J Menopausal Med.  2017 Aug;23(2):117-123. 10.6118/jmm.2017.23.2.117.

Vocal Symptoms and Acoustic Findings in Menopausal Women in Comparison to Pre-menopause Women with Body Mass Index as a Confounding Variable

• Hamdan AL
• Ziade G
• Tabet G
• Btaiche R
• Fakhri G
• Yatim F
• Sarieddine D
• Seoud M

• KMID: 2389227
• DOI: http://doi.org/10.6118/jmm.2017.23.2.117

Abstract

OBJECTIVES
To compare the prevalence of phonatory symptoms in menopausal women compared to pre-menopause women with body mass index (BMI) as a confounding variable.
METHODS
A total of 69 women, 34 menopausal and 35 pre-menopausal were invited to participate in this study. Demographic variables included age, smoking, and BMI. All subjects were asked about the presence hoarseness, loss of high or low frequencies, pitch breaks, throat clearing, dryness in the throat and vocal fatigue. Acoustic analysis was performed and the Voice Handicap Index (VHI)-10 was filled by all the subjects.
RESULTS
There was a significantly higher prevalence of throat clearing and dryness in the menopausal group compared to the pre-menopause group with a P value of 0.035 and 0.032 respectively. When BMI was taken into account, there was no statistically significant difference in the prevalence of any of the phonatory symptoms in menopausal women with high BMI and pre-menopause. There was no statistically significant difference in the means of any of the acoustic parameters between the menopausal group and pre-menopausal group. There was no significant difference in the mean VHI-10 between the menopause group and the pre-menopause (P = 0.652).
CONCLUSIONS
The results of this investigation substantiate the importance of fat as an alternative source of estrogen which can mask some of the phonatory symptoms.

Keyword

Body mass index; Menopause; Phonation

MeSH Terms

Acoustics*
Body Mass Index*
Confounding Factors (Epidemiology)*
Estrogens
Fatigue
Female
Hoarseness
Humans
Masks
Menopause
Pharynx
Phonation
Premenopause*
Prevalence
Smoke
Smoking
Voice
Estrogens
Smoke

Reference

1. Sood R, Kuhle C, Kapoor E, Rullo J, Thielen J, Frohmader K, et al. A negative view of menopause: does the type of symptom matter? Climacteric. 2016; 19:581–587.

2. Almeida M, Laurent MR, Dubois V, Claessens F, O'Brien CA, Bouillon R, et al. Estrogens and androgens in skeletal physiology and pathophysiology. Physiol Rev. 2017; 97:135–187.

3. Gandhi J, Chen A, Dagur G, Suh Y, Smith N, Cali B, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol. 2016; 215:704–711.

4. Muka T, Oliver-Williams C, Kunutsor S, Laven JS, Fauser BC, Chowdhury R, et al. Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis. JAMA Cardiol. 2016; 1:767–776.

5. Ferraz PR, Bertoldo SV, Costa LG, Serra EC, Silva EM, Brito LM, et al. Vocal parameters and voice-related quality of life in adult women with and without ovarian function. J Voice. 2013; 27:355–360.

6. Abitbol J, Abitbol B. The voice and menopause: the twilight of the divas. Contracept Fertil Sex. 1998; 26:649–655.

7. Boulet MJ, Oddens BJ. Female voice changes around and after the menopause--an initial investigation. Maturitas. 1996; 23:15–21.

8. Schneider B, van Trotsenburg M, Hanke G, Bigenzahn W, Huber J. Voice impairment and menopause. Menopause. 2004; 11:151–158.

9. Caglayan EK, Engin-Ustun Y, Sari N, Karacavus S, Seckin L, Kara M. Evaluation of bone density measurement in type 2 diabetic postmenopausal women with hypertension and hyperlipidemia. J Menopausal Med. 2015; 21:36–40.

10. Sharma N, Natung T, Barooah R, Ahanthem SS. Effect of multiparity and prolonged lactation on bone mineral density. J Menopausal Med. 2016; 22:161–166.

11. Pasco JA, Nicholson GC, Brennan SL, Kotowicz MA. Prevalence of obesity and the relationship between the body mass index and body fat: cross-sectional, population-based data. PLoS One. 2012; 7:e29580.

12. Shobeiri F, Jenabi E, Poorolajal J, Hazavehei SM. The association between body mass index and hot flash in midlife women: a meta-analysis. J Menopausal Med. 2016; 22:14–19.

13. Klinga K, von Holst T, Runnebaum B. Influence of severe obesity on peripheral hormone concentrations in pre- and postmenopausal women. Eur J Obstet Gynecol Reprod Biol. 1983; 15:103–112.

14. D'Haeseleer E, Depypere H, Van Lierde K. Comparison of speaking fundamental frequency between premenopausal women and postmenopausal women with and without hormone therapy. Folia Phoniatr Logop. 2013; 65:78–83.

15. D'Haeseleer E, Depypere H, Claeys S, Van Lierde KM. The relation between body mass index and speaking fundamental frequency in premenopausal and postmenopausal women. Menopause. 2011; 18:754–758.

16. D'Haeseleer E, Van Lierde K, Claeys S, Depypere H. The impact of menopause and hormone therapy on voice and nasal resonance. Facts Views Vis Obgyn. 2012; 4:38–41.

17. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894:i–xii. 1–253.

18. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, et al. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol. 1997; 6:66–69.

19. Kay Elemetrics. Visi-Pitch II model 3300 instruction manual. Lincoln Park, NJ: Kay Elemetrics;1996.

20. Randolph JF Jr, Sowers M, Bondarenko IV, Harlow SD, Luborsky JL, Little RJ. Change in estradiol and follicle-stimulating hormone across the early menopausal transition: effects of ethnicity and age. J Clin Endocrinol Metab. 2004; 89:1555–1561.

21. Freeman EW, Sammel MD, Lin H, Gracia CR. Obesity and reproductive hormone levels in the transition to menopause. Menopause. 2010; 17:718–726.

22. Abitbol J, Abitbol P, Abitbol B. Sex hormones and the female voice. J Voice. 1999; 13:424–446.

23. Caruso S, Roccasalva L, Sapienza G, Zappalá M, Nuciforo G, Biondi S. Laryngeal cytological aspects in women with surgically induced menopause who were treated with transdermal estrogen replacement therapy. Fertil Steril. 2000; 74:1073–1079.

24. Davis CB, Davis ML. The effects of premenstrual syndrome (PMS) on the female singer. J Voice. 1993; 7:337–353.

25. Raj A, Gupta B, Chowdhury A, Chadha S. A study of voice changes in various phases of menstrual cycle and in post-menopausal women. J Voice. 2010; 24:363–368.

26. Meurer EM, Wender MC, von Eye Corleta H, Capp E. Phono-articulatory variations of women in reproductive age and postmenopausal. J Voice. 2004; 18:369–374.

27. Mendes Laureano J, Sá MF, Ferriani RA, Romao GS. Variations of jitter and shimmer among women in menacme and postmenopausal women. J Voice. 2009; 23:687–689.