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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鈥檚 common for adults to notice changes in their vocal quality and strength as they get older.

鈥淓veryone experiences aging differently, so there isn鈥檛 a specific age when these vocal changes start,鈥� says Karla O鈥橠ell, MD, an otolaryngologist with the 喵咪社区 Voice Center, part of the 喵咪社区 Caruso Department of Otolaryngology 鈥� Head and Neck Surgery and 喵咪社区. Dr. O鈥橠ell specializes in treating patients for vocal, airway and swallowing problems. She also sees patients at .

However, Dr. O鈥橠ell also emphasizes that patients shouldn鈥檛 automatically assume that voice changes are simply a result of aging. 鈥淚t could be age-related changes, which aren鈥檛 really concerning. But since it could also indicate a medical problem, you should come in for an evaluation.鈥� 

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鈥橠ell 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. 

鈥淎s the vocal fold muscle gets thinner, and as that vibratory cover gets thinner with age, the vocal folds don鈥檛 come together as easily in the middle,鈥� Dr. O鈥橠ell says. 鈥淎nd when they don鈥檛 come together as easily in the middle, air leaks through, which can result in a voice that sounds rougher, breathier or quieter.鈥�

While this process affects both men and women, Dr. O鈥橠ell 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鈥橠ell says she works with a lot of retired patients who come to realize that since leaving the workforce, they don鈥檛 use their voice as often. Underuse can contribute to the vocal cord muscles鈥� decline.

鈥淲hen you鈥檙e young and your voice is hoarse, resting it helps. But it鈥檚 almost the opposite phenomenon as you age,鈥� she explains. 鈥淲e鈥檝e observed that using your voice and staying up with it is a helpful way to maintain it.鈥� 

Are there home remedies for vocal hoarseness?

Voice therapy is often the first-line treatment for age-related voice changes. 鈥淭hink of it like weightlifting for your vocal cords and voice,鈥� Dr. O鈥橠ell 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. 

鈥淰oice therapy works really well, but it is something patients have to maintain,鈥� Dr. O鈥橠ell says. 鈥淚t鈥檚 like when you hire a trainer to help you get fit. You鈥檒l work with the trainer for a while and then once you鈥檝e reached your goal, you鈥檒l follow a program on your own to maintain that level of fitness.鈥�

However, for patients whose vocal cords have thinned to the point where they鈥檙e no longer touching at all, Dr. O鈥橠ell 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鈥橠ell 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.

鈥淲hile we don鈥檛 have a magic wand to get your voice back to how it sounded 20 years ago,鈥� says Dr. O鈥橠ell, 鈥渨e can help make your voice more functional for your life as it is now.鈥�

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