The primary aim of this study was to describe coping with noise-induced hearing loss (NIHL) from the perspective of middle-aged men. An additional aim was to gain a deeper insight in their experiences of suffering from NIHL. Taped interviews were conducted with 53 consecutive patients. The interviews focused on the subjects' own descriptions of demanding auditory situations and what they did, thought and felt in these situations. The verbatim transcribed interview protocols were analysed by a method influenced by the tradition of grounded theory (Glaser and Strauss, 1967). The first important finding was that the coping model, consisting of controlling and avoiding strategies, described by Hallberg and Carlsson (1991), was validated by the present data. Second, it was shown that avoiding strategies dominated among men with NIHL, although situational circumstances, interactional conditions, social closeness and degrees of priority, awareness and acceptance sometimes changed the behaviour towards the more controlling strategies. Identification of these five factors should be regarded as an extension of the original model of coping, a third important contribution of this study. The driving force for coping was the hearing impaired person's striving to avoid definition as a deviant in social interactions in order to maintain a positive (normal) self-image. Health professionals are requested to encourage men with NIHL to recognize, confirm and actively seek solutions to problems caused by their hearing loss rather than to reinforce their denial of hearing difficulties.