Even though half the population goes through it, the symptoms of menopause are still not fully clear.
Hot flashes, night sweats and fatigue often get the spotlight, but there can be several other surprising signs of menopause — including your voice changing.
And while nearly half of US women feel completely uninformed about the condition, this lesser-known sign is affecting more and more women, according to one groundbreaking new study.
Although a completely natural process that affects all women — occurring when ovaries produce less of the hormones estrogen and progesterone and stop releasing eggs altogether — the details around menopause are still fuzzy, even to doctors.
But a USF Health research paper published in the journal Menopause has shed new light on one big change in women and why it happens.
After looking at several studies over the last 20 years, researchers discovered that almost half of menopausal women have experienced noticeable vocal modifications such as increased roughness, hoarseness and a loss of vocal stability.
Certain professions are more affected than others, with the study finding that teachers, actors and singers suffered unwanted vocal changes.
How our voices sound is a complex process requiring precise coordination of multiple bodily systems, and the muscles, proper airflow from the lungs and elasticity of vocal cords all play a role in the vocal folds.
Even the smallest disruptions can have a negative impact, including hormonal fluctuations that help keep the structure of our larynx or voice box intact.
And while the decrease in estrogen and progesterone plays a role, they’re not the only ones, as women often turn to hormone therapy to manage symptoms.
“Unfortunately, testosterone is a male hormone and one of the side effects is a ‘more masculine’ voice,” said lead researcher and director of the USF Health Voice Center Yael Bensoussan. “I ask if they’re on testosterone, and they say, ‘Yes,’ and… they were never told that it would affect their voice.”
But it’s not just women going through menopause who are hearing these changes.
Bensoussan also noted that one of her patients, a singer, sounded different whenever she had her period.
There are a variety of treatments for this unusual sign, with voice therapy, hydration and systematic hormone therapy listed in the paper as top options.
There’s also a procedure known as bilateral vocal fold injection augmentation that consists of injections into the vocal cords to “plump up” the folds to counter any weakening of the muscles.
Bensoussan and the other researchers involved are also looking into AI-powered voice biomarkers as a noninvasive tool to detect small changes in vocal function — including those connected to hormonal fluctuations caused by menopause.
Ultimately, though, this predicament is currently not fully understood, especially why it happens.
“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.
“And we need more research to understand at what level does giving hormones help the voice — and who should we give them to,” she added.
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