Can pregnancy actually change your hearing?

Yes. Hormone surges, especially estrogen, affect the auditory system. The clearest example is otosclerosis, a condition where bones in the middle ear undergo abnormal growth and become fused, blocking sound transmission. It is strongly genetic, but the estrogen surge during pregnancy can accelerate it in someone who carries the predisposition. Menopause sits on the other end of the same story: a drop in estrogen can also have auditory consequences. Both pregnancy hearing loss and menopause hearing loss are real and under-discussed.

Are cu-tips, bobby pins, and ear candles safe?

No. Cu-tips push wax deeper for most people instead of removing it. Bobby pins regularly perforate eardrums. Ear candling has dripped wax onto patient eardrums and sent them to surgery. None of these are safe ear-cleaning methods, even though most of us grew up using them. If you suspect wax impaction, get it removed in office.

Why are hearing aids alone not enough?

Hearing aids amplify sound. They do not retrain the brain to decode that sound after years of high-frequency loss. The brain has adapted to mush and needs to relearn how to separate speech from background noise. LACE (Listening and Communication Enhancement) is a structured auditory training program that fills that gap. Baker Audiology is the only practice in the region offering it. The combination of hearing aids plus brain training is what produces the outcome people actually want: understanding, not just volume.

Is my hearing covered by insurance?

More often than people assume. Many private-pay clinics do not bother with insurance because it is administratively painful. Baker Audiology accepts insurance and does the appeals and follow-up work for the patient. Medicare covers diagnostic exams for nearly everyone. The only way to know what your specific plan covers is to call and ask, and many people are pleasantly surprised.

Episode 16 - Dialed In Health

"I can hear, but I can't understand": hearing in pregnancy, tinnitus, and the brain side of audiology

Audiology Hearing Loss Tinnitus Pregnancy May 22, 2026 - 45 min

With Melissa Baker (Owner) and Dr. Libby Benson, Audiologists - Baker Audiology & Hearing Aids · Sioux Falls

Episode Chapters

Jump to any section

01:28The frame: hearing is a brain, body, and timing problem 02:38Meet Melissa Baker and Dr. Libby Benson 06:22"I can hear, but I can't understand" explained 08:03Pregnancy, menopause, and otosclerosis 10:50Tinnitus: causes and when it matters 11:37When to actually get your hearing checked 13:40Cu-tips, bobby pins, and ear candling 19:09The hearing-level scale, in plain English 19:50Insurance: more covered than you think 23:48Screener vs. diagnostic: what gets missed 27:30Tinnitus matching, middle ear, and the conditions a screener misses

Key Takeaways

"You hear with your brain, not your ears. Hearing aids amplify. They do not retrain the brain. That is why hearing aids alone hit a wall."

Melissa Baker and Dr. Libby Benson on the brain-side gap in audiology

Episode Insight

Treat your ears like your eyes. If something happened with one of your eyes overnight, you would call right away. Same logic for hearing. Many of these losses are reversible if caught fast.

On the urgency people skip

Episode Insight

Pregnancy is not just hormonal. Estrogen surges can accelerate otosclerosis, a fusion of the smallest bones in the body (in your middle ear) that quietly blocks sound transmission. Most patients are women in their 30s.

On the under-discussed link between hormones and hearing

Episode Insight

A baseline test before symptoms is the single most useful thing you can do. Without it, sudden loss looks the same as gradual age-related change. With it, your audiologist can spot an emergency.

On the case for testing in your 20s and 30s

Episode Insight

LACE auditory training is the brain-training program that fills the gap hearing aids leave behind. Baker Audiology is the only practice in the region offering it as a structured program.

On what actually changes outcomes

Episode Insight

Questions Answered

Why do I hear people fine but can't understand what they say?

High-frequency hearing loss. Low-pitch sounds carry the volume of speech (vowels and softer consonants like b, p, g). High-pitch sounds carry the meaning (th, f, s, sh). When the high frequencies fade, you hear the volume but the consonants that separate "math" from "mat" or "map" go missing. You spend energy guessing, fall behind, and start smiling and nodding instead of asking people to repeat.

Can pregnancy actually change my hearing?

Yes. Hormone surges, especially estrogen, affect the auditory system. Otosclerosis is the clearest example: a genetic condition where the bones in the middle ear undergo abnormal growth and fuse together, blocking sound. The estrogen surge of pregnancy can accelerate it in someone who carries the predisposition. Menopause sits on the other end of the same story. A drop in estrogen has auditory consequences too. Neither is widely discussed in OB or primary care.

Should I get a hearing test before I notice a problem?

