Symptoms A-Z

Voice Change Symptoms, Causes & Common Questions

Understand your voice change symptoms, including 6 causes & common questions.

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Contents

  1. Symptoms
  2. Causes
  3. 6 Possible Voice Change Conditions
  4. Treatments and Relief
  5. FAQs
  6. Questions Your Doctor May Ask
  7. Statistics
  8. References

Voice Change Symptoms

Having one's voice change throughout life is normal and expected. Boys' voices deepen upon reaching the teen years, and everyone will have some changes as they age. However, having your voice change suddenly can be due to an underlying illness. It is important to address severe or persistent voice changes with a medical provider sooner than later.

Voice changes may also be called voice breaking, dysphonia, presbyphonia or presbylaryngis.

Symptoms of voice changes can be described by a few common characteristics, as well as those unique to a few different categories.

Characteristics

A few common characteristics of voice changes include [1,2]:

In adolescent boys

In adolescent boys, it's normal to hear the following:

  • Squeaking, creaking sounds may occur whenever they try to speak.
  • Their voices may sound normal one moment and then suddenly drop much lower the next.

In older people

Older individuals usually present the following symptoms:

  • The voice becomes higher in men.
  • The voice becomes deeper in women.
  • The voice becomes "thin," meaning it is softer and hard to hear in noisy situations.
  • The voice may become tremulous or "shaky."

Social Isolation

Voice changes may also cause social isolation due to:

  • A feeling of embarrassment over changes in the voice.
  • A loss of control over voice quality.

Duration

In adolescents, especially boys, the voice will go on changing and becoming deeper until the late teenage years.

Who is most likely to be affected?

Those most likely to be affected by voice changes include:

  • Boys reaching puberty.
  • Anyone over the age of about 50.

When is it most likely to occur?

Sometimes these voice changes are most noticeable early in the morning before you have had a chance to clear your throat.

Is voice change serious?

Voice changes can vary in severity, described below.

  • Not serious: Voice changes due to anxiety, or due to a simple cold or upper respiratory infection, are not serious. A counselor can help with anxiety and a simple cold will eventually go away with good care.
  • Moderately serious: A teenage boy whose voice does not change should see a medical provider for hormone testing and possible hormone therapy.
  • Serious: Some types of throat/laryngeal cancer have persistent hoarseness as a symptom. This should be investigated if the hoarseness lasts longer than two weeks.

Voice Change Causes

Many conditions can cause the symptom of voice change. We've listed several different causes here, in approximate order from most to least common [3,4].

Hormone-related changes

Hormonal changes can be experienced leading to changes in voice [5,6].

  • Boys: The larynx (voice box) and vocal cords grow and change rapidly once puberty begins. This is why the voice "breaks" in adolescent boys.
  • Girls: These changes affect girls, too. Their voices will also deepen and mature, just to a lesser degree.

Normal aging

The same changes that affect the rest of the body in an older person affect the vocal cords. These include:

  • Gastroesophageal reflux disorder (GERD): Also known as heartburn, this can be very irritating to the vocal cords.
  • Loss of muscle mass: This includes the strength needed to force air from the respiratory system through the voice box.
  • Diminished fine motor control: This includes fine control of the vocal cords.
  • Hearing loss: This nearly always occurs to some degree as a person ages and can make it difficult for the person to hear their own voice as they speak. This may result in a strained or altered voice.
  • Thinning of the mucous membranes: This affects the shape and flexibility of the vocal cords and therefore the sound quality produced.

Upper respiratory infection

A cold and its secretions can cause swelling and inflammation of the vocal cords and result in mild laryngitis.

  • Viral infections
  • Bacterial infections

Bacterial growths on the vocal cords

These can be caused by overuse and change the voice by altering the shape and vibration of the cords.

  • Polyps
  • Nodules
  • Cysts

Anxiety

Social anxiety can cause a person to feel that they cannot breathe and the throat is closing up. This can definitely alter the voice and make it difficult to speak at all.

