Let’s talk (peri)Menopause and the voice, what is happening?
One of the most poignant part of the female voice’s career and journey is when the body begins and goes through (peri) menopause. Its imperative that we understand how the voice works optimally through this phase and what physical changes are actually occurring in the body that influence the instrument. In this way, we can actively preserve, enhance, and hone in on our work with clarity and direction. These changes usually occur between the ages of 40-60, it just depends on the person, from peri-menopause to the end of menopause, which can take up to 15 years. (For me, I noticed symptoms at age 43.) If the singer does not know what is happening, or how to address the voice then they won’t be able to maintain and/or grow in development through this phase and they will likely lose aspects of their technique that may have been taken for granted.
Below are some of the changes that may occur due to lowered estrogen, progesterone and testosterone (or erratic changing levels of these hormones).
Vocal changes that can be observed functionally:
Loss of range and/or Lowered range
More prevalent gaps or inconsistencies in registration blend and function
Timbre changes, including vibrato
Vocal fatigue
(Its important to note that these changes alone don’t necessarily imply that the singer is going through menopause. These changes could be caused by something else, so its important to know many aspects of a singer’s development, practicing, technique, vocal use, etc. that could also be reasons for these changes.)
Other changes occurring in the body:
Loss of moisture retention
Thickening of the vocal cords
Muscle mass loss, strength and tissue repair capabilities
Increased inflammation
Tendon, ligament, and joint stiffness
These affect vocal function in every way. But we CAN help our instrument!
MOISTURE: Estrogen and Progesterone play a key role in the body’s ability to regulate and retain moisture. Their fluctuation can lead to not only drier/raspier function in vocal sound quality, but also gaps in registrational fluidity (blending between chest and head voice).
THICKENING: If one knows nothing else physiologically, it is that pitch is fixed and unalterable. To sing in tune and have accessibility to all pitches in our range, especially higher pitches as we age, we must have the correct dimensions for the vocal cords: in length AND thick/thinness. All instruments work this way for pitch. If a singer is not getting the high ‘A’ they used to have, it is because the cords are not allowed to make the proper adjustment. When a singer goes through menopause, the cords thicken (as they do with age, too), and therefor, to keep the high notes they’ve always had, one needs to make sure the vocal cords can achieve their proper thinning process, one of the most important parts of vocal vitality and longevity! Functionally, the cords must be stretched and lengthened by the correct use of the crico-thyroid (it’s contraction), and gradual, incremental release of the arytenoids as the pitch ascends. This simultaneous coordination of antagonistic forces is the main source of equilibrium for registration. It is imperative that the crico-thyroid be in good shape, both in it’s strength and endurance. AND, it is also imperative that the arytenoids do not take over in power and over-bearing strength so as not to upset the precarious balance between these muscle systems to maintain proper pitch (ie: thinning). This step is KEY.
MUSCLE MASS LOSS, STRENGTH, TISSUE REPAIR: Estrogen protects muscle breakdown; so when estrogen lowers during menopause, women lose muscle mass and strength at a much faster rate than they used to. In addition, lower estrogen means the body’s muscle satellite cells (which the body relies on to rebuild and heal muscles) are depleted by the loss of estrogen. To put it simply, this means: muscles can’t repair or build as fast or as efficiently. The muscles used in the larynx to sing (there are over 60!) lose their strength and power faster than they used to. Essentially, if you don’t use it (AND use it better, more efficiently, and smarter than you used to), you’ll lose it. Just as with any other muscle in the body, if we are not getting estrogen, we need to try to compensate for our muscles by considering:
Hydration: Enough water which assists in transporting essential nutrients and oxygen directly to the muscle cells.
Resistance Training: If it were our biceps or calves, we would need to lift weights or use resistance bands several times a week to actively stimulate growth and resist muscle decline. So, we MUST have a resistance training/exercise program in place for our vocal/laryngeal/pharyngeal muscle systems, knowing precisely what we are doing, and WHY.
Protein Intake: Eating adequate protein supports muscle repair, recovery, and rebuilding processes. (Just don’t do too much, which leads to other problems.)
Rest and Recovery: For a while, we may need extra recovery time between intense vocal workouts or sets/exercises because hormonal shifts/low estrogen can slow natural tissue repair.
INFLAMMATION: Estrogen is a natural anti-inflammatory. So, when estrogen levels go down, the result is that our inflammatory proteins increase, which means that inflammation goes unchecked, causing muscle soreness and joint stiffness. We have joints and cartilages working in the larynx. Therefor, we must do what we can preventatively to inhibit inflammation and prevent it. One should do their own additional research about keeping inflammation down in the body, which is also influenced by what we eat, how we move, and even cortisol levels (provoked by stress). One of the root causes of additional inflammation, for the voice during menopause, is declining estrogen.
STIFFNESS: There is a rapid reduction in collagen during peri/menopause, which makes joints and connective tissues stiffer, and can mean less fluid vocal movement, and a higher chance for injury. This connectively relates to our water retention, and inflammation. We need collagen for healthy bones, connective tissues, cartilages and tissues. Again, here, one can do their own research as to ways to supplement collagen that work for them, but the root cause is the lack of estrogen.
THE LESSON:
HOW we work with our voice via technique SHIFTs as our body changes. The same warm ups or exercises that used to work well to maintain our voice and have excellent technique aren’t enough because the instrument itself is changing. We need to trigger the muscles to respond in a new, additional way. We must modify the approach as we listen to FUNCTION to get the desired result, taking it one step at a time. This requires a teacher with keen listening that has the knowledge of functional training (exercise X ~specific pitch, intensity, vowel~ produces outcome Y.) They need the ability to hear what the muscle systems are doing, how they are out of balance, how to trigger and stimulate the correct muscular response, and in what order, allowing for recovery, and then building strength and endurance. THIS IS A PROCESS that requires a professional.
I’m still on my peri-menopause journey, but after having worked with many women in the last few decades that have dealt with peri/menopause, it is encouraging to know through experience and witness that we don’t have to just “accept, suffer, excuse or change voice type.” That may be some singers’ solution, but with proper training, keeping in mind what changes are taking place in the body, and how it affects the vocal apparatus, I believe we can train it accordingly and support it, too. It is always good to have another vocal pedagogue’s input as to what they also hear functionally and see if it is alignment with your experience and goals. This was most helpful to me. I began to put the puzzle pieces together for myself, and you can, too.
As Cornelius Reid said “with complete knowledge, all voices can be fixed.” Here is the true testament to what you know, and how do to it.
May your voice be blessed, and a blessing to others as you navigate this time in life! (And let me know how I can help!)
