Does a hormonