Giving voice

Posted by Liz on Aug 14, 2009 in HRT, voice | 0 comments

Did you know that the female larynx is sensitive to sex hormone changes? Evidently, along with some of the better known symptoms — sleep disturbances, mood swings, hot flashes, night sweats, weight gain, etc — vocal quality may also change in some women.

Experts say that fluctuating sex hormones, i.e. estrogen, progesterone and androgen, can result in a thinning and dryness in the vocal folds (or vocal cords). Because it takes greater effort to make sounds, voice changes can occur. Notably, studies have shown that not all women are affected by these changes nor are they affected in the same ways. However, when women are affected, their voices may get rougher/huskier, lose stability, lose their top notes and vocal range, and change their timbre. Professional singers or actors, or even consultants on the lecture circuit, all of whom rely on their voices to earn a living, are especially affected.

Researchers acknowledge that further study is needed to distinguish between vocal changes that occur as a result of menopause versus those that occur as a direct result of aging. Yet, regardless of the cause and degree that each factor contributes, voice changes can affect almost half of postmenopausal women.

Treatment options include:

• Hormone replacement therapy. Study results have been mixed, with some findings showing improvements in voice complaints and voice function/vocal quality and others, demonstrating none. Further research is needed that evaluates the effect of HRT on the larynx as well as its ability to prevent voice changes if instituted early. Of course, HRT is wrought with other dangers that might make its use, prohibitive or not worth the risk/benefit ratio.
• Voice therapy. Although many questions remain unanswered, vocal coaches  and speech pathologists say that voice therapy can help relieve vocal fatigue. There are exercises that work well to address aging vocal cords, rebuild muscle tone and help women learn how to use their voice more efficiently.The American Speech-Language Hearing Association has a great resource for finding a local professional in your area that specializes in vocal deficiencies.
• Vitamin therapy. Research has shown that multivitamin therapy that includes magnesium, mineral salts, vitamins B5, B6 and E may improve vocal quality and help keep the vocal folds moist. Although experts say that there is not enough evidence for the role of vitamins in voice, vitamins, minerals and anxioxidants play an important role in health regardless of whether voice changes occur.

A quick search on PubMed turned up numerous articles on voice changes during the menopause and the article I sourced for this post (cited below), specifically references nine of these.

I am wondering how many women who are in the menopausal transition are experiencing these problems and are seeing clinicians who might not be aware of the potential link.

What about you? How is your voice quality? Have you noticed any changes?

[Source: D’haseleer E et al. The menopause and the female larynx, clinical aspects and therapeutic options: a literature review. Maturitas (2009) In press.)