How Hormones Affect the Singing Voice Throughout Life

By Meredith Colby

We’ve all had the experience of a misbehaving voice that we did nothing to deserve. Our higher range may not be cooperating, our voice might feel heavy or thick, or we might feel vocally tired sooner than normal.

Our first response, typically, is to start applying techniques to troubleshoot. Sometimes we feel embarrassed or frustrated, because we think it's up to us to “solve the problem” for ourselves or our clients or students. But sometimes it has nothing to do with either the singer’s technique or our coaching.

Sometimes it’s just hormones.

The voice is a secondary sex characteristic: physical traits that emerge during maturation in response to hormones but that are not directly tied to reproduction. As such, sex hormones influence our voices throughout our lives. And for voice teachers and vocal coaches, it’s good to remember – as well as remind our clients – that the instrument we're working with is constantly changing.

Your vocal folds respond to hormones

Both your brain and your larynx are sensitive to sex hormones, including estrogen, progesterone, and testosterone, which act on the tissues of the vocal folds. That direct action on the tissue helps explain why hormonal changes can affect both vocal fold structure and function.

While everyone's voice changes over time, some of the most noticeable fluctuations occur in people who menstruate, become pregnant, or experience menopause.

The menstrual cycle and your singing voice

Throughout the menstrual cycle, estrogen and progesterone levels rise and fall. These fluctuations can influence vocal fold lubrication, tissue congestion, and vocal efficiency.

Estrogen (estradiol) generally promotes mucus secretion. In menstruating women, this contributes to maintaining the conditions for easy vocal fold vibration. In the two days before ovulation, estradiol spikes. At that time, the singer can experience excess mucus, reduced flexibility, swelling of the vocal folds, or a feeling of “heaviness” in their voice.

In the days following ovulation and before menstruation, progesterone is at its highest levels. At this time, the singer can experience dryness, vocal fatigue, and loss of agility or range.

The name for this collection of symptoms is dysphonia premenstrualis, and like all the things that apply to voices and people, it shows up differently for individual singers.

Some studies report measurable vocal changes during the menstrual cycle, and others find little difference in vocal performance or perceived voice quality. 

So although we can't assume that every menstruating singer will experience predictable changes to their voice, it’s important to remember that hormones can influence vocal performance – or even be to blame. 

Pregnancy changes more than your waistline

As any pregnant person will tell you, pregnancy changes everything. Hormones go hog-wild during pregnancy and are almost certain to affect the voice, particularly during the third trimester.

The elevated progesterone levels in pregnancy can affect, among other things, vocal fold lubrication and contribute to tissue congestion. In the third trimester, the internal organs of the expectant mother are profoundly squished, altering lung volumes and breathing mechanics.

Overall, being pregnant is almost certain to change the singer’s experience of her voice. We can, and should be, reassuring to our singers during this time.

Menopause, testosterone, and the aging voice

Hormonal changes continue as we age, and they affect voices differently. 

During and after menopause, estrogen levels decline, and although androgen levels stay the same, the singer will experience a relative increase. This situation can contribute to a lowered speaking pitch, reduced vocal range, vocal fatigue, or changes in vocal timbre.

In men, testosterone generally declines more gradually. Age-related changes can include thinning and bowing of the vocal folds, increased breathiness, and sometimes a higher speaking pitch.

Of course, hormonal changes are only part of vocal aging. Muscles, connective tissues, and the respiratory system also change over time, affecting how our voices feel, sound, and behave. That doesn’t mean that a person should stop singing, but it does mean some adjustments - both functional and psychological - may be necessary.

What does this mean for voice teachers & vocal coaches?

The physical properties of a singer’s voice can change from week to week, and across their lifetime.

When a singer experiences vocal challenges that they – or we – don’t expect, we need to consider the possibility that their physiology has temporarily changed. 

Of course, that doesn’t mean we should try to diagnose hormonal problems. But it does mean asking good, informed questions, listening to what the singer reports, and resisting the urge to treat every unexpected vocal change as a technical problem.

Our job is to help singers understand and work with the instrument they have today.

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This article is based on readily available information as well as the following research reference: Zamponi, V., Mazzilli, R., Mazzilli, F., & Fantini, M. (2021). Effect of sex hormones on human voice physiology: From childhood to senescence. Hormones, 20, 691–696. https://doi.org/10.1007/s42000-021-00298-y