As we grow older, the structures of the larynx change, often causing changes in the voice production system. These alterations can often lead to incomplete closure of the vocal folds during each cycle of vibration and irregular vibration. When this happens, the dynamic range of the voice may be reduced, making it difficult to speak sufficiently loud, or the voice may sound rough, as if the speaker has a “frog” in the throat. In an effort to compensate for these changes, many people will contract the muscles of the vocal tract more and generally use more effort to speak, which can lead to fatigue. In addition, age-related changes in the way the nerves and muscles function can result in a wobble, or tremor to the voice. The pitch of the voice may be raised in men, or lowered in women, and the overall range of pitches may be reduced.

When making a diagnosis, physicians consider the combination of complaints, the patient’s age, and the appearance of the vocal folds on a video stroboscopy.

These voice changes are often dismissed as the inevitable result of growing older, but some of them can be overcome, usually with voice therapy. A small percentage of patients may want to go further with surgical intervention to thicken the vocal folds. If you have been experiencing bothersome vocal changes and feel they may be a result of aging, make an appointment with a voice doctor to learn more about what can be done.

The prognosis is excellent for both voice therapy and surgical interventions—the most important thing is to follow through with the treatment.