Singing Through Menopause

by Jamea Sale, contributing author, DevelopingVoices.blog

“While the vocal apparatus does change as we grow older, researchers have found that voice training may help maintain the voice as we age.”  (Butler, 2001).

The Female Voice undergoes changes throughout the lifetime. Her habitual voice pitch descends from age 4 to 50 years, & finally settles in her 80s. Adolescent girls must navigate voice changes when the larynx experiences a growth spurt in which the vocal folds experience a 3 to 4 millimeter total increase in the length (Kahane, 1975).

Female singers face additional challenges with the onset of menopause that have a direct effect on the vocal mechanism. Estrogen deprivation causes substantial changes in the mucous membranes that line the vocal tract. As estrogen levels decrease, laryngeal tissues begin to absorb water causing the vocal folds to swell, blood vessels to become enlarged, and vocal fold mass to increase (Emerich, Hoover.  Sataloff, 1996). Changes in hormone levels have been associated with decreased fundamental frequency (pitch) hoarseness, decreased vocal range, and difficulty with complex motor tasks (Boone, 1997; Emerich. et aI., 1996).

Estrogen therapy has been helpful in forestalling the typical voice changes that follow menopause. It has been shown that those on HRT (hormone replacement therapy) tend to have a higher habitual voice pitch than those not on HRT, (Hamden et al 2018) yet there seemed to be no significant difference in voice complaints between the two groups.

VOCAL CHANGES AS WE AGE:

• Atrophy of the Laryngeal Cartilages
• Reduced volume and projection of the voice (thin sound)
• Reduced vocal endurance & fatigue
• Reduced efficiency in muscle coordination causing pitch inaccuracies
• Rough or hoarse vocal sound
• Tremor or shakiness in the voice
• Hearing Loss
• Vocal cord atrophy (bowing) causing breathy tone
• For women: Laryngeal atrophy, edema, and increased presence of deep, narrow furrows or grooves in the vocal fold (vocal fold sulci). Changes in the vocal folds may include edema and thickening of the superficial layer of the lamina propria [the thin vascular layer of connective tissue beneath the epithelium]

WHAT IS HAPPENING TO CAUSE THESE CHANGES?

• Cartilages naturally ossify (turn to bone) by age 65 causing less flexibility & resiliency in the vocal mechanism.
• Muscles and ligaments lose elasticity and collagenous fibers making them thin and stiff.
• The outer layers of vocal folds deteriorate, creating less protection for the vocal muscles underneath.
• The vocal fold edges can become ragged resulting in a “roughness” to the voice quality.
• Folds may exhibit a gap or “bowing” in the middle third causing a “breathy” tone.
• Decline in respiratory function beginning around age 40 with a 40% loss between the ages of 40 and 80.
• Adverse health conditions natural to aging can affect the respiratory and cardiovascular system.
• Many medications affect the salivary glands, and mucous-secreting membranes of the respiratory tract, reducing and thickening mucosal secretions, resulting in minimal lubrication of that area. The resulting dry cough may eventually damage the vocal folds.
• Sedative effect of some meds slow response time of the laryngeal muscles.
• Regular use of aspirin predisposes singers to hemorrhage especially in unconditioned singers.

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KEEP SINGING WITH A DAILY AND SYSTEMATIC VOCAL FITNESS PROGRAM

• Warm up the muscles connected directly or indirectly to the vocal mechanism: groups of muscles in the face, neck, shoulders, arms, upper chest, abdomen, sides of the torso, and upper/lower back.
• Stature: Maintain upright, buoyant, balanced.
• Inhalation & Exhalation Exercises: Pant, Sing Staccato Vowels, Puff, Hiss, Shh, etc., Hum gently, gradually letting the sound swell.
• Relax & Stretch the Vocal Tract: Lip & Tongue Trills: Bbb, Prr, Trr, Hrr, Motor Boat Sounds & Sirens. Drop your mouth open downward as far as you can with ease & say “ta, ta, ta, ta” while gently feeling the jaw motion with your hand: breathe out as you say the syllables & sing as many as you can.
• Resonators: Nasal “wicked witch” to “cowardly lion” voice to stretch the larynx, pharynx & soft palate muscle groups.
• Articulators: 5-note up & down scale exercises for the 1. Jaw (ya, ya, ya), 2. Lips (ba, ba , ba), 3. Teeth (ta, ta, ta), 4. Tongue (la, la, la), 5. Soft Palate (nga, nga, nga), 6. Throat (ha, ha, ha
• Flexibility: Up & down glissandos (up to 3 octaves), Gliding on triplets.

