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Valentina Carlile Osteopata
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Writer's pictureValentina Carlile DO

Voice and Singing Osteopathy: How can PMS affect the voice?

Voice and Singing Osteopathy: How can PMS affect the voice?

The larynx is a hormonal target organ, this has been demonstrated by numerous studies over the years.

When hormonal changes occur, women may find that their voice changes. Singers, speakers, teachers and women in general who use their voice a lot are particularly aware of this.


Premenstrual Syndrome (PS) is commonly described by women as a condition that afflicts them in the phase preceding their period. It is precisely during this period that women experience vocal changes.

When estrogen levels fall, just before menstruation, levels of water retention in the tissues increase, creating an increase in blood supply to the vocal cords. The resulting aphonia or hoarseness is due to increased activity of the thyroid gland. Estrogens can also create other disorders such as, for example, increased secretion by the glandular cells located below and above the vocal cords, which leads to a large production of mucus.

All this, enhanced by the production of progesterone which occurs at the same time, is accompanied by a correlated increase in the viscosity and acidity of the mucous secretions, and by a decrease in the volume of the secretions, situations which thus cause chordal dryness.


Some of the other effects that singers can experience during this period (and sometimes even during their period) are: difficulty singing high notes, having a hoarse or dirty vocal quality, decreased volume and breathing quality, intonation problems.


Additional disorders may include: vocal fatigue, decreased vocal range, hearing disorders and ophthalmological disorders.


Hearing disturbances include decreased or increased hearing acuity, hypersensitivity to loudness, hypersensitivity to rhythmic repetition, malaise, tinnitus, inner and middle ear changes in response to transient deafness.


Energy metabolism disorders such as changes in appetite, which cause weight gain, can affect the singer psychologically and physically.


The realization of weight gain can negatively impact a singer, especially if she is videotaped or appears on television, or if she has to perform in a live show.


Fatigue can be the biggest problem for singers experiencing SP.


Some physical characteristics, such as tightness and vitality, may be altered.


The larynx is very sensitive and vulnerable to fatigue.


Neurological or psychological disorders such as difficulty concentrating, migraines, feeling of vulnerability may also be encountered.


Singers can be emotionally hypersensitive and particularly sensitive to criticism, or even angry and hostile.


A singer who finds herself having extreme emotional reactions can see her reputation compromised and even, at times, end her career.


The cause and effect of these vocal changes can be very personal indeed.


For professional singers it can become a real loss of confidence that affects the image they have of themselves and takes possession of it the moment they realize they have this problem.


This could be one of the reasons why it isn't discussed very openly or, discussing a woman's hormonal problems could simply stem from some sort of taboo.

How can an Artist manage this disorder?

• Becoming aware of how and when it manifests itself is already a good starting point

• Keeping a monthly calendar can help

• Keeping a monthly calendar can help

• Doing aerobic exercise such as running, swimming or dancing helps in this case but also in terms of general well-being

• Follow stress management programs like yoga, relaxation.


Physical and vocal rest may be necessary at this stage.


Vitamin and mineral salt supplements make their contribution. Specifically, the following are mentioned: vitamin B6, magnesium, calcium and potassium; vitamin D to manage leg cramps, iron for anemia, in short, multivitamin and multimineral complexes are useful for all these symptoms.


Using honey in hot teas can help hoarseness, dryness and vocal fatigue, since honey is very moisturizing.


Drinking a lot of water is a further important factor, as long as not in large quantities close to a show, as in this case it can promote reflux.


It is also better to avoid aspirin which can increase bleeding.


It is a good idea to consult a gynecologist to discuss the use of hormone therapy, the 'pill'.


Osteopathic treatment is an excellent aid for circulatory, vascular and lymphatic rebalancing, limiting 'accumulations' and improving the fluidity and quality of the body's own connections.


So, there is no need to worry about your artistic career. Becoming aware of the disorder is just a step towards creating a team capable of managing the disorder so that being a woman is not once again an element of discrimination in the Music Industry.

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