How to Read an Audiogram: A Patient-Friendly Guide

An audiogram can look like a confusing chart of numbers, lines, and symbols. If you have recently had a hearing test, you may be wondering what the results mean, whether your hearing is considered normal, and how the chart connects to the conversations that feel difficult in daily life.

 

The good news is that you do not need to be an audiologist to understand the basics. This guide explains how to read an audiogram, what the axes and symbols represent, why the shape of the results matters, and which questions can help you make sense of your own hearing care plan.

What does an audiogram show?

An audiogram is a graph of the quietest sounds you can detect at different pitches. During a pure-tone hearing test, tones are presented through headphones or insert earphones. You respond when you hear each tone, and the softest level you detect at each pitch is recorded as your hearing threshold.

 

An audiogram is sometimes called a hearing test, but it is not a simple pass-or-fail exam. It gives a picture of your hearing sensitivity in each ear. Your hearing care professional combines it with your health history, ear examination, speech testing, and your own communication experiences.

 

The chart can help show:

 
• Whether hearing is within a typical adult range or reduced at certain pitches

 
• Whether the change is greater in one ear or affects both ears

 
• Whether the pattern is mainly in low pitches, high pitches, or across much of the range

 
• Whether further testing or hearing support may be useful

 

A pure-tone audiogram does not, by itself, explain every reason you may struggle in background noise or tell the whole story of how you understand speech. That is why the conversation with your hearing care professional matters as much as the graph.

Step 1: Read the horizontal axis for pitch

The horizontal axis runs from left to right and is labeled frequency, measured in Hertz (Hz). Frequency describes pitch.

 
• Lower frequencies are on the left. Examples include a low musical note, thunder, or the deeper parts of some voices.

 
• Higher frequencies are on the right. Examples include a whistle, a bird chirp, or the higher-pitched sounds in words such as “s,” “f,” and “th.”

 

Many adult hearing tests include frequencies from about 250 or 500 Hz through 8,000 Hz, although the exact range can vary. Additional frequencies may be tested when a clinician needs a more detailed picture.

 

Moving from left to right does not mean that sounds are getting louder. It means the test is moving from lower-pitched sounds to higher-pitched sounds.

Step 2: Read the vertical axis for loudness

The vertical axis is measured in decibels hearing level, written as dB HL. It shows how loud a tone had to be before you detected it.

 

The audiogram is different from a chart of everyday environmental noise. On an audiogram:

 
• The top of the chart represents softer sounds.

 
• The bottom represents louder sounds.

 
• A point lower on the page means the sound had to be louder for you to hear it.

 
• A higher threshold number generally means reduced hearing sensitivity at that frequency.

 

A result near 0 dB HL does not mean that there is no sound. It is a reference level based on typical hearing sensitivity. Also, decibels on an audiogram should not be read like a simple volume dial; dB HL is a clinical scale used to describe hearing thresholds.

 

As a general orientation for adults, many charts use ranges similar to these:

 
• Around -10 to 25 dB HL: often considered within a typical or normal range

 
• 26 to 40 dB HL: often labeled mild hearing loss

 
• 41 to 55 dB HL: often labeled moderate hearing loss

 
• 56 to 70 dB HL: often labeled moderately severe hearing loss

 
• 71 to 90 dB HL: often labeled severe hearing loss

 
• 91 dB HL or higher: often labeled profound hearing loss

 

These ranges are helpful guideposts, not a personal diagnosis. Definitions can vary slightly among organizations, and the effect of hearing loss depends on which pitches are affected, how each ear compares, and how you function in real-world listening situations.

What do the symbols and patterns mean?

Right and left ear symbols

On many standard audiograms, the results for each ear use different colors and symbols. A common convention is:

 
• A red circle (O) for the right ear

 
• A blue X (X) for the left ear

 

These symbols often represent air-conduction testing, in which tones travel through headphones or insert earphones. Some charts use additional symbols for bone-conduction testing, masked results, or sounds presented through a speaker.

 

Always check the legend on your own chart because symbols and colors can vary. The important point is to look at each ear separately rather than focusing only on one overall number.

Air conduction and bone conduction

Air-conduction testing measures the full hearing pathway, from the outer ear through the middle ear and inner ear. Bone-conduction testing uses a small vibrator placed behind the ear or on the head to send vibrations to the inner ear, bypassing the outer and middle ear.

