Read below about voice change, including causes, treatment options and remedies. Or get a personalized analysis of your voice change from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

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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 Overview

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.

A.I. Health Assistant Causes for Voice Change

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced voice change. This list does not constitute medical advice.

  1. 1.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.

    With proper treatment, symptoms may be relieved within days & at most several weeks.

    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
  2. 2.Common Cold

    The common cold is a viral infection of the upper respiratory tract.

    The common cold resolves within 7 to 10 days.

    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
  3. 3.Myasthenia Gravis (Over 50)

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

    Indefinite

    Rarity:
    Rare
    Top Symptoms:
    weakness, general weakness, trouble swallowing, voice change, double vision
    Urgency:
    In-person visit

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  4. 4.Myasthenia Gravis (Under 50)

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

    Indefinite

    Rarity:
    Ultra rare
    Top Symptoms:
    general weakness, trouble swallowing, weakness, voice change, double vision
    Urgency:
    In-person visit
  5. 5.Acute Bacterial Sinusitis

    Acute bacterial sinusitis occurs when the sinuses become infected and, in turn, inflamed, which causes pain and other symptoms. The sinuses are air-filled cavities in the face that are generally clean and empty but when they're sick collect excess mucus and can become infected. When your symptoms are persisting for 10 days or more or are getting worse over time, it's more likely that you'll have a bacterial infection as compared to a viral infection.

    7-15 days

    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
  6. 6.Acute Viral Sinusitis

    Sinusitis is an inflammation of the sinus spaces behind the nose and cheeks. These spaces produce mucus, which drains into the nose. If the nose is swollen or if the mucus does not drain, this can block the sinuses and cause pain or infection.

    Symptoms should subside within 7-10 days

    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

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

If you've answered yes to one or more of these questions, try our voice change symptom checker to find out more.

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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”).

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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