Search IconSearch
December 30, 2020/Living Healthy/Primary Care

Voice Changes: What Can They Tell You as You Age?

How hormones and aging alter your acoustics

elderly man touching throat

During puberty, surprising cracks and unexpected squeaks can signal changes in your voice. Later on, as you age, you may notice other changes, such as weakening of the voice.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

What’s behind these vocal shifts, and what do they say about your health?

“Lack of a voice change in boys who grow up can signal a problem,” says Claudio Milstein, PhD. “Weakening of the voice later in life may point to health issues as well.”

So it makes sense to listen to your changing voice and report any concerns to your doctor.

Your voice during puberty

Puberty is a process of sexual maturation. A voice change is one of the secondary sexual characteristics adolescents develop. In boys, this happens between ages 12 and 16; in girls, between ages 10 and 14.

The first sign of puberty in girls is breast development, while in boys it’s an increase in the size of the testicles. As this is happening, the voice tends to change as well.

“Before puberty, your larynx, or voice box, sits higher in the neck. As you go through puberty, the larynx grows and moves down lower in the neck,” explains Dr. Milstein. “Your vocal folds (cords) also thicken and enlarge.”

This change is more noticeable in boys. “They develop the typical jumping pitch, and their voices can suddenly drop about an octave lower,” he says.

Girls’ voices also change as they mature, but less dramatically. Their pitch drops only about three tones.

This process may take up to a year. Usually, by age 17, the voice fully stabilizes. If a teen’s voice hasn’t changed by that time and other secondary sexual characteristics have not developed, hormonal issues may be at play.


“Check with your child’s pediatrician if there is no change in voice, no growth, no lowering of the testicles in boys, no breast development in girls and no development of body hair,” says Dr. Milstein.

Your voice later in life

Unlike puberty, when everyone’s voice changes, voice changes with aging are not universal, Dr. Milstein says. There are two main reasons why your voice may change with age:

1. An aging vocal mechanism. The most common cause of a voice change later in life is aging of the voice box and the respiratory system that powers the voice.

Aging may bring a loss of flexibility. The joints of the larynx may become stiff, and its cartilage may calcify. The vocal cords may lose muscle tone, flexibility and elasticity, and dry out. Sometimes, the muscles of the larynx can atrophy, become thinner and weaker. Your ribs may become more calcified. Your torso may shrink, and your lungs may become smaller, stiffer and less pliable.

All of these changes may weaken the voice, Dr. Milstein says.

2. A decline in overall health status. Sometimes, a voice change can herald a developing medical problem. For example, chronic fatigue and neurological problems can cause a shaking, or tremor, in the voice. The voice can also change because of benign (nodules, polyps) or malignant lesions (cancer), or if one of the vocal folds becomes paralyzed.

Rejuvenating the voice

A diminishing voice sometimes leads to a less active social life.

“If it’s difficult for others to hear and understand you, you may not want to sing in church, volunteer, or go out with friends,” he says. “When you become more socially isolated, your quality of life drops. This can lead to depression and affect overall health.”

But that doesn’t have to happen. If you’re having voice issues, it’s wise to be evaluated by a voice specialist, a laryngologist, or a speech pathologist with expertise in voice.

“We’ll examine your vocal cords to determine the problem,” he says. “Thanks to modern science and technology, many treatments can make your voice sound better.” These include:

  • Voice rehabilitation therapy: Daily voice exercises to strengthen voice production.
  • Vocal cord microsurgery: A treatment for vocal cord lesions, such as polyps or cysts.
  • Vocal fold injections: Injections to plump up the vocal cords.
  • Voice implants: Implants to stabilize the vocal cords.

“Once we rejuvenate the voice, communication and quality of life improve. We find that patients socialize more and participate in more activities,” says Dr. Milstein.


Learn more about our editorial process.

Related Articles

man singing softly and playing guitar
April 13, 2020/Ear, Nose & Throat
10 Ways to Keep Your Voice Healthy and Strong

Your voice is vital — so treat it right

Injection filled with botox
June 9, 2019/Ear, Nose & Throat
A Surprising Use for Botox: Helping People Regain Their Voices

It’s a treatment for spasmodic dysphonia

Person coughing into a tissue by window during sunny, summer day
June 4, 2024/Primary Care
Summer Sniffles: Winter Isn’t the Only Time You Can Catch a Cold

Enteroviruses are often to blame for summer colds, leading to a runny nose, sore throat and digestive symptoms

Foot being tickled by a feather, with laughter floating around
May 30, 2024/Primary Care
Why Are People Ticklish?

The tickling response may be more about protection than enjoyment

Person blowing nose, surrounded by medicines and home remedies
May 30, 2024/Primary Care
Why Do I Keep Getting Sick?

Stress and unhealthy habits can lead to more colds, but taking some precautions may help you stay well

Smiling person under sunny blue sky, holding tube of sunscreen, applying to face
May 24, 2024/Primary Care
The Difference Between Mineral and Chemical Sunscreens

Mineral sunscreens have a heavier texture to create a physical barrier, while chemical sunscreens are lighter and use a chemical reaction to prevent UV damage

Lifeguard looking at water with binoculars while two kids fly kites on the beach
May 23, 2024/Primary Care
12 Summer Health Risks To Watch Out For

From bug bites and blisters to sunstroke and swimming safety, here’s how to stay well this season

Jellyfish sting on wrist and thigh
May 20, 2024/Primary Care
Should You Pee on a Jellyfish Sting?

This persistent myth isn’t true and can actually cause more pain than relief

Trending Topics

Female and friend jogging outside
How To Increase Your Metabolism for Weight Loss

Focus on your body’s metabolic set point by eating healthy foods, making exercise a part of your routine and reducing stress

stovetop with stainless steel cookware and glassware
5 Ways Forever Chemicals (PFAS) May Affect Your Health

PFAS chemicals may make life easier — but they aren’t always so easy on the human body

jar of rice water and brush, with rice scattered around table
Could Rice Water Be the Secret To Healthier Hair?

While there’s little risk in trying this hair care treatment, there isn’t much science to back up the claims