Research shows how the voice changes through menopause

Voice changes in menopause are often overlooked, despite affecting women significantly, especially those in jobs where the voice is central to daily work, new research has revealed.

A review of existing studies found that vocal changes receive far less attention than symptoms such as hot flushes or brain fog, even though they can have major consequences for teachers, reporters and voice actors.

Researchers found these changes are poorly understood, partly because they develop slowly.

Menopause, which usually occurs around age 52, involves falling oestrogen levels that affect the vocal folds – the tissue in the larynx that produces sound.

This can lead to deeper, hoarser voices with reduced projection.

Rupal Patel is professor of communication sciences and disorders and director of the Voice of Women Lab at Northeastern University.

Patel said: “Voice changes during menopause are subtle and gradual but for those who use their voice a lot — voice super users — these have massive implications on their daily life and also their profession.

“Many times the other symptoms of menopause have more attention but voice changes, because they’re subtle and gradual, are not necessarily given the same importance in terms of affecting the individual’s life.”

The impact is greatest for professional voice users, three-quarters of whom are women.

“If you’re a teacher or in any one of these professions that uses the voice a lot, it can actually mean a difference between taking days off work and being productive or not,” Patel said.

“Voice-over actors who are females often complain that they’re no longer desirable voices.”

She added: “It’s actually a big issue because most of the voice super users, 75 per cent of them are women. If you think about teachers, 75 per cent of teachers are women. If you think about voice-over artists, there’s just a high predominance of women.”

Another difficulty is that vocal changes have often been mistaken for other conditions.

Patel and her team aim to address this gap using new technology, including artificial intelligence, to study voice in greater detail.

She previously founded VocaliD, a company that cloned the voices of female voice-over artists with their consent, partly to prepare for the career challenges women face as they age.

Patel said: “They knew that people would have less interest in their voice as they aged, and they thought that would be an insurance policy.

“If they banked their voice ahead of time, created their synthetic voice, they could still speak as their younger selves with their synthetic voice and then as their voice ages take on other roles.”

Current projects include exploring whether hormone replacement therapy can help preserve voice quality and whether changes to the oral cavity during menopause may contribute to sleep apnoea in women.

Patel said more recognition is urgently needed: “How can this be ignored for so long when 100 per cent of women, regardless of whether you’ve had a child or not, are going to go through menopause?”