How Menopause Affects Women's Voices and Its Significance

A recent study conducted by the University of South Florida, published in the journal Menopause, sheds light on an often overlooked aspect of women's health: changes in voice during menopause. The research highlights that many women experience voice alterations—such as increased roughness, hoarseness, and a loss of vocal stability—primarily due to declining levels of estrogen and progesterone. These hormonal fluctuations impact the structure and function of the larynx (voice box), affecting muscles, tissue pliability, and airflow, which are critical for sound production.

Leading researchers Yael Bensoussan, MD, from USF Health Voice Center, and Rupal Patel from Northeastern University, explain that women who rely heavily on their voices professionally—teachers, actors, singers—are particularly vulnerable to these changes. The complexity of voice production involves multiple systems, including respiration, phonation (sound creation), articulation, and resonance. Disruptions in any of these can significantly impair vocal quality.

The study suggests several treatment options to address menopausal voice changes:

• Voice therapy aimed at reducing vocal strain
• Hydration and steaming to mitigate dryness
• Hormone therapy in collaboration with gynecologists
• Bilateral vocal fold injections to restore clarity and volume

Additionally, innovative approaches like AI-powered voice biomarkers show promise for early detection of subtle hormonal-related vocal shifts, offering a non-invasive diagnostic tool.

Bensoussan emphasizes the importance of increased awareness and collaboration between voice specialists and gynecologists. She notes that many women, especially those in voice-dependent careers, are often dismissed or misdiagnosed with conditions like reflux or laryngitis when in fact hormonal changes are the underlying cause.

Her personal observations stem from treating middle-aged women presenting with tired or rough voices without visible abnormalities in their vocal cords. Many women report their voices sounding different during menstruation or hormonal fluctuations, a phenomenon often overlooked in clinical practice. Bensoussan also raises concerns about testosterone therapy prescribed for menopausal women, which can lead to undesirable masculine vocal traits if not properly managed.

This research underscores the need for more studies, greater clinical awareness, and interdisciplinary efforts to support women experiencing menopausal voice changes. With advancements in AI and a deeper understanding of hormonal impacts, early detection and personalized treatment plans could significantly improve quality of life for affected women.