Rare and unusual causes

Rare and unusual causes include:

  • Neurological illnesses, whichmay cause a tremor in the voice, the same way they do in the nerves and muscles.
  • Throat/larynx cancer, which can cause chronic hoarseness, vocal cord paralysis, and lumps in the neck [7].

We've listed some specific conditions that can cause the voice to change, along with how to identify each of them.

6 Possible Voice Change Conditions

The list below shows results from the use of our quiz by Buoy users who experienced voice change. This list does not constitute medical advice and may not accurately represent what you have.

Acid reflux disease (gerd)

Acid reflux disease, also known as GERD, occurs when the acidic contents of the stomach come back up into the esophagus. The most common symptoms are heartburn and regurgitation.

Rarity: Common

Top Symptoms: nausea, sore throat, pain below the ribs, cough with dry or watery sputum, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Common cold

The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.

The common cold is, of course, very common. Americans catch over one billion colds per year, with adults averaging two to three per year, and children averaging as many as eight colds per year.

The common cold usually lasts about a week, and is self-limited (meaning it goes away on its own). Although there is no treatment for the common cold, there are many strategies for prevention and improvement of symptoms.

Rarity: Common

Top Symptoms: fatigue, headache, cough, sore throat, congestion

Symptoms that never occur with common cold: being severely ill, severe muscle aches, rash, severe headache, sinus pain

Urgency: Self-treatment

Myasthenia gravis (over 50)

Myasthenia Gravis is an autoimmune disease, where the immune system attacks the connection between nerves and muscles.

Rarity: Rare

Top Symptoms: weakness, general weakness, trouble swallowing, voice change, double vision

Urgency: In-person visit

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Myasthenia gravis (under 50)

Myasthenia Gravis is an autoimmune disease, where the immune system attacks the connection between nerves and muscles.

Rarity: Ultra rare

Top Symptoms: general weakness, trouble swallowing, weakness, voice change, double vision

Urgency: In-person visit

Acute bacterial sinusitis

Acute bacterial sinusitis, also called bacterial rhinosinusitis or "sinus infection," has symptoms much like viral rhinosinusitis but a different treatment.

Any sinusitis usually begins with common cold viruses. Sometimes a secondary bacterial infection takes hold. Like cold viruses, these bacteria can be inhaled after an infected person coughs or sneezes.

Anyone with viral sinusitis, upper-respiratory allergy, nasal passage abnormality, lung illness, or a weakened immune system is more prone to bacterial sinusitis.

Symptoms include thick yellowish or greenish nasal discharge; one-sided pain in the upper jaw or teeth; one-sided sinus pain and pressure; fatigue; fever; and symptoms that get worse after first improving.

See a doctor right away for severe headache, high fever, stiff neck, or vision changes. These can indicate a medical emergency.

Diagnosis is made with a simple examination in the doctor's office.

Bacterial sinusitis can be treated with antibiotics, but this is not always necessary. Often rest, fluids, and over-the-counter pain relievers and decongestants are enough.

Prevention is done through good lifestyle and hygiene to keep the immune system strong.

Rarity: Common

Top Symptoms: fatigue, headache, cough, sinusitis symptoms, muscle aches

Symptoms that always occur with acute bacterial sinusitis: sinusitis symptoms

Symptoms that never occur with acute bacterial sinusitis: clear runny nose, being severely ill

Urgency: Primary care doctor

Acute viral sinusitis

Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.

It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.

Because children have small, underdeveloped sinuses, this illness is far more common in adults.

Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.

If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.

Diagnosis can usually be made through history and examination alone.

Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.

Rarity: Common

Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion

Symptoms that always occur with acute viral sinusitis: sinusitis symptoms

Symptoms that never occur with acute viral sinusitis: being severely ill

Urgency: Self-treatment

Voice Change Treatments and Relief

Treatments can begin at home for voice changes, as long as symptoms are not severe. If symptoms persist and you cannot find relief, you should consult your physician.

At-home treatments

A few at-home remedies you can try to assess voice changes include [4]:

  • Maintain overall health and fitness: This will help maintain the health of your vocal cords, too.
  • Maintain vocal cord fitness: Read out loud very clearly for a few minutes each day or sing along to music.

