Hormones and the Female Voice: An Exploration of the Female Hormonal Cycle from Puberty to Menopause and How it Affects the Vocal Apparatus

Abstract

The purpose of this paper is to examine the female hormonal cycle throughout a woman's life and its effects on the singing voice. Dealing with vocal issues brought on by hormonal fluctuations can be extremely frustrating for the professional singer, as these issues can wreak havoc on performance and practice schedules. The best weapon of defense against its unpredictability is information. Unfortunately, data on the female hormonal cycle and its effects on the voice is not covered in most standard vocal pedagogy books. Information on the subject is often relegated to a small section of a chapter, and even then usually describes only the symptoms: edema, hoarseness, and loss of high notes and power. The question as to why these symptoms happen every month and during menopause, and whether there is anything that can be done to alleviate them, remains largely unanswered. A candid discourse on the subject of hormones and the female voice has begun, but now must brought into the open. It is a subject that needs to be broached in voice studios everywhere. Can the effects of hormonal fluctuations on the voice be managed? What treatments are there for the symptoms; are they safe; are they effective? How can we further the dissemination of information on this subject? This paper will attempt to answer these questions by compiling data from the studies and research of esteemed doctors and scientists on this subject into one document, making it easy for young students and interested voice teachers to access this important information. It is my goal with this monograph to help and inform my readers. The human larynx is directly influenced by lifelong cyclical hormonal fluctuations. A woman's monthly cycle, which lasts from puberty to menopause, causes changes in hormone concentrations. These changes can affect a woman's physical and emotional states, causing bloating, and temporary abnormalities in sleep, mood, concentration levels, and energy. These effects are also seen in the vocal tract, where edema, vocal fatigue, decreased range, and lowering of the fundamental frequency can occur. The monthly symptoms of hormonal change are called premenstrual syndrome, or PMS. Similarly, the symptoms manifested in the larynx are called premenstrual vocal syndrome, or PMVS. This paper is an examination and exploration of the effects of PMS and PMVS on the singing voice. To do so, it provides a brief overview of the steroid hormones: estrogen, progestogen, and androgen. These three hormones are responsible for the development and maturation of primary and secondary sexual characteristics. It is only through studying the specific functions of each of the steroid hormones that it is made clear why some women suffer so profoundly each month from PMS and PMVS. Additionally, this paper provides information regarding the benefits and drawbacks of oral contraceptives, or OCPs. OCPs contain synthetic hormones that mimic the body's own natural hormones, and they regulate the body's levels of estrogen and progesterone, which prevents ovulation. In addition to their contraceptive use, OCPs are used to treat endometriosis, acne, and irregular periods. By preventing the body's hormonal levels from fluctuating, OCPs have proven highly effective as a treatment of PMS and PMVS. Further, the changes to the voice during pregnancy will be examined. The increased hormonal concentrations associated with pregnancy act upon the reproductive organs, muscles, bone, cerebral cortex, and mucosa, as well as the larynx. This paper also explores what happens to the voice throughout the stages of menopause, the symptoms of which can range from moderate to quite severe. Treatment options are discussed, including both hormone replacement therapy and alternative methods. Lastly, this paper shares information gathered from a survey of singers regarding their own experiences with PMS and PMVS, OCPs, pregnancy, and menopause.