 

Comparing these results can help a clinician understand the type of hearing change:

 
• Conductive hearing loss involves a problem moving sound through the outer or middle ear.

 
• Sensorineural hearing loss involves the inner ear or the nerve pathways that carry sound information to the brain.

 
• Mixed hearing loss includes both conductive and sensorineural components.

 

The spaces between air- and bone-conduction results can provide useful clues, but they should not be interpreted without the rest of the evaluation. Earwax, fluid, eardrum changes, inner-ear conditions, and many other factors can affect results.

The shape of the graph is important

The pattern across frequencies is called the configuration of the hearing loss. A result may be described as:

 
• Flat: when thresholds are fairly similar across pitches

 
• Sloping: when hearing is better in lower pitches and poorer in higher pitches

 
• Rising: when hearing is poorer in lower pitches and better in higher pitches

 
• Notched: when a particular range is more affected than the pitches around it

 

A high-frequency pattern may explain why a person hears that someone is talking but misses softer consonants or finds speech less clear in background noise. A different pattern may affect other parts of speech and everyday sound. The chart provides clues, but your communication goals and listening experiences help determine what the results mean for you.

What is the speech area or “speech banana”?

Some audiograms include a shaded area showing where many speech sounds occur across pitch and loudness. Because of its shape, this area is sometimes called the speech banana.

 

It can be a helpful visual aid, but it is not a guarantee of how well you will understand every conversation. Speech changes from person to person, and real conversations are affected by distance, lighting, background noise, the speaker’s voice, and the language being used.

Why pure-tone results are not the whole story

A pure-tone audiogram measures whether you can detect tones. Hearing care professionals may also perform speech testing, such as a speech threshold or word-recognition test. These measures look at how you respond to spoken sounds and words.

 

This distinction matters because hearing a tone in a quiet test room is not the same as following a fast conversation in a busy restaurant. Two people with similar audiograms may describe very different daily challenges. Likewise, someone with thresholds that look relatively mild may still feel that meetings, phone calls, or group conversations require a great deal of effort.

 

Tell your hearing care professional about the situations that matter most to you, such as:

 
• Understanding family members at home

 
• Following conversations in restaurants or group settings

 
• Hearing on the telephone or during video calls

 
• Listening at work, in classes, or at community events

 
• Hearing alarms, announcements, or other important sounds

 

These examples help connect the graph to your goals instead of treating the chart as an isolated score.

What should you do after receiving your audiogram?

1. Ask for a plain-language explanation

It is reasonable to ask a professional to walk through the chart one ear at a time. Useful questions include:

 
• Which pitches are easiest and hardest for me to hear?

 
• Is the pattern similar in both ears?

 
• What type and degree of hearing loss, if any, does the evaluation show?

 
• How might these results affect speech understanding or listening in noise?

 
• Were speech testing, bone-conduction testing, or middle-ear tests also completed?

2. Keep a copy and compare results over time

Your audiogram is a record of your hearing at a particular point in time. Keep a copy so future results can be compared with it. A change over time may be more meaningful than any single test, especially when testing conditions are similar.

3. Connect the results to your everyday experience

Write down the situations that are hardest for you. A hearing chart may show a pattern, but your examples help guide practical recommendations. Communication strategies, assistive listening tools, hearing aids, or medical follow-up may be considered depending on the findings and your needs.

 

Hearing aids can make important sounds more accessible for many people, but the decision is personal. Comfort, communication goals, lifestyle, technology preferences, and the type and degree of hearing loss all matter. A hearing care professional can help you understand your options without requiring you to decide based on the graph alone.

4. Know when a hearing change needs prompt attention

A gradual change can usually be discussed through a scheduled hearing evaluation. A noticeable drop in hearing that develops suddenly—over hours or a few days, especially in one ear—should not be assumed to be earwax, allergies, or congestion. Contact a healthcare professional immediately or seek urgent medical care, because some causes of sudden hearing loss need prompt assessment.

Conclusion

Learning how to read an audiogram can make a hearing appointment feel less mysterious. Remember the basics: the horizontal axis shows pitch, the vertical axis shows how loud a sound needed to be, and the symbols identify which ear was tested. The pattern across the chart can offer clues, but speech testing and your real-life listening experiences are also important.

 

If you have questions about your results, asking for a clear explanation is a positive next step. A hearing care professional can help connect the numbers to your communication goals and explain whether monitoring, communication strategies, hearing technology, or medical follow-up may be appropriate.