The effects of the menopause and hormonal replacement therapy on the female professional voice: a bibliographic review

Filipa Lã, João Luis Silva Carvalho, Nancy Lee Harper

It is recognised that the use of hormone related medication, such as the combined oral contraceptive pill (COCP), used by a large number of young western classical female singers, has effects on a singer’s voice quality and performance. The menopause is a biological certainty in a woman’s life; however, the effects of the menopause or of hormone replacement therapy (HRT) on the performer’s voice have not been systematically explored. During the menopause, there is a reduction in the serum concentrations of oestrogens and progesterone, and the ratio of oestrogen to androgen becomes androgen dominant. Similarly to what has been demonstrated with vocal changes associated with the menstrual cycle, it can be expected that during the menopause vocal aberrations will also occur thus affecting the career of a female professional voice user. However, the majority of studies which have explored vocal behaviour during the menopause are descriptive, and the few studies that have been carried out present controversial results. Therefore, this presentation aims to:
(i) explain briefly the hormonal variations associated with the climacterium;
(ii) establish a relationship between these hormonal variations and vocal symptoms associated;
(iii) describe the methodologies used in previous studies and discuss the controversial nature of their results;
(iv) discuss the relevance of double blind randomised placebo controlled trials in achieving robust results on the vocal effects of the use of a particular hormone related medication.

1. Dr. Filipa Lã
Post-Doctoral research fellow
Department of Communication and Arts
Universityof Aveiro
Address:Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
Email address: filipala@ca.ua.pt
Phone number:(+351) 93 8545168
Email address : filipala@ca.ua.pt
2. Professor João Luís Silva Carvalho
Professor in Gynaechology and Obstetrics
Faculty of Medicine, University of Porto, Hospital of São João do Porto
Address: Centro de Estudos e Tratamento em Infertilidade
Avenida da Boavista, nº 2300, 3º
4110-118, Porto
Phone number: (+351) 22 607 6530
Email address: silvacarvalho@ceti.pt
3. Professor Nancy Lee Harper
Professor of Music
Department of Communication and Arts
University of Aveiro
Address: Campus Universitário de Santiago, 3870 Aveiro, Portugal
Phone number: (+351) 234 370389
Email address: harper@ca.ua.pt