Singing at menopause: A systematic review with pedagogical implications

Abstract

Menopause is a certainty in a female singer’s life; depletion of estrogens may lead to physical, mental, and vocal symptoms. To investigate the extent to which these symptoms affect singers, a systematic literature review was carried out using eight interdisciplinary bibliographic databases. Combinations of the following key words were used: menopause, climacterium, singing, singers, and choir. From 18 studies, including three doctoral dissertations and a master’s thesis, only 10 met the inclusion criteria. The heterogeneity of study designs and methods of data collection and analysis precluded the carrying out of a meta-analysis. Instead, descriptors of symptoms affecting the voice, and vocal characteristics associated with menopause (menopause descriptors) were categorized, and their frequency of occurrence determined, according to six types of primary dataset: (1) self-reported symptoms, (2) acoustic characteristics, (3) observations of the larynx, (4) perceptual evaluations, (5) analysis of electrolaryngographic waveform characteristics, and (6) analysis of hormone concentrations. The descriptors that occurred most frequently in the literature concerned aspects of voice production, whereas those concerning vocal health, and vocal practice and performance, were less common. Of the three subsystems that comprise the vocal instrument, the vibrating vocal folds seem to be more affected than breathing and resonance. Changes in vocal range, timbre, endurance, and vocal fold mobility occur during menopause, affecting singers’ voice quality. Some singers reported that their ability to perform was compromised, mainly due to memory lapses and lack of confidence. Maintaining regular singing and practicing semi-occluded vocal tract exercises throughout the menopausal transition seem to help singers to overcome the negative impacts of menopause on vocal performance.