If you can hear sounds and understand some words but not others, or you can’t differentiate between a person’s voice and surrounding noise, your hearing issue might be in your ear’s ability to conduct sound or in your brain’s ability to process signals, or both.

Brain function, age, overall health, and the genetic makeup of your ear all play a role in your ability to process sound. You might be dealing with one of the following types of hearing loss if you have the aggravating experience of hearing people speak but not being able to comprehend what they are saying.

Conductive Hearing Loss

When we tug on our ears, continuously swallow, and say again and again to ourselves with growing annoyance, “something’s in my ear,” we may be suffering from conductive hearing loss. The ear’s ability to conduct sound to the brain is diminished by problems to the outer and middle ear like wax buildup, ear infections, eardrum damage, and fluid buildup. Depending on the severity of issues going on in your ear, you may be able to make out some individuals, with louder voices, versus hearing partial words from others talking in normal or lower tones.

Sensorineural Hearing Loss

Where conductive hearing loss can be caused by outer- and middle-ear problems, Sensorineural hearing loss impacts the inner ear. Injury to the inner ear’s hair-like cells or the auditory nerve itself can stop sound signals from going to the brain. Voices might sound slurred or muddy to you, and sounds can sound as either too low or too high. If you can’t separate voices from background noise or have difficulty hearing women and children’s voices particularly, then you may be suffering from high-frequency hearing loss.