearing loss
Common audiogram patterns
The speech banana
What your results mean for hearing aids

What Is an Audiogram?

An audiogram is a graph that maps your hearing ability. It shows the softest sounds you can hear at different pitches in each ear. Think of it as a report card for your ears — not pass or fail, but a precise picture of where your hearing is strong and where it drops off.

An audiogram can diagnose your hearing loss and indicate what type of hearing loss you have. It can distinguish your hearing in each ear and whether you have hearing loss on one or both sides.

During the test, you wear headphones and press a button every time you hear a tone. The audiologist plays sounds at different volumes and pitches and plots the results on the graph. The pattern those marks form tells the whole story.

The Two Axes — Frequency and Volume

Sample Audiogram — How to Read It

Example audiogram showing mild-to-moderate sloping hearing loss — common with age-related loss. Red circles = right ear. Blue X's = left ear.

The horizontal axis — frequency (pitch)

The horizontal axis shows frequency measured in Hertz (Hz). Think of this as pitch — from low sounds like a bass drum on the left (250 Hz) to high sounds like a bird chirping on the right (8000 Hz). The numbers typically go: 250, 500, 1000, 2000, 4000, 8000.

The vertical axis — volume (loudness)

The vertical axis shows intensity measured in decibels (dB). This represents how loud a sound needs to be for you to hear it. Here's the counterintuitive part: the numbers start at 0 at the top and go down to 120 at the bottom. The lower down the mark on the chart, the louder the sound needed to be for you to hear it.

Key insight: Higher on the chart = better hearing. Lower on the chart = worse hearing. This trips people up because it feels backwards — but think of it as "how loud does it have to get before you hear it?" Lower on the chart means sounds have to get much louder before you detect them.

What the Symbols Mean

Each mark on your audiogram represents the softest sound you could hear at a specific pitch in a specific ear. Here's what the standard symbols mean:

○

Right ear (air conduction)

Red circle. Plotted in red. Represents sounds heard through headphones — the standard way we hear in daily life.

Left ear (air conduction)

Blue X. Plotted in blue. Same test as the right ear — just the other side. Blue = left is the universal convention.

＜

Right ear (bone conduction)

An angled bracket pointing right. Tests how sound travels through the skull bone — helps identify the type of hearing loss.

＞

Left ear (bone conduction)

An angled bracket pointing left. If bone conduction is better than air conduction, the loss may be treatable medically (conductive loss).

Air vs bone conduction: If your air conduction (O or X) and bone conduction (< or >) results are similar, the loss is in the inner ear (sensorineural — the most common type). If there's a big gap between them, it's conductive loss — often treatable. If both are abnormal, it's mixed loss.

Degrees of Hearing Loss

For adults, an audiogram reading between -10 and 25 dB is considered within normal limits. Beyond that, loss is categorized by degree. Your audiologist calculates your "pure tone average" (PTA) — typically the average of your thresholds at 500, 1000, and 2000 Hz — to assign a degree:

Degree	dB Range	What you might notice	OTC suitable?
Normal	–10 to 25 dB	No significant difficulty	No aid needed
Mild	26–40 dB	Trouble in noise, soft speech, groups	✅ Yes — OTC works well
Moderate	41–55 dB	Difficulty with normal conversation	✅ Yes — OTC may work
Mod-Severe	56–70 dB	Need loud speech; TV very high	⚠️ Borderline — get evaluated
Severe	71–90 dB	Loud speech barely audible	❌ Prescription needed
Profound	91+ dB	Very little hearing without aids	❌ Specialist required

Common Audiogram Patterns

The shape of your audiogram matters as much as the degree. Two people with the same average dB loss can hear very differently depending on which frequencies are affected. Here are the most common patterns:

Most common — age-related & noise-induced

🎿 Sloping (High-Frequency) Loss

Good hearing at low frequencies (left side of chart), dropping off significantly at high frequencies (right side). What you'll experience: difficulty hearing women's and children's voices, and consonant sounds (s, f, th, sh). You'll often say "I can hear you talking, but I can't understand what you're saying" — because you're hearing the low-frequency vowels but missing the high-frequency consonants. This is what my audiogram shows.

Noise-induced

🕳 Notched Loss

A specific dip in hearing sensitivity around 3,000–6,000 Hz, with recovery at higher frequencies. Typically resulting from noise-induced damage. Common in people with occupational noise exposure or a history of loud music.

Less common

🔄 Reverse Slope Loss

Poorer hearing at low frequencies with better hearing at higher frequencies. This pattern may be linked to genetic conditions or certain medical disorders like Meniere's disease. Much rarer than sloping loss.

Often hereditary

🫧 Cookie Bite (Mid-Frequency) Loss

Reduced sensitivity in the middle frequencies with better hearing at low and high ends — the chart looks like a bite was taken out of the middle. Often hereditary and can impact the perception of speech nuances.

The Speech Banana

Many audiograms include a banana-shaped region plotted on the chart. This represents where the sounds of normal conversation fall. When your hearing thresholds fall below the speech banana, those are the sounds you're likely missing in conversation. This explains why two people with the same "degree" of hearing loss can have very different experiences — it depends on which parts of speech they can still access.

Vowel sounds (a, e, i, o, u) cluster at low to mid frequencies. Consonants — the sounds that give speech its clarity — live in the high frequencies. A sloping loss that spares the low frequencies but hits the highs will leave you hearing the volume of speech but missing its clarity. That's why so many people say "I can hear fine — I just can't understand what people are saying." That's not a paradox. That's a high-frequency sloping audiogram.

What Your Results Mean for Hearing Aids

Once you understand your audiogram, the path forward becomes clearer:

OTC hearing aids are appropriate for mild to moderate loss (roughly 26–55 dB average). If your audiogram shows moderate-to-severe or severe loss, OTC devices won't provide adequate amplification and professional fitting is the right path.

If your loss falls in the OTC range, your next step is figuring out which device matches your audiogram pattern. A sloping high-frequency loss — the most common — benefits most from a device with strong high-frequency amplification and speech clarity processing. That's exactly what the ELEHEAR Beyond Pro's AI system is designed for.

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Questions about your results? Drop them in the comments. I'm not an audiologist, but I've been reading my own audiograms for 10+ years and I'm happy to help you make sense of yours.