Medical treatments

You should schedule an appointment or consult your physician for the following.

  • Discussion of medical treatment: This may be needed for chronic hoarseness and unexplained weakening or "thinning" of the voice, especially if these have lasted for more than two weeks.
  • Discussion of surgery: This may be needed if medical treatment alone cannot resolve the problem.
  • Voice therapy: A speech and language pathologist can help with improving the quality of the voice, especially in cases of social anxiety.

Seek immediate treatment in the emergency room or call 911 if the following occur

If there is choking or difficulty breathing along with the voice changes, call 911.

FAQs About Voice Change

Here are some frequently asked questions about voice change.

Can essential tremor affect the voice?

Essential tremor is a rhythmic shaking often inherited that affects the arms and legs and, sometimes, the voice box and vocal cords. It can manifest as a constant, rhythmic change in the voice involving loudness, pitch, and rhythm. Whispering is sometimes easier for the person. Medication may be helpful in some cases.

Can laryngitis lead to permanent voice change?

If the cause of laryngitis usually a viral infection is treated with voice rest and fluids and the vocal cords are allowed to heal, there is usually no permanent injury. However, if you try to force your voice to work while you have laryngitis, this can lead to serious damage that may not be reversible.

Can screaming or yelling, as might happen at a sports event, cause permanent voice change?

Even one episode of vocal misuse such as hours of yelling at a sports event can cause irregular nodules to form on the vocal cords and change the sound of the voice. Ongoing misuse, as in screaming out lyrics as a rock singer, can cause permanent damage that will require voice therapy and sometimes surgery to correct.

Can a person lose the ability to sing, but still be able to speak normally?

It is not unusual for anyone who constantly uses their voice especially full-time singers and lecturers to develop small, irregular nodules on the vocal cords as a response to overuse. This can make it all but impossible to sing, but the speaking voice will still function even though it may sound different from the way it did before.

Is it serious if I have both voice change and difficulty swallowing?

In rare cases, this is a sign of tumor growth, but most often these symptoms occur together simply as part of a swallowing disorder and are common in older or elderly people. Swallowing disorder is caused by things such as GERD (heartburn), poor teeth or poorly fitting dentures, a paralyzed vocal cord, and scar tissue following throat surgery.

Questions Your Doctor May Ask About Voice Change

To diagnose this condition, your doctor would likely ask the following questions:

  • Do you have a cough?
  • Do you have a sore throat?
  • Any fever today or during the last week?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

Take a quiz to find out why you're having voice change

Voice Change Symptom Checker Statistics

People who have experienced voice change have also experienced:

  • 12% Hoarse Voice
  • 4% Cough
  • 3% Sore Throat

People who have experienced voice change were most often matched with:

  • 55% Myasthenia Gravis (Over 50)
  • 33% Acid Reflux Disease (Gerd)
  • 11% Common Cold

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Voice Change Symptom Checker

Take a quiz to find out why you're having voice change

References

  1. Huntzinger A. Guidelines for the Diagnosis and Management of Hoarseness. American Family Physician. 2010;81(10):1292-1296. AAFP Link
  2. Kim JE, Rasgon B. The Hoarse Patient: Asking the Right Questions. The Permanente Journal. 2010;14(1):51-53. NCBI Link
  3. Feierabend RH, Malik SN. Hoarseness in Adults. American Family Physician. 2009;80(4):363-370. AAFP Link
  4. Freeborn D, Kacker A. Voice Disorders. University of Rochester Medical Center. URMC Link
  5. Pederson M, Agersted ABA, Jonsson A. Aspects of Adolescence and Voice: Girls Versus Boys - A Review. Journal of Child and Adolescent Behavior. 2015;3:211. OMICS Link
  6. Hari Kumar KV, Garg A, Ajai Chandra NS, Singh SP, Datta R. Voice and Endocrinology. Indian Journal of Endocrinology and Metabolism. 2016;20(5):590-594. NCBI Link
  7. Signs and Symptoms of Laryngeal and Hypopharyngeal Cancers. American Cancer Society. Updated November 27, 2017. American Cancer Society Link