If you have tinnitus, your doctor may recommend a hearing test. Some hearing tests check for hearing loss, while others allow doctors to gain information about your tinnitus, such as its sound, pitch, or volume.

Hearing tests can sometimes help doctors determine the cause of tinnitus.

They can also help doctors make appropriate treatment recommendations, while serving as a baseline measure to determine the effectiveness of these treatments.

This article provides an overview of tinnitus, including the different hearing tests doctors may perform to assess your tinnitus and its effect on your hearing.

We also ask whether having tinnitus can affect your hearing test, and whether having a hearing test can cause or worsen your tinnitus. Finally, we outline some hearing tests that are specifically for assessing tinnitus.

Around 90% of people with tinnitus have some degree of hearing loss. In most cases, the sound frequency of the tinnitus matches the sound frequency of the hearing loss. This means that if you have high frequency tinnitus, you will most likely have difficulty hearing high frequencies.

If you have tinnitus, your doctor will refer you to an audiologist who will perform a hearing test to assess the nature and severity of your tinnitus, and the effect it is having on your hearing. These tests may include:

  • Speech recognition test: Assesses your ability to hear and repeat certain words.
  • Pure tone audiogram: Assesses your ability to hear different volumes and sound frequencies.
  • Tympanogram: Measures the ability of your middle ear structures to transmit and amplify sounds.
  • Acoustic reflex testing: Measures the contraction of your middle ear muscles in response to loud sounds.
  • Otoacoustic emission testing: Measures the movement of hair cells within your inner ear.

If you have tinnitus due to hearing loss, you may score below average on the pure tone and speech recognition tests. Depending on the nature of your hearing loss, your audiologist may also detect issues with the functioning of your middle ear or inner ear.

Tinnitus may interfere with your ability to detect certain sounds and pitches, even if you don’t have any underlying hearing impairment. As such, it’s important to tell your audiologist if you’re experiencing tinnitus on the day of your hearing test.

Tinnitus is usually a subjective experience. However, the following tests can help audiologists assess your perception of your tinnitus, including its sound, pitch, and volume:

  • Tinnitus sound matching (TSM): During this test, your audiologist will play common tinnitus sounds back to you, layering multiple sounds, and adjusting the pitch until the sound exactly matches that of your tinnitus. Tinnitus sound matching provides a baseline for assessing the effectiveness of subsequent tinnitus therapies.
  • Minimum masking level (MML): The MML refers to the volume at which an external noise masks your tinnitus. Establishing the MML provides a baseline level of how loud you perceive your tinnitus to be. Audiologists can then use this to devise appropriate tinnitus therapies, such as masking therapies, or sound therapies.
  • Loudness discomfort level (LDL): The LDL refers to the volume at which you find external sounds uncomfortable or painful. This helps audiologists determine the likely effectiveness of different tinnitus treatments, such as:

There is no evidence that a hearing test can cause tinnitus. Indeed, the National Institute on Deafness and Other Communication Disorders (NIDOCD) doesn’t list hearing tests as a potential cause or risk factor for tinnitus.

There is also no evidence that hearing tests can damage hearing. A 2023 review of hearing loss screening guidelines notes that there are currently no observational studies or randomized controlled trials assessing the potential harms of hearing loss screening.

Most medical professionals also agree that hearing tests are a low risk procedure.

Tinnitus is the perception of ringing or other sounds inside the ear, in the absence of any actual external sound. If you have tinnitus, doctors may recommend that you have a hearing test to check your hearing ability and to gain more information about your perception of your tinnitus, such as its sound, pitch, and volume.

Some hearing tests that doctors may use specifically to assess your tinnitus include tinnitus sound matching, minimum masking level, and loudness discomfort level. These tests can help doctors devise appropriate tinnitus treatments, while also serving as a baseline against which to determine the effectiveness of these treatments.

If you experience tinnitus on the day of your hearing test, it’s important that you tell your audiologist. This is because your tinnitus may interfere with your ability to detect certain sounds and pitches, even if you don’t have any underlying hearing impairment.