Low-frequency hearing loss is a relatively rare condition in which a person has a decreased ability or inability to hear deeper or low-pitched sounds. These occur in the frequency of 2,000 hertz (Hz) or lower, like an airplane passing overhead or a running appliance.

There are many different causes of low-frequency hearing loss, including Meniere’s disease and genetic syndromes. Treatment often involves hearing aids or addressing the root cause, or both of these approaches.

Types of Low-Frequency Hearing Loss

The type of hearing loss you have is dictated by which part of the ear is compromised. There are two main types of low-frequency hearing loss:

  • Sensorineural low-frequency hearing loss is caused by damage to the hair cells, your cochlea, or your auditory nerve.Conductive low-frequency hearing loss is caused by a problem within your middle ear.

The Hearing (Auditory) System

Your hearing (auditory) system is divided into three main parts—the outer ear, middle ear, and inner ear.

  • Outer ear: Contains the pinna (the fleshy, visible part of your ear, also called the auricle) and the ear canal
  • Middle ear: Contains the tympanic membrane (also called your eardrum) and three tiny bones called ossicles (malleus, incus, and stapes)
  • Inner ear: Contains a snail-shell-shaped structure called the cochlea, semicircular canals, and the auditory nerve

How you hear is a complex, precise phenomenon. Basically, your outer ear “catches” sound waves, which are funneled through your ear canal. The sound waves then vibrate your tympanic membrane, which causes the ossicles to move, stimulating very small hair cells located within your cochlea. These hair cells then turn the sound vibrations into nerve signals that are sent to your brain via your auditory nerve.

Low-Frequency Hearing Loss Symptoms

People with low-frequency hearing loss have a hard time hearing low-pitch, deeper sounds, like a man’s voice (which is typically deeper than that of a woman or child).

Other sounds that a person with low-frequency hearing loss may be unable to hear or have more difficulty hearing include:

  • Thunder in a rainstormThe “humming” of a refrigeratorThe “rumbling” sound of a car, truck, or airplane motorBass sounds (like a tuba) in a musical concertVowel sounds (which are spoken at a lower pitch than consonants)Phone conversations (sounds are delivered at lower and middle frequencies)

It’s important to note that people with low-frequency hearing loss can understand speech normally (although they usually prefer face-to-face conversations).

Causes

Low-frequency hearing loss may be caused by either an inner ear problem (sensorineural hearing loss) or a middle ear problem (conductive hearing loss).

There is a range of low-frequency hearing loss. Some people have only a mild loss, which may go undetected for years until a person undergoes diagnostic testing. Others have a more severe or profound hearing loss of low-frequency sounds. 

Sensorineural Low-Frequency Hearing Loss

Low-frequency sensorineural hearing loss is mainly associated with Meniere’s disease. Other potential causes include various genetic syndromes, low cerebrospinal fluid pressure, and possibly aging or viral infections.

Meniere’s Disease

Meniere’s disease develops as a result of fluid pressure buildup within the inner ear. The exact mechanism by which this occurs remains unknown.

With Meniere’s disease, a person will typically experience sudden episodes of vertigo, tinnitus, and hearing loss (which is usually low frequency). These episodes may last several minutes to a few hours.

Over several years, the hearing loss may become permanent and include the loss of high frequencies as well.

Genetic Mutations

Wolfram syndrome is a rare autosomal recessive genetic disease caused by a mutation (a change in the genetic sequence) of the WFS1 gene.

In addition to low-frequency sensorineural hearing loss, this condition causes diabetes mellitus, diabetes insipidus, and optic atrophy (when the nerve that connects your eye to your brain is damaged).

Besides Wolfram syndrome, a congenital malformation of the cochlea called Mondini dysplasia has been associated with low-frequency sensorineural hearing loss, as have other very rare genetic mutations.

Low Cerebrospinal Fluid Pressure

Situations in which a person develops a low cerebrospinal fluid pressure in the brain, like after undergoing spinal anesthesia, may cause low-frequency sensorineural hearing loss.

With low cerebrospinal fluid pressure, the low-frequency hearing loss and other potential symptoms (e.g., headache, nausea, vertigo, tinnitus) become worse with standing or sitting up.

