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.