Perimenopausal voice change*

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.

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