Overview

• The peer-reviewed narrative review was published online Sept. 10 in Menopause by USF's Yael Bensoussan and Northeastern's Rupal Patel.
• Falling estrogen and progesterone are linked to reduced laryngeal tissue integrity, leading to hoarseness, vocal fatigue, roughness, and instability even when exams appear normal.
• Women who rely on their voices for work—especially singers, along with teachers and actors—are identified as most at risk for adverse professional impact.
• Recommended management spans voice therapy, hydration and steaming, coordinated consideration of hormone therapy with gynecology, and bilateral vocal fold injections when indicated.
• Clinicians are urged to avoid misdiagnosis, provide clear counseling about testosterone’s potential to masculinize the voice, and support development of NIH-funded AI voice-biomarker tools and further clinical studies.