Yes. A baseline lets your audiologist measure your future deterioration against your own ears, not a generic chart. Some people hear at negative 20 decibels naturally. A 20-decibel drop is a major change for them, but a clinic without a baseline would still call it normal. With a baseline, sudden hearing loss can be spotted as an emergency that needs an MRI, a steroid course, or a same-day referral.

What is tinnitus and when does it actually matter?

Tinnitus is internal ringing, buzzing, or hissing when no external sound is present. Random one-off tinnitus is normal for almost everyone and is usually hair cells in the inner ear signaling stress. Causes include earwax, TMJ, inflammation, dehydration, viral illness, and long COVID. Tinnitus that does not go away within a day, or keeps repeating, is the moment to get it checked. Hearing aids are the most effective treatment for chronic tinnitus because the brain hearing real sound masks the internal noise.

Why do hearing aids alone hit a wall?

Hearing aids amplify sound. They do not retrain the brain to decode that sound. After years of high-frequency loss, the brain has adapted to mush and needs to relearn how to separate speech from background noise. That is what LACE (Listening and Communication Enhancement) auditory training does. It is a structured brain-training program, and Baker Audiology is the only practice in the region offering it. The combination of hearing aids plus LACE is what delivers understanding, not just volume.

Is hearing care covered by insurance?

More often than people assume. Many private-pay clinics skip insurance because the appeals process is painful. Baker Audiology accepts insurance and does the appeals and paperwork for patients. Medicare covers diagnostic exams for nearly everyone. Many people walk in expecting to pay cash and learn they have meaningful coverage.

What does a real diagnostic exam include that a school-style screener does not?

A screener is a pass-fail check in a noisy environment. A diagnostic exam adds speech-in-noise testing, eardrum function testing, middle ear function testing, and tinnitus matching. It can catch otosclerosis, fluid, ear infection, Eustachian tube dysfunction, acoustic neuroma, and other conditions that a screener never looks for.

Myth Busters

Myth: Cu-tips clean your ears.

Reality: For most people, cu-tips push wax deeper. The morning ritual most of us grew up with is the opposite of cleaning.

Myth Buster

Myth: Ear candling clears wax.

Reality: Ear candling has dripped melted wax onto patient eardrums and sent them to surgery. Skip it.

Myth Buster

Myth: Hearing loss is just a volume problem.

Reality: It is a brain decoding problem. That is why volume alone (more amplification, louder TV) makes things worse, not better.

Myth Buster

Myth: Hearing aids are a last resort.

Reality: Delaying makes outcomes worse. The brain forgets how to process the missing frequencies. Earlier intervention plus auditory training delivers better understanding.

Myth Buster

Myth: Tinnitus has no real treatment.

Reality: Hearing aids are the most effective evidence-based treatment for chronic tinnitus. Once the brain hears real sound, the internal ringing recedes.

Myth Buster

About This Episode

Most people walk into an audiology clinic saying the same thing: "I can hear, but I just can't understand." The hearing industry has historically treated that as a device problem: louder amplifier, fancier hearing aid, done. Melissa Baker and Dr. Libby Benson take it apart in this episode. It is a brain problem first, a body problem second, and a timing problem third.

The brain side: high-frequency hearing loss strips the consonants that carry meaning (th, f, s, sh) and leaves the low-frequency vowels that carry volume. By the time you finish guessing whether someone said "math" or "mat," they are two sentences ahead. The brain adapts to that mush, and after years of adaptation, just amplifying sound does not bring the meaning back. That is the wall hearing aids hit alone. Baker Audiology is the only practice in the region offering LACE auditory training, the structured brain-training program that fills the gap.

The body side: hormones matter more than most clinicians admit. Pregnancy surges and menopause drops both affect the auditory system. Otosclerosis, a genetic condition where the smallest bones in your body (the ones in your middle ear) undergo abnormal growth and fuse, frequently shows up in women in their 30s after pregnancy. It is treatable, sometimes surgically reversible, and almost always missed without a baseline test to compare against.

The timing side: Melissa and Libby keep coming back to one rule. Treat your ears like you treat your eyes. You would not wait a decade after your vision changed before getting checked. The audiology version of an annual eye exam is a baseline hearing test in your 20s or 30s, before there is a complaint. With one in the file, an audiologist can tell a normal 5-decibel year-over-year shift from a 30-decibel emergency that needs an MRI or a steroid course. Without one, every audiogram looks the same.

Baker Audiology is independent, privately owned, and built around patient experience. Birds chirping in the bathroom, a treasure chest at the front desk, insurance appeals handled in-house, and a lady who pays in pie. If that sounds like a strange combination for a clinical practice, the point is exactly that. Hearing care has a 30-year history of being grim and gray. This is the opposite of that.