Voice in different phases of menstrual cycle among naturally cycling women and users of hormonal contraceptives

Previous studies have shown changes in women's behavior and physical appearance between the non-fertile and fertile phases of the menstrual cycle. It is assumed that these changes are regulated by fluctuations in sex hormone levels across the cycle. Receptors for sex hormones have been found on the vocal folds, suggesting a link between hormone levels and vocal fold function, which might cause changes in voice production. However, attempts to identify changes in voice production across the menstrual cycle have produced mixed results. Therefore, the purpose of this study was to investigate changes in sexually dimorphic vocal characteristics and quality of women's voices in different phases of the cycle and to compare these with users of monophasic hormonal contraception. Voice samples (vowel phonation) of 44 naturally cycling women were obtained in the menstrual, late follicular (confirmed by LH surge) and luteal phases, and in 20 hormonal contraceptive users across equivalent stages of the monthly cycle. Results showed that voices of naturally cycling women had higher minimum pitch in the late follicular phase compared with the other phases. In addition, voice intensity was at its lowest in the luteal phase. In contrast, there were no voice changes across the cycle in hormonal contraceptive users. Comparison between the two groups of women revealed that the naturally cycling group had higher minimum pitch in the fertile phase and higher harmonics to noise ratio in the menstrual phase. In general, present results support the assumption that sex hormones might have an effect on voice function. These results, coupled with mixed findings in previous studies, suggest that vocal changes in relation to hormonal fluctuation are subtle, at least during vowel production. Future studies should explore voice changes in a defined social context and with more free-flowing speech.