When the subject of Menopause comes up most women will talk about the physiological symptoms, i.e., the hot flushes and night sweats etc., but could Menopause also be affecting your voice? In short, the answer is yes!
In simple terms, the vocal cords/folds contain tissue and muscle which requires collagen to function effectively. One of the main ingredients in the production of collagen is oestrogen. So, as oestrogen levels decrease, we start to see changes in our skin, muscle tone, hair…and our voices.
Surprisingly, when I was conducting my Master's research on Menopause: The effects on the ageing female classical voice, I noticed that under the list of potential symptoms the medical literature rarely (if at all) made reference to vocal changes.
So, let's explore how Menopause may be affecting your voice, what you can do to stand up to Menopause and how to continue singing long term.
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Hi, I'm Rebecca! And I truly love everything about the art, science, and teaching of singing. If you're looking to build an effective and healthier singing technique so that you can sing with more ease and confidence, then you're in the right place! Here's a few other blog posts you might also like to read:
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HOW MENOPAUSAL SYMPTOMS AFFECT THE VOICE
Yep, that’s right. I believe that the typical menopausal symptoms like hot flushes/flashes and poor memory can indirectly affect your voice. I feel I need to explain…
Menopausal symptoms fall into two categories; physiological and psychological. The most common physiological symptoms include:
Hot flushes/flashes
Palpitations
Night sweats
Insomnia
Tiredness
Fatigue
Headaches
Weight gain
Digestive problems
According to Horwood, 80% of women in the UK experience hot flushes/flashes. Hot flushes/flashes occur because oestrogen is a key component in helping the body to regulate temperature. Hot flushes/flashes are unpredictable and are most likely to be brought on by physical or emotional exertion. So, probably during singing.
Some women feel embarrassed by hot flushes/flashes. They may also experience reddening of the face and neck perspiration. Not something you want in the middle of a performance, eh?
And this may be a contributing factor as to why women stop performing.
Equally, night sweets, insomnia, tiredness and fatigue lower patience to practice or rehearse and give a general feeling of physical exhaustion. Again, another reason to stop performing.
On the other side is the psychological symptoms. The most common psychological symptoms include:
Lack of confidence
Poor memory
Lack of concentration
Depression
Anxiety
Irritability
Mental clarity
Poor memory, for example, can be caused by changing oestrogen levels in the hippocampus, the part of brain responsible for memory, which can impact the ability to memorise music, stage directions or even remembering to turn up to rehearsal!
But it’s not all doom and gloom. On the positive side, singing has been shown to help combat feelings of anxiety and depression. Reasons to keep singing.
VOCAL CHANGES
The important question is, what are the likely vocal changes. According to my research the most common vocal changes experienced by singers are:
Difficulties with the upper range (most commonly reported by Sopranos)
Flexibility
Agility
Power
Breath support
Stamina
Vocal quality
Suffering vocal changes can be devastating and difficult to accept for some singers.
In fact, when I’m working with singers going through the Menopause, my primary goal is to help them discover and be confident with the voice they have now not the voice they had before. And this is tough!
Some singers feel that they have to change their repertoire, their voice type, or even more drastically, stop singing to altogether. But do vocal changes necessarily mean you have to make changes or stop singing? Not necessarily!
Regrettably, you cannot cure or irradiate the effects of Menopause. It’s all down to managing symptoms.
SYMPTOM MANAGEMENT
Well, if I cannot cure or irradiate symptoms, what can I do? That was your next question, right?
To be honest the answer is complicated.
Menopause affects women in different ways so the solution is specific to the individual.
I’ve comprised a list of four ways you can do to improve menopausal and vocal symptoms.
1 | MEDICAL TREATMENT
The most common medical solution for managing symptoms is HRT (Hormone Replacement Therapy). HRT consists of oestrogen, progestogen and testosterone and is prescribed in varying strengths to suit individual needs.
HRT is dismissed by most women because it has received a lot of negative press in recent years; spreading fears of the risks of breast cancer and thromboembolism. But did you know…HRT also has other advantages including, reducing osteoporosis, coronary heart disease and risks of developing dementia and Alzheimer's disease? There is also some evidence that suggests that HRT can improve and prolong vocal longevity. However, it’s early days.
Now, I’m not a doctor, but my advice is if you are suffering from or worried about your physiological, psychological and/or vocal symptoms, seek professional medical advice from your GP. What harm can it do to have that conversation with a medical professional? Your GP can advise you personally whether HRT is right for you. And you can go from there. What have you to lose?
You can find more information about Menopause and HRT at the British Menopause Society.
2 | NATURAL TREATMENTS
If HRT is definitely not for you, why not try some of the natural treatments like, homoeopathy, acupuncture, massage, reflexology, Tai Chi, Yoga, osteopathy or Alexander Technique?
Or, if you’re wanting to target specific symptoms, then there are a variety of vitamin and herbal supplements available from health food stores, that are claimed by some women to help manage their symptoms.