LIFETIME MAINTENANCE OF THE BODY, MIND AND VOICE

Daily Exercise, Hydration, Nutrition, Regular Rest, Enjoy Friends, Mental Agility Exercises, Preventative Health, Don’t Smoke, Support the Speaking Voice (breathe as though you are singing).

HELP FOR COMMON VOCAL FAULTS

Vibrato problems are often associated with the aging voice and are either due to tongue/jaw tension or the low breath energy that can be associated with aging.

Things to try:

• Examine posture watching out for sloped shoulders, head-poked forward  and clenched jaw.
• Vocalize with: slack jaw, use beginning of a ‘yawn’ space, try tongue out singing.
• “Knoll” slides, add physical gestures to encourage spinning breath while singing. Imagine 3-dimensional vowel shapes and learn to clarify an open space.
• Experiment: Sing exercises with straight tone to vibrato.

Thin Tone is due to the folds not fully closing.

Sustain vowels on a single pitch, step-wise repeating note patterns, “ngah” brings the vocal folds together without too much squeeze, gentle staccatos on vowels, ding/ming/ning. Take care to not over-blow (blow the folds open).

Creaky Voice is due to speaking at an unnaturally low pitch and not refreshing breath.

Say, “Mm-Hmm,” as though agreeing with something. Become aware of the low-pitch voice use & investigate situations that exacerbate the habit.

 NOTE: Much of the time, hoarseness and vocal difficulties are not simply age-related change. Any change that you notice in your voice should be a warning sign that something may be wrong. See your otolaryngologist (ear, nose, throat doctor). Almost all voice problems are highly treatable.

For more questions, email Author Jamea Sale: 

REFERENCES:

Andrews, Moya L. Manual of Voice Treatment: Pediatrics through Geriatrics. San Diego, Calif.: Singular Pub. Group, 1995. Print.

Boone, D.R. (1997). The three ages of voice: The singing/acting voice in the mature adult. Journal of Voice, 11(2),161-164

Butler, Lind, Weelden. (2001) “Research on the Aging Voice: Strategies and Techniques for Healthy Choral Singing.” The Phenomenom of Singing. Vol. 3.

Edwin, Robert. Voice Pedagogy for Aging Singers. Journal of Singing. May/June 2012. Volume 68, No. 5, pp. 561–563.

Emerich, K., Hoover, c., S Sataloff, R. T., (1996). The effects of menopause on the singing voice. Journal of Singing, 52(4), 39-42.

Hamdan, A. L., Tabet, G., Fakhri, G., Sarieddine, D., Btaiche, R., & Seoud, M. (2018). Effect of Hormonal Replacement Therapy on Voice. Journal of Voice, 32(1), 116–121.

Kahane, J. (1975). The developmental anatomy of the human prepubertal and pubertal larynx. [Dissertation]. 338.

Meredith, Victoria.  Sing Better As You Age:  A Comprehensive Guide for Adult Choral Musicians.  Santa Barbara Music Publishing, Inc., 2007, Print.

Peppard. R. C. (1990). Effects of aging on selected vocal characteristics of female singers and non-singers. Abstract from: OCLC FirstSearch: Dissertation Abstracts International. 52. 0 I B: 0190.

Sataloff, Robert T. “Vocal Aging and Its Medical Implications: What Singing Teachers Should Know, Part 1,” Journal of Singing. Sept/Oct., Vol 57, No.1.

Smith, B. (Brenda J. (2018). So you want to sing for a lifetime : a guide for performers. Rowman & Littlefield Publishers.Stathopoulos, E., Huber, J., & Sussman, J. (2011).

Changes in Acoustic Characteristics of the Voice Across the Life Span: Journal of Speech Language and Hearing Research, 54(August), 1011–1021.