Written by: Roselyn Mathew / Voice / February 15, 2023 / 8 minutes read

Voice disorder is a condition where a person’s voice sounds different than what is expected. Voice disorder might cause difficulties in being understood and can also make it difficult for a person to speak comfortably. 

It is generally assumed that voice disorders are due to injuries to the brain or throat or due to overuse or misuse of the voice. However, voice disorders can also be caused by other issues that affect the vocal folds (2 thin structures that produce voice) or their surrounding structures indirectly. It is important to be aware of these conditions in order to prevent a voice disorder and to ensure that the vocal folds are in a healthy condition. 

We will look into certain issues that could lead to a voice disorder and ways to prevent them.

Stress is usually caused due to situations that are out of our control. It is where we feel pressure, tension and anxiety. Stress can lead to issues like headaches, poor sleep, lack of appetite or overeating, issues with memory, inability to think clearly and can also affect our general behaviour and personality. 

Stress can also lead to a voice disorder. Mental stress could result in increased tension in the throat and the vocal folds which leads to vocal strain. A person who speaks with a lot of tension might have low volume, strained vocal quality and won’t be able to talk comfortably for longer periods of time. If the stress is not severe, it would often feel easier to speak at home or in less stressful conditions. But if the stress is severe, it would be difficult to speak in all types of situations due to the excessive tension and pressure on the vocal folds. 

Along with other voice techniques to reduce stress on the throat and vocal folds, it is also required to reduce mental stress as much as possible. This can be done by meditation, having proper breathing techniques and focusing on approaches like cognitive behaviour therapy. 

Hormonal changes are often overlooked in voice changes. Hormones are the chemicals that are produced by the different glands of the body and they are responsible for different bodily processes like metabolism, reproduction, growth and development, sexual functions etc. Hormones also play an important role in voice. For example, the testosterone hormone is responsible for the deepening of voices in males during puberty.

Imbalances in hormone secretions affect the body in many ways. Voice can also change due to imbalances in certain hormones. For example, excess of androgens after menopause results in lowering of pitch and might also lead to mild hoarse voice quality. 

It has also been seen that an excess or inadequate production of growth hormone from the pituitary gland leads to hoarseness, high or low vocal pitches, and low volume.

Studies have shown that hypothyroidism results in hoarseness of voice and reduced vocal range. These changes take place very slowly so it is often unnoticed till the change is much higher than the normal range. 

It is important to periodically check hormone levels and make sure that hormones are being secreted in the adequate levels. Ageing in women results in reduction in female hormones and increase in male hormones. This might lead to drop in pitch and mild hoarseness. The population most affected by this are professional voice users like singers and teachers. This can be regulated by hormone replacement therapy. 

GERD is a condition where the acid in the stomach goes from the stomach to the esophagus (the tube that connects mouth and stomach). It causes a lot of discomfort like heartburn, chest pain, bloating, regurgitation, dry cough etc. When the acid reaches the throat level, vocal folds might get irritated which results in hoarseness in voice. Repeated gastric reflux in the throat level can damage the vocal folds. GERD can also lead to muscle tension dysphonia where the muscles in the larynx and vocal folds become very tight resulting in greater effort to speak, low volume and not being able to speak comfortably for a longer time.

Ways to reduce GERD is to regulate diet, take medications to regulate stomach acid and to follow other practices like monitoring body positions etc.

Hydration is essential for the proper functioning of the body.  Dehydration or reduced water affects different organs and systems in the body. Reduced water intake could affect vocal folds and voice. Voice is produced when vocal folds touch each other to close and open. This is very frequent and rapid (around 130-240 times/second). If the vocal folds are hydrated the process happens smoothly. But if the vocal folds are dehydrated, this repeated touch causes friction and hence leads to damage to the surface of the vocal folds. This results in harshness and hoarseness and other complications like vocal folds polyps and nodules which causes serious voice issues and might also result in permanent vocal damage, if ignored. 

Drinking lots of water might not be sufficient if a person lives or works in a dry environment. It is important to make sure that the environment is not dry. Installing humidifiers is helpful to reduce dryness in air. It is very helpful to do steam inhalation, where the humid air directly passes through the vocal folds. 

Resonance is important for speaking and singing. Generally, men use chest resonance and women use head resonance for speaking. These aid in increasing the speaking volume. But if a person uses their throat resonance, there would be a greater effort for the vocal folds to function. This increases vocal strain and makes it difficult to speak comfortably with a good volume. 

It is important to use either chest or head resonance while speaking and singing in order to avoid vocal strain.

There are certain conditions that are generally not expected to cause a permanent voice disorder but these can cause mild to severe voice disorders. It is important to be aware of these and prevent them. If you think you have a voice disorder; it will be wise to consult a trained Speech-Language Pathologist in order to get assessed and treated to prevent further issues.

To speak with one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.