Aging

There are rare reports of low-frequency hearing loss occurring in old age. Hearing loss that occurs with age is almost always primarily high frequency.

Ramsay Hunt Syndrome

Viral infections typically cause a sensorineural hearing loss associated with the loss of high-frequency sounds. That’s not the case with Ramsay Hunt syndrome.

Ramsay Hunt occurs when the shingles virus (herpes zoster) infects the facial nerve. This affects both high- and low-frequency sensorineural hearing loss. Facial paralysis may also occur.

Sudden Hearing Loss

Some types of sudden sensorineural hearing loss may affect low-pitch sounds. A person with sudden sensorineural hearing loss may experience other symptoms like ear fullness, vertigo, or tinnitus.

People with low-frequency sudden sensorineural hearing loss have a better chance of hearing recovery than those with high-frequency sudden sensorineural hearing loss.

Conductive Low-Frequency Hearing Loss

Low-frequency hearing loss may also stem from a middle ear problem, such as secretory otitis media or otosclerosis.

Secretory Otitis Media

Secretory (also called serous) otitis media occurs when fluid accumulates within the middle ear as a result of an unresolved infection or from a eustachian tube blockage (e.g., from allergies).

With this fluid accumulation, your eardrum cannot vibrate properly to transmit sounds. Low-frequency sounds are reduced first, followed by high-frequency sounds.

Otosclerosis

Otosclerosis occurs when there is an overgrowth of bone around the foot plate of the stapes bone in the middle ear, causing hearing loss in the lower frequencies.

This condition is more common in women and usually develops between the ages of 15 and 40. Possible causes include autoimmune processes and viral infections, as well as genetic, metabolic, and hormonal factors.

Diagnosis

Low-frequency hearing loss can be diagnosed by an audiologist with a hearing test. The hearing level results are displayed on a chart called an audiogram.

The audiogram will reveal a “reverse-slope” pattern, where the line on the graph starts at the lower left and slopes upward steeply, indicating the loss of low-pitched sounds. This is opposite the result seen on an audiogram for high-frequency hearing loss, where the line on the graph starts in the upper left and slopes downward steeply.

If your healthcare provider suspects that your low-frequency hearing loss is associated with other conditions, like Meniere’s disease or otosclerosis, other diagnostic tests may be ordered, such as imaging tests or vestibular testing.

Treatment

The treatment of low-frequency hearing loss depends on the underlying cause.

Some causes are reversible—for example, low-frequency hearing loss that occurs as a result of low cerebrospinal pressure from spinal anesthesia can be reversed with a blood patch procedure.

Likewise, low-frequency hearing loss from secretory otitis media generally improves on its own. If persistent or severe, an ear tube can be placed. Low-frequency hearing loss is then usually restored.

Low-frequency conductive hearing loss from otosclerosis can generally be reversed through the surgical repair of the stapes bone in the middle ear. This surgery is called a stapedectomy (or stapedotomy) and involves using a laser to make a hole in the stapes footplate and then placing a prosthetic device or implant.

Hearing Aids, Therapies, and Modifications

For irreversible causes of low-frequency hearing loss, hearing aids, which are programmed to amplify lower-pitch sounds, are the mainstay of treatment.

Meniere’s disease can be particularly tricky to treat, as the disease tends to occur in stages. Hearing loss may come and go earlier on in the disease, and then usually progressively worsens.

It’s important to find an audiologist who has experience fitting hearing aids for people with low-frequency hearing loss. It may be a bit of a trial-and-error process to get the settings just right.

Besides hearing aids, in order to improve other symptoms of Meniere’s disease (such as vertigo and tinnitus), various lifestyle habits and therapies may be useful, including:

  • Salt restriction
  • Limiting caffeine and alcohol use
  • Vestibular rehabilitation therapy
  • Taking a diuretic

A Word From Verywell

If you are concerned about your (or your child’s) reduced ability to hear low-pitch sounds, ask your healthcare provider for an audiology referral. The good news is that this condition, albeit rare, can be diagnosed easily and objectively with an audiogram. Treatment is important—not only to make everyday life easier and more enjoyable, but also for your safety (so you are able to hear a car or truck approaching, for example).