Voice and Speech Changes in Various Phases of Menstrual Cycle
Aksungar, Fehime Benli
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Background. The reproductive system in females undergoes a regular cyclic change known as the menstrual cycle. Laryngeal changes are evident and fluctuate systematically during the reproductive years with the menstrual cycle. The impact of estrogens in concert with progesterone produces the characteristics of the female voice, with a fundamental frequency (F-0) higher than that of male. Objective. To characterize changes in voice and speech in adolescent females in different phases of the menstrual cycle-during menstruation, after menstruation, mid-menstrual cycle, and premenstruation. Materials and Methods. Sixteen adult females who were nonusers of oral contraceptives participated in a cross-sectional study of menstrual cycle influences on voicing and speaking tasks. Acoustic analysis (F-0, intensity, perturbation measurements [jitter and shimmer], and harmonic-to-noise ratio), maximum phonation time (MPT), s/z ratio, and perceptual assessments (grade [G], roughness [R], breathiness [B], asthenia [A], and strain [S] [GRBAS] and Voice Handicap Index-10 [VHI-10]) scales were performed during all phases. Results. None of the acoustic analysis parameters and MPT and s/z ratio measurements revealed statistically significant difference (P > 0.05). Perceptual voice assessment scales either clinician based or patients self-evaluated showed significant differences among phases (P < 0.05). Conclusions. The objective voice analysis methods, such as acoustic analysis, MPT, and s/z ratio, determined no difference; however, the subjective voice analysis methods, such as clinician-based perceptual assessment (GRBAS) and patients self-evaluation (VHI-10) scales, demonstrated significant changes during different phases of menstrual cycle.