The symptoms of menopause go far beyond hot flushes. Read on for a comprehensive list of how menopause impacts the voice.

When Joanne Bozeman noticed changes to her voice in mid-life, she was baffled. She hadn’t changed her lifestyle or practice routine, but things seemed to be in flux.

It wasn’t until her vocal coach suggested that the culprit could be hormonal changes due to menopause that the penny dropped. “I went ahhhh, that’s what’s going on!” she says.

So Joanne set about trying to learn all she could about the effects of perimenopause and menopause on the voice and to put the subject on the radar of singers and singing teachers. 

She’s now renowned for her research on the influence of hormones on the female voice and is the co-author of Singing Through Change: Women’s Voices in Midlife, Menopause, and Beyond.

Menopause is not about old age

Speaking on the Singing Teachers Talk podcast, Joanne stresses that menopause is a midlife situation for most women. “The average age when a woman goes through the menopause is 51,” she says. “And the perimenopause leading up to that typically happens in our 40s, or even earlier. 

“This idea of midlife voice changes is a much more helpful way to look at it. When you find this subject in pedagogy sources, it tends to be in the ageing voice area, but let’s move it out of there.”

Defining perimenopause and the menopause

Menopause is defined as the point in time when a woman has gone for 12 months without menstruating. Perimenopause is the period leading up to menopause. On average, perimenopause lasts for four years, but individual experiences can vary greatly.

Some women sail through perimenopause and menopause without any symptoms, while others experience sweeping hormonal changes that leave them depressed and struggling to work. And many other women fall somewhere in between.

Effects on the voice

Ask people to list menopause symptoms, and they’ll most likely rattle off hot flushes, night sweats and brain fog (and they’d be right, these are common complaints).

But menopause can also cause all sorts of changes to the voice. Often women don’t realise that changes to their voice are hormone related and instead blame themselves or a lack of skill. 

Here’s a list of ways menopause can impact the voice.

• Change of timbre/loss of clarity – For some genres having a rougher tone may be fine, but in classical Western singing, it’s a problem. 
• Impaired agility – A singer may complain that their voice feels stiff or inflexible. The voice may not move as fast as it once did, and it could be harder to do riffs, runs and arpeggios.
• Instability – Some women find their voices become unstable.
• Lowered upper range – A singer may lose some notes on top or feel uncomfortable singing notes that they could previously reach with ease.
• Pitch insecurities – A singer who is usually bang on with great pitch may suddenly struggle.
• Unpredictability – One day, the voice does one thing, and the next day it does something else. The singer isn’t changing their approach, but the outcome is different.
• Weakness or loss of power – This can also include breathiness, vocal fatigue or difficulties in the passaggio.

Emotional impact

Symptoms of perimenopause and menopause aren’t always physical. A woman might also experience:

• Confusion about sudden changes that don’t correlate with a change in habits or practice.
• Sadness or a loss of confidence.
• Self-blame – a woman might question her abilities as a singer.
• Isolation – Learning that other people are going through the same thing and experiencing similar symptoms can be helpful.

But it’s not all bad news

Some women notice positive changes in their lower range – they discover low notes that they’ve never had before.

A useful tip for managing the voice during perimenopause and beyond

Joanne suggests that singers keep a voice journal to track vocal changes and how they correlate with their cycle.

“It’s really useful to think: What’s going on? How frequent are my periods? What is my voice feeling like on this day? What is happening with the ceiling of my voice? Or am I getting more low notes? 

“You can also note if things change when you take medications because medications can affect the voice, as we know. For example, blood pressure medications can cause dryness.”

Learn more

Listen to the full-length interview with Joanne to learn:

• Which vocal exercises she recommends for singers experiencing hormonal changes.
• Other factors that influence a singer’s experience during menopause such as past vocal injury and vocal habits.