Hormone balance - Red Clover and Black Kohash
Hot flushes/night sweats/vagina dryness - Dong Quai
Insomnia - Hops and valerian
Anti-depressant - St John’s Wort
Pre-menstrual stress/vagina dryness - Evening Primrose Oil
Increase energy levels/balance hormones – Ginseng
Lowering body temperature – Yarrow
Anxiety/sleep - Motherwort
When it comes to maintaining a healthy voice there is a lot of advice out there. Some of it is good, some not so good. So, be careful. But basic vocal hygiene applies whether you’re going through Menopause or not. These include:
Staying hydrated
Eating a balanced diet
Exercising regularly
Get enough rest/sleep
Stop smoking
Keep alcohol consumption to a minimum
Don’t shout/scream
Avoid excessive coughing or throat clearing
Always start practice or rehearsal with some gentle vocal warm-up exercises
And remember, don’t sing if you:
have a cold
your voice feels sore/hoarse
I appreciate that some of these can be difficult, like getting enough sleep, if you’re suffering from night sweats or insomnia. You can only do your best.
>>Related<< Ultimate Guide to Vocal Health
3 | LIFESTYLE
We all know that living a balanced lifestyle is about eating and exercising right. So, there’s no exceptions or excuses as we get older. It’s all about maintaining a healthy weight to height ratio.
The same principles apply when we are younger, although we may need to make some adjustments. Horwood recommends making these adjustments to your diet.
Hot flushes – reduce spicy foods, alcohol, caffeinated drinks, sugar and salt.
Digestive problems - eating a high fibres diet consisting of fruit, vegetables and drinking lots of water.
Depression: increase Vitamin B intake which is found in meat, dairy, whole grains, green vegetables and fruits like, bananas, dried apricots, figs and dates.
Increase oestrogen levels - consume phytoestrogens plants which include soya, red clover, linseed, beans, seeds, nuts, vegetables (such as broccoli, red onion, celery, sweet red peppers, tomatoes), garlic, fruits, (especially berries, grapes, citrus, plums), cereals like barley, couscous, rye, oats, polenta seeds and pulses (such as sunflower, sesame, pumpkin, chickpeas, haricot, kidney and broad beans) and lentils.
The key to successful exercising is setting aside regular time. I think that exercise is always best when it doesn’t feel like exercise. Like walking or cycling in the countryside or attending a relaxing Yoga or Tai Chi class. Either way, exercise is an essential part of maintaining a healthy lifestyle.
4 | TAKE SINGING LESSONS
When it comes to singing, my research showed that amateur singers were less likely to practice or take regular singing lessons compared to professional singers. And yet...they reported the greater degree and severity of vocal changes. Surprising? I think not!
Whilst my research didn’t consider vocal technique, it was clear that professional singers were more likely to be able to manage their vocal changes because they had acquired the necessary skills to adapt during lessons and throughout their careers. But this is just a theory...
So, if you’re an active singer, whether that’s professional or amateur, then taking singing lessons regularly could help to improve symptoms and preserve vocal longevity. How?
Well, a singing teacher will be able to point out unhealthy or inefficiently habits and help you to develop new healthier and efficient habits. This will help you to sing freer, more confidently and happier.
If you’re not a confident singer don’t dismiss the benefits of taking private one to one lessons in the first instance to build your voice and confidence to enable you to join a choir.
If you’re not a singer, well, then singing lessons don’t necessarily have to all be about singing. Huh? Have I lost you? Singing has physical and mental healing powers. No, really it does!
If you suffer from respiratory issues, singing can help improve breathing and prevent illness, for example. Singing is also known for releasing endorphins (the happy hormone) which improves mood, and helps against anxiety and depression.
You could literally be the worst singer in the world but the singing teacher doesn’t care. You’re paying them! No, I joke! You may not end up gracing the stage at Covent Garden but you will be doing something that will improve your physical and mental wellbeing. Think of it as an alternative form of a workout.
SO, WHAT DO I DO NOW?
That’s your journey now. Remember, every woman experiences Menopause differently. There’s no prescribed solution. What might work for one, might not be the solution for you. I’ve given you the basics. It’s time to sit down with a cup of tea and a few biscuits and figure out what is right for you.
Ask yourself:
How is Menopause affecting my voice?
What impact does it have?
Does it impact my day to day life/my career/my love of singing?
How severe are my Menopausal symptoms?
How severe are my vocal changes?
And then decide what you want to do about it. Don’t underestimate the help of a medical professional…or a singing teacher. But the truth is, there’s a lot we still don’t know about Menopause and how it affects the voice. The research is still ongoing.
The reassuring thing is you don’t have to suffer in silence. There’s information out there and it is continually growing. You can take what you’ve learnt here and create a plan to do something to manage your symptoms. Nobody knows your symptoms better than you do!
For further guidance, I’ve included in the resources below a list of essential reading for singers, menopause and the voice. Enjoy reading…and keep singing!
