Should I Have One Hearing Aid Or Two?

Binaural and monaural hearing aid systems explained

A hearing aid fitted in just one ear is known as a monaural system, whilst hearing aids fitted in both ears is a binaural system.


So what would be best for you?


To answer this you have to first start with the results of your free hearing test, as this will show you whether you are experiencing loss in just one ear (unilateral loss) or if you are suffering from loss in both ears (bilateral hearing loss).

Loss in one ear is usually attributed to a condition, disease or trauma (such as damage from sudden loud noises) which impacts on the transit of sound in the middle ear.

This is known as conductive hearing loss.

Loss in both ears is usually attributed to sensoneural hearing loss.

This term is used to describe any kind of hearing loss which causes a problem with the inner ear. There are several causes of this (such as genetics) but by far the most common is presbycusis.

Presbycusis is simply the clinical name given to progressive age-related hearing loss.

This affliction usually affects both ears simultaneously, causing bilateral hearing loss and is unfortunately non-preventable and non-reversible.

Although presbycusis is age-related, the condition can begin in people as young as 18.

After the age of 65 around 20% of the population experience hearing loss, and for those 74 and over this figure goes up to 40% and beyond.

The only effective treatment of progressive hearing loss (and most of the other forms of hearing loss) is through the fitting of hearing aids.


If you have bilateral hearing loss, two hearing aids are far better than one:

Having two aids work together ensures you have a balanced hearing experience.

However, if you have bilateral hearing loss and only go for a single hearing aid, you are going to have an unbalanced hearing experience.

You will find it very hard to localise sounds and you will have a hearing dead spot to one side. Although having one hearing aid will improve your hearing, your hearing experience will be sub-optimal. 

These are the benefits of a binaural hearing aid system for those with hearing loss in both ears

  • You can ‘localise’ sound easier (i.e. detecting the origin/direction of a sound). This has additional safety benefits as well.
  • Speech recognition becomes easier.
  • Group situations are easier to cope with.
  • Sound quality is better due to having a 360 degree hearing range rather than a 180 degree range.
  • Two aids working together requires lower volume control, creating less distortion, feedback and a smoother tone quality.
  • The lower volume also helps you cope better with sudden loud noises.
  • You can hear noises from much further distances away.
  • Your hearing becomes balanced – think of it like wearing headphones over both ears rather than just one.
  • Hearing aids can help mask tinnitus in about 50% of people. If a hearing aid does mask your tinnitus you will still suffer in the unaided ear if you only have one fitted.
  • There is a huge jump in sound clarity when two are fitted.
  • It's less tiring to wear two hearing aids rather than one.

As you can see, that is a fairly comprehensive list!

If you have hearing loss in both ears there is no doubt that fitting just one hearing aid will make your hearing better than no aid at all.

However, fitting two aids is far more effective if you have hearing loss in both ears!

Who needs a monaural hearing aid system fitted?

It is a surprisingly common misconception that you will only need a single hearing aid to restore your hearing.

People who require a single hearing aid to be fitted are those who are suffering from unilateral hearing loss, which is less common than bilateral hearing loss.

In the case of a person with unilateral hearing loss, one ear is damaged but the other can hear ‘as normal’ so natural hearing is unbalanced.

In this case a single hearing aid is required to make up for the damaged ear in order to provide comfortable, balanced hearing.

How do I know if I have hearing loss?

The answer to this is simple – with a free hearing test as performed by a fully trained and accredited hearing aid audiologist.

You may see such things as online hearing tests or even apps which do hearing tests but these are (at best) simply indicators that you may have hearing loss.

If you are concerned about your own hearing or the hearing of a loved one you can simply click on the button below to book yourself in for a hearing test at a time and place which is convenient for you.

We operate nationally and we can visit you at your home, so wherever you are in the UK just leave us your details and we will handle the rest: