Perimenopausal voice change

Perimenopausal voice change is a syndrome that seems to be related to the effect on voice of declining estrogen levels. Some women seem to escape this problem almost entirely; others experience pronounced symptoms. When severe, the affected woman will note the following: (1) upper range is either lacking, or extremely effortful; (2) there is paralaryngeal discomfort and muscular tension when she attempts to sing in the upper range; (3) there is a tendency to sing flat in the upper range. May be counteracted with varying degrees of success through vocal exercise and/or estrogen replacement therapy.