The audiogram explained: what a hearing test measures and how to read it

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By Sandra Meyer, hearing care professional (Spanish qualification: audioprotesista), registration no. 2822, Professional College of Higher Health Technicians of the Valencian Community · Published 7 October 2026

An audiogram is the chart that shows the results of a hearing test: how well you hear, from low pitches to high, one ear at a time. The test itself is painless – you listen for beeps and repeat a few words. This guide goes through each step and explains how the chart is read, so that what your hearing care professional tells you makes sense.

1. What a hearing test is, and why it’s no substitute for a doctor

A hearing test (audiometry) measures your hearing: which sounds you hear, from what volume, and how well you understand words. It is simple and painless. You sit down, in a sound booth or a quiet room.

It tells us how you hear and whether a hearing aid could help. It is not a medical diagnosis. If we see something a doctor should look at, such as hearing loss in one ear only or a sudden drop in hearing, we will tell you and recommend that you see an ear, nose and throat doctor.

2. Before the test: a few questions, and a look inside the ear

First we have a chat. We ask what you notice, since when, and in which situations: watching television, in a restaurant, on the phone.

Then we look inside your ear with an otoscope, a small torch with a magnifier. This shows us whether there is a build-up of earwax. If there is, the test result would not be reliable. We tell you and refer you to a doctor to have it removed. Then you come back and we do the test.

3. Pure-tone audiometry

You put on headphones and hear beeps, some low and some high, getting softer each time. Whenever you hear one, you raise your hand or press a button. This tells us the softest sound you can hear at each pitch. This is called air conduction.

Then we repeat the test with a small vibrating device placed behind your ear. This is bone conduction: the sound travels through the bone, bypassing the outer and middle ear. Comparing the two helps us understand where the hearing loss comes from.

Finally, we measure at what volume sound becomes uncomfortable. This matters: a hearing aid must be loud enough without ever becoming unpleasant.

4. Speech audiometry: hearing isn’t the same as understanding

Some people hear sounds but can’t make out the words. That is why we do a second test: you hear words and repeat them. This measures how much you understand, not just how much you hear.

‘I can hear, but I can’t understand’ is something we hear very often. This test shows us whether that is happening to you.

If you also notice ringing or buzzing in your ears, you’ll find more information on our tinnitus page.

5. Following speech in background noise: the ACT test

Many people hear well at home but get lost in a restaurant or at a family meal. That is what the ACT test is for: it measures how well you follow speech when there is background noise. If this is what you find hardest, let us know when you book.

6. How to read an audiogram

The audiogram is the chart where we record the results:

• From left to right, the pitches: low on the left, high on the right.
• From top to bottom, the volume: soft sounds at the top, loud ones at the bottom. The lower the mark, the louder that pitch has to be for you to hear it.
• Each ear has its own symbol: usually a red circle for the right ear and a blue cross for the left.

Many consonants, such as ‘s’, ‘f’ or ‘t’, are soft, high-pitched sounds. So when high pitches are hard to hear, you can tell someone is talking but it’s hard to make out what they’re saying.

This explanation is to help you follow what your hearing care professional tells you. It is not meant for interpreting your own audiogram: the result is assessed together with all the other tests.

7. What counts as a ‘normal’ audiogram?

The World Health Organization grades hearing by the average in the better ear:

The grade is only part of the picture. Two people with the same audiogram can understand speech very differently, especially in noise. That is why we look at all the tests together.

8. Is an online hearing test enough? And what happens afterwards

Online or app-based tests can give you a rough idea. But they can’t control the volume of your headphones or the noise in the room, and they don’t test bone conduction or speech. They are no substitute for a full hearing test.

When the test is finished, we show you the audiogram there and then and explain what it means for your daily life. If you would like a copy, just ask. If you don’t need a hearing aid, we’ll tell you. If you have previous audiograms, bring them along and we’ll compare them.