Managing Perimenopausal and Menopausal Voice Changes

Abstract

Managing Perimenopausal and Menopausal Voice Changes Nancy Bos (bio), Joanne Bozeman (bio), and Cate Frazier-Neely (bio) SINGING A CAPPELLA TO ZYDECO Readers of this column are likely familiar with the concept of cross-training for singers (see Robert Edwin's article, "Cross Training for Singers," Journal of Singing 65, no. 1 [September/October 2008]). Originally used in athletics, cross training is participation in a variety of sports and training methods to maintain balanced muscular development and flexibility, and to minimize injury from overdoing one type of physical activity. Tennis players may swim, golfers may jog, skiers may rock climb. Athletes may also balance workouts in other ways from doing yoga to having specific strategies in the weight room and gym. Broadly speaking, cross training as applied to singing would include: • Singing regularly throughout the entire range, including frequent vocalizing on pitches outside of the typical range of the singer's repertoire. • Exercising the voice in targeted ways to increase or maintain strength and flexibility, appropriate to the vocal conditioning and to the demands of various styles. • Practicing repertoire from more than one vocal style or genre. (This may or may not include performing in these styles.) As teachers and researchers interested in the special context of female singers during midlife, we have recently authored a book on the topic: Singing Through Change: Women's Voices in Midlife, Menopause, and Beyond (StudioBos Media), which affirms that cross training can help women to continue singing healthily over time. A singer's voice is affected by hormonal changes throughout life, though individual responses vary. Reproductive hormones, more broadly considered sex steroid hormones, have receptors that are found throughout the body: the neuromuscular, respiratory, and skeletal systems, connective tissues, the gut, and the larynx. In addition, the entire central nervous system, which supports the systems of phonation, emotion, and communication, is sensitive to hormone levels. Therefore, it should not be surprising that even subtle shifts in hormone levels can impact singing. Along with the hormonal changes of menopausal transition, the gradual aging process and the rich, though complex psycho-social challenges of midlife may cause women to experience minor to profound voice changes. Cross training is a pedagogic framework that teachers should consider when working with female singers in this age span. Several women's stories follow that illustrate how a flexible and creative use of cross training concepts helped these singers negotiate [End Page 375] the evolution of their voices in midlife (considered ages 40–60), and beyond. ________ Lexi, age 57, has been studying singing since she was a child, in styles such as pop, big band, and contemporary Christian music. A semiprofessional for many years, she occasionally ran into vocal trouble as a self-proclaimed vocal overdoer. At age 27, because of ongoing hoarseness, she saw a renowned laryngologist and worked with a speech therapist to optimize her speaking voice. She then started singing lessons with a pop and commercial jingle singer and found professional success while studying with him. She also became a singing teacher herself. In her early 40s, Lexi was having a lot of trouble with her voice while recording an album. Her laryngologist diagnosed a vocal fold cyst, and before she could have surgery to remove it, it burst and left a sulcus, a groove or divot on the surface of the vocal folds. She was also having perimenopausal symptoms in her late 30s and early 40s, but was not aware that fluctuations in hormones could have an impact on the voice. Lexi again worked with a speech therapist and a new singing teacher that the therapist recommended. They helped her regain her singing voice as well as her confidence. At age 47, Lexi was back again at her laryngologist's office, this time struggling with hoarseness, lack of stamina, what she called errant pitches, and "glitching." Glitching for Lexi is when a single note or short series of notes in the middle of a phrase simply don't phonate—complete silence for a brief moment in the middle of singing. The doctor found nothing alarming in the exam, but recognized the impact of menopause on her voice, especially since Lexi had gone off hormone...