A recent study from the University of South Florida, published in the journal Menopause, has brought attention to a health issue that often goes unnoticed: the impact of menopause on women’s voices. The study reveals that changes in voice quality, attributed to declining levels of estrogen and progesterone, can significantly affect women, particularly those who use their voices professionally.
Led by Dr. Yael Bensoussan, director of the USF Health Voice Center, and Rupal Patel, a professor at Northeastern University, the research highlights that women in professions such as teaching, acting, and singing are most vulnerable to voice changes. These changes can manifest as roughness, hoarseness, and a loss of vocal stability.
The Complexity of Voice Production
The study emphasizes the intricate nature of voice production, which involves the coordination of respiration, phonation, articulation, and resonance. “Voice production is a complex physiological process requiring the precise coordination of multiple systems,” the authors noted in their paper titled “Menopause and the voice: a narrative review of physiological changes, hormone therapy effects, and treatment options,” published online.
According to the study, even minor disruptions in these systems can affect vocal quality. The vocal folds depend on musculature, pliability, and airflow, while tension and elasticity are crucial for sound production. “Hormonal fluctuations play a critical role in maintaining the structural integrity of laryngeal tissues,” the authors wrote.
Treatment Options and Future Directions
The research team outlined several treatment options to address these voice changes:
- Voice therapy to reduce strain.
- Hydration and steaming to alleviate dryness of mucosal tissues.
- Hormone therapy in collaboration with gynecology.
- Bilateral vocal fold injections to restore clarity and volume.
Additionally, the study highlights the potential of AI-powered voice biomarkers as a noninvasive tool to detect subtle vocal changes linked to menopause. Dr. Bensoussan emphasized the need for further research and collaboration with gynecologists to better understand the role of hormone therapy in managing these changes.
“What needs to be done in the future is more research and more collaboration with gynecologists,” Bensoussan said. “And hopefully there will be more awareness to refer patients with these symptoms to a voice specialist.”
Real-World Implications
Dr. Bensoussan, an assistant professor in Otolaryngology at the Morsani College of Medicine, is also spearheading research to develop a database of human voices analyzed with AI to identify potential disease biomarkers. Her interest in menopause-related voice issues was sparked by her patients’ experiences.
“I was seeing a lot of middle-aged women just around menopause age, and they were coming in with very specific symptoms of rough voices, and dry coughs,” she explained. Despite normal visual examinations of the vocal cords, these women reported tired voices, prompting Bensoussan to explore the hormonal effects on voice changes.
Broader Awareness and Challenges
Dr. Bensoussan recalls a singer whose teacher could detect her menstrual cycle based on changes in her voice. “Often these women—like many in women’s health—are dismissed and told ‘Oh, it’s reflux, oh it’s laryngitis, oh it’s nothing,'” she said. “But a lot of these voice professionals are being dismissed because there’s not enough understanding that hormones have a huge impact on the voice.”
Another concern raised by the study is the use of testosterone therapy in menopausal women. “Unfortunately, testosterone is a male hormone and one of the side effects is a ‘more masculine’ voice,” Bensoussan noted. Women often arrive at her office unaware of this side effect, leading to distress and frustration.
The collaboration with Patel, who experienced her own voice changes during perimenopause, and Dallas gynecologist Dr. Cheryl Kinney, helped solidify the project’s direction. Bensoussan’s presentation at a Menopause Society event in Chicago was met with surprise and interest, underscoring the lack of awareness about the hormonal impact on voice.
Conclusion and Future Prospects
The study concludes that AI voice biomarkers could revolutionize early detection of menopause-related voice changes, but emphasizes the importance of increased awareness and interdisciplinary collaboration. As research continues, the hope is that women experiencing these changes will receive the attention and care they need from voice specialists and healthcare providers alike.
