Menopause and the voice
- Kathleen
- Oct 26
- 6 min read
Updated: Oct 28
In recent years we have seen more media coverage of menopause and its many effects on the body. We’re seeing more people feeling empowered to talk about this time of change and its effect on their day-to-day life. We hear about brain fog, night sweats, anxiety, vaginal dryness, and so much more! But we’re yet to hear much about the effects menopause can have on our voice.
Recent research estimates that a whopping 46% of us will experience vocal symptoms during menopause. So why don’t we hear more about what to expect and how to manage this when so many of us use our voices in our work as public speakers, in meetings, and as teachers or leaders? What about those who use our voices in our hobbies? And all of us use our voice to express our needs, wants and feelings to others – we deserve to know what to expect when this changes, and how to preserve our voices.
What is menopause?
When I recently asked a group of singers “How long does menopause last?” their (excellent) answer was TOO LONG! Whilst it might feel like this, menopause is actually just one day. We define menopause as the day 12 months after your last period, so it’s just a 24 hour event! Before this, we have perimenopause. This is when most of us will start noticing symptoms such as hot flushes, brain fog, dryness, and many others. During perimenopause our hormone levels fluctuate, resulting in symptoms that can vary from day to day, and month to month. This can last on average around 4 years but could be anything from a very short period of time, to up to ten years or more for some. After perimenopause, we have our menopausal day, and then following this we are post-menopausal. Post menopause, oestrogen levels are lower but more stable. For some this means that symptoms become more manageable, and for others this lower oestrogen level will continue to cause troublesome symptoms in the longer term.
How does it affect the voice?
So, what can we expect when menopause hits our voice? There are 10 key symptoms you might experience:
Dryness
During menopause, we experience dryness not only as a gynaecological issue, but also vocally. Our vocal folds are covered by a mucosal layer which, as oestrogen levels fall, sloughs off. This can mean we experience dryness in the vocal folds leading to coughing or irritation when we speak or sing.
Unpredictability
As hormone levels fluctuate, many people find that their voice becomes less reliable and more unpredictable. You might find that you lose control over pitching and find tuning difficult, or that your voice yodels sometimes when you start speaking. If you're a singer you might also find it hard to achieve a smooth onset at the beginning of a phrase. These effects are not necessarily long lasting or permanent - some people find that they come and go or are less troublesome post-menopause.
Losing volume/power
Many of the interviewees I spoke to mentioned not being able to project their voice as loudly or powerfully as before. As one told me, “I couldn't scream, if someone came at me in the street I just couldn't scream for help anymore.” Others find that their vocal folds don't close fully, leaving them with a breathy and less powerful vocal sound.
Swelling
Changes in progesterone levels can lead to oedema - fluid retention and swelling - in the vocal folds. This can leave you feeling like you have a lump in your throat, and that you need to swallow to try and clear it. As well as being uncomfortable, this can reduce the range of sounds you're able to produce comfortably.
Losing flexibility
During menopause, singers can lose flexibility in their voice. This might mean having trouble with trills, melisma, or other fast-moving passages of notes. It might also take longer for the voice to warm up fully, meaning that both singers and public speakers can take longer to prepare for sessions.
Range/register changes
During menopause, you might find that your range drops and you lose access to higher notes. Some singers find that they gain lower notes at this time too, but this varies from person to person. If you choose to take HRT, there is some evidence that this can preserve access to your higher register post-menopause, but research in this area is still scarce and you should discuss medication with your doctor before making any decisions. In addition to range changes, some people find that transition between registers through their passaggio becomes trickier, and they have to re-engage in vocal exercises to regain smooth control over this area of the voice.
Vocal fatigue
As we lose muscle tone during menopause, the muscles involved in vocal production can weaken. This, in addition to a decrease in lung function for some, can lead to vocal fatigue. Some speakers and singers report feeling vocally tired sooner, or being unable to sustain breath to the end of longer sentences or lines of songs.
Tension
It’s unsurprising that, with all the change in the voice menopause can bring, we might make efforts to try and stabilise the voice. Unfortunately, this instinct often results in added tension in the body, which can put stress on the vocal apparatus. This can lead to a pressed, tense sound in the voice, or feeling discomfort / pain when speaking or singing.
Timbre changes
As hormone levels fluctuate, the colour or sound of your voice can change. Some singers report losing the ‘brilliance’ or ring in their sound, and others describe their voice as sounding ‘rougher’ or having a ‘brittleness in the sound’. For speakers, this can be disorientating as the way they present themselves to others alters. For singers, this can affect their ability to perform repertoire to their expected standard as the sound produced takes on a flatter, duller vocal colour. This can also affect a performer’s confidence levels, as the sound they have trained for years to produce changes without them altering their approach to singing.
Changes to vibrato
Singers who have a vibrato might notice changes to this sound as they go through menopause. Reported changes have included developing a slower vibrato, a wider vibrato, and developing more vibrato in the sound. This can be particularly challenging for choral singers who aim to blend their voice with others.
In addition to these physical changes, it’s also important to acknowledge that menopause can bring cognitive and emotional challenges, particularly slower cognition and/or brain fog. For those who have to use their voice publicly such as singers or teachers, this can add to tension and fatigue when using the voice professionally. It’s also acknowledged that anxiety can be a menopausal symptom, and this can be exacerbated for those who have to speak or sing in front of others when experiencing unpredictable and debilitating symptoms.
What can we do to support our voice during menopause?
Firstly, monitoring patterns of vocal symptoms, even before menopause hits, can be really useful in tuning into your voice, how it feels, and when it’s undergoing change. Try adding vocal symptoms to a period tracker app if you use one, and look out for moments in your cycle where your voice feels more tired, dry, inflexible, or unpredictable. Understanding what is happening as your hormones change pre-menopause, can help you find confidence and coping strategies when similar changes happen during menopausal change.
Learning some simple breathing techniques can be useful in stabilising the voice, and maintaining power during hormonal flux. Accent Method is a widely recognised approach to abdominal breathing and is used by the NHS and SLTs across the UK. The approach has been adapted specifically for singers and has been taught by the British Voice Association. You can watch an introduction to the method HERE.
Regular hydration is key in maintaining healthy voice production. As the NHS suggests, 8 small glasses of water a day is a good start, remembering that little and often is the key to maintaining consistent hydration. If you often experience dryness in the voice, you might choose to inhale steam, or use a nebuliser for some instant vocal hydration.
Learning some technique from an experienced vocal coach will help you build a personal routine of exercise and vocal maintenance. Think of this like seeing a PT at the gym – identifying areas where technique and exercise can help your individual vocal needs and supporting you to maintain these in your own day to day practice.
Finally, taking time for vocal rehab and rest when you need it is crucial during menopausal change. Allow your body time to recuperate after high load speaking or singing days, and make sure that you warm-up and cool-down, just as you would before and after any other form of exercise.
Menopause can be a time of extreme change, and we need to take time to look after ourselves as it occurs. The voice is such an important part of our identity, any change during this time can be hugely challenging, both personally and professionally. But we can also try to enjoy the benefits of vocal change – a deeper resonance and sense of authority in a lower voice, or perhaps an enhanced sense of control over how we present ourselves as we pay attention to our voice and how we use it. Enjoy getting to know your voice all over again as it changes, and feel empowered as you learn to use it in a deliberate, informed way.
If you would like support in managing your menopausal voice, get in touch HERE.
