I am 46 years old, and I sing in my church choir. My singing seems to be changing as I grow older. One of my friends said that a woman’s hormones can affect her singing. Is she right?
Your Menopause Question: I am 46 years old, and I sing in my church choir. My singing seems to be changing as I grow older. One of my friends said that a woman’s hormones can affect her singing. Is she right?
Our Response: Your friend is correct. There is a library of literature on this topic. Anecdotally, have you ever noticed that your aging mother’s voice seemed to creak or sound hoarse as she got older (Smith, 1962, and Grodnitz, 1971)? When did this health issue become apparent? This is not a new discovery, as history has shown.
As early as 400 B.C.E., Roman choirs needed singers with high voices. However, girl singers were not allowed on stage. Instead, young boys, before entering puberty, served that purpose. As they entered puberty, however, their voices dropped, limiting their usefulness in the choir (Jenkins, 2000).
Enter a dark part of voice history. To prevent young boys from entering puberty, when they were between the ages of 7 and 9, they essentially were castrated. Although their testicles were not removed surgically, blood supply to them was ablated, leaving the testicles to necrose and die. One might think that this barbaric procedure, which often led to young boys dying from improper and unsterile surgery, would have disappeared with the fall of the Roman Empire. However, this was not the case. This procedure was evident even in the early 1700s, in the United States, where it is estimated that 4,000 boys underwent castration each year. While castration finally was outlawed in the mid-1800s, this procedure and its relationship to voice and puberty was evident before healthcare workers even knew that hormones were involved (Jenkins, 2000).
So, let’s follow the science. First, the observation. Among adults, women’s voices after puberty drop 24% and men’s voices drop 75% (Abitbol, 1997). Because voice is so dependent on functional vocal cords, the obvious step was to examine how the vocal cords respond to hormone changes. In 1982, a professional married couple, he, a head and neck surgeon, and she, an OB/GYN physician, studied a group of women undergoing anesthesia for other reasons. By simultaneously taking a swab from the vocal cords and also from the cervix and comparing both with the time in menstrual cycle, they showed that the mucosa taken from both areas was similar based on the status of the patient’s hormones, a condition now described as laryngopathia premenstrualis (Abitbol, 1997 and Ouyong, 2018).
Today, professional singers take advantage of these findings. Because the first half of a menstrual cycle is dominated by estrogen to prepare the endometrium for possible pregnancy, this window for singers is desired for maximum vocal cord function when compared to the latter half of the cycle when progesterone dominates.
Furthermore, professional singers have watched their singing careers decline as they enter menopause with the loss of ovarian estradiol, a career-ending issue that even hormone replacement therapy often cannot correct (Decoster, 1997; Abitbol, 1997; and Kinney, 2019). Witness how successful singers who opt for bariatric surgery may find their singing careers jeopardized (Abdul-Latif, 2014). Finally, recall the phrase “it’s not over until the fat lady sings.” Obesity generates elevated levels of estrone. While not as powerful as estradiol, estrone is sufficient to protect the vocal cords.
What is the take home message? The body is not a collection of independent systems. Instead, it should be thought of as an integrated network. This network is controlled, in large part, by our hormones.
James Woods | 12/23/2021
