Why Is My Voice Changing as I Get Older?

Hoarseness may be part of aging, but therapy can help your voice stay strong.

Voice changes are a normal part of the aging process. Also known as dysphonia or hoarseness, it’s common for adults to notice changes in their vocal quality and strength as they get older.

“Everyone experiences aging differently, so there isn’t a specific age when these vocal changes start,” says Karla O’Dell, MD, an otolaryngologist with the USC Voice Center, part of the USC Caruso Department of Otolaryngology – Head and Neck Surgery and Keck Medicine of USC. Dr. O’Dell specializes in treating patients for vocal, airway and swallowing problems. She also sees patients at USC Verdugo Hills Hospital.

However, Dr. O’Dell also emphasizes that patients shouldn’t automatically assume that voice changes are simply a result of aging. “It could be age-related changes, which aren’t really concerning. But since it could also indicate a medical problem, you should come in for an evaluation.” 

Why does your voice change as you get older?

Our voice changes with age because of how our muscles and tissues evolve over time. The vocal cords are made of muscle tissues, and just like muscles in other parts of the body, they tend to lose mass as we get older.

Dr. O’Dell explains that the connective tissue covering the vocal cords also thins as we get older. This important tissue, called the lamina propria, allows the vocal cords to vibrate. 

“As the vocal fold muscle gets thinner, and as that vibratory cover gets thinner with age, the vocal folds don’t come together as easily in the middle,” Dr. O’Dell says. “And when they don’t come together as easily in the middle, air leaks through, which can result in a voice that sounds rougher, breathier or quieter.”

While this process affects both men and women, Dr. O’Dell says vocal fold muscle atrophy tends to be more pronounced in men. 

She adds that a common culprit for age-related voice changes may sound surprising: not talking enough. Dr. O’Dell says she works with a lot of retired patients who come to realize that since leaving the workforce, they don’t use their voice as often. Underuse can contribute to the vocal cord muscles’ decline.

“When you’re young and your voice is hoarse, resting it helps. But it’s almost the opposite phenomenon as you age,” she explains. “We’ve observed that using your voice and staying up with it is a helpful way to maintain it.” 

Are there home remedies for vocal hoarseness?

Voice therapy is often the first-line treatment for age-related voice changes. “Think of it like weightlifting for your vocal cords and voice,” Dr. O’Dell says.

Exercises for vocal fold atrophy are focused on increasing airflow, strengthening muscles and improving vocal stamina. Specific techniques may include using your voice in an energized way with pitch glides and an emphasis on feeling vibrations in your face instead of straining your throat.

A speech-language pathologist will design a therapy regimen and work with patients to teach them the exercises. For the best results, patients should continue their voice therapy exercises regularly over the long term. 

“Voice therapy works really well, but it is something patients have to maintain,” Dr. O’Dell says. “It’s like when you hire a trainer to help you get fit. You’ll work with the trainer for a while and then once you’ve reached your goal, you’ll follow a program on your own to maintain that level of fitness.”

However, for patients whose vocal cords have thinned to the point where they’re no longer touching at all, Dr. O’Dell says she may recommend injection augmentation. The in-office procedure involves injecting filler into the vocal cords to add volume to them. 

No matter which route patients choose to take in terms of treatment, Dr. O’Dell encourages anyone experiencing vocal changes to get checked out by an ENT specialist. It could be age-related changes but could also be a more significant problem that would require diagnosis and treatment.

“While we don’t have a magic wand to get your voice back to how it sounded 20 years ago,” says Dr. O’Dell, “we can help make your voice more functional for your life as it is now.”

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