Hormones and Your Voice
Is Testosterone Therapy Changing Your Voice? Or is it Something Else Entirely?
Imagine that you're a violinist who's been playing the same beautiful instrument for decades. You know every nuance of its tone, every subtle variation in its voice. But then, one day you wake up and find that the strings don't sound the same - there's a thickness that drags the frequency down, turning your bright, clear high notes into something deeper and less familiar.
For midlife women, especially professional voice-users, such as singers and speakers, midlife voice changes can be terrifying. Is your testosterone therapy contributing to your voice change? Is something else going on? What exactly do we know about voice change in midlife and the role hormones like testosterone, estrogen, and progesterone play?
The answers might surprise you.
While online forums buzz with warnings about testosterone therapy destroying women's voices, the actual scientific evidence tells a more nuanced story - one where the most significant voice changes may have nothing to do with testosterone therapy at all.
The Fear Factor: How I Became Voice-Impaired and Scared
A few months ago, I started noticing that my voice was deeper. I figured I had a cold and blew it off. I thought I sounded kind of sexy, truth be told - I’d become the husky-voiced woman who wore retro-styled readers in her podcasts, pausing every few minutes to sip water/Diet Coke as a means of clearing the cobwebs from my throat.
But my newfound huskiness lingered until one day, I got concerned. Was my testosterone cream causing my voice changes?
I knew that when androgens, such as testosterone, cause voice changes in women, those changes were usually irreversible. High doses of androgens cause the vocal cords to thicken, similar to what would happen if you coated violin strings in a layer of tar. Because an adult woman’s laryngeal cartilage has ossified (become bone), those thicker cords cause what researchers call “entrapped vocality,” potentially resulting in hoarse, weak, deep sound lacking proper harmonics.
During this same period, I’d received several comments from women, worried that testosterone therapy had caused their voice changes.
Lisa said that within two months of starting testosterone pellets, she noticed her voice deepening. "It was subtle at first," she wrote, "but by month two, even my husband was commenting on it."
Ann, a singer on testosterone therapy for eight months, said she could no longer hit the high notes that were once effortless.
Sarah, a teacher who had been on testosterone for two years, told me her voice fatigues more easily than it used to, requiring more frequent breaks.
Given my own throaty woes, as well as the alarming number of questions I’d been getting from patients and social media messages, I decided it was high time to dive into the literature and ask the question: Was my testosterone cream turning me into James Earl Jones during his Darth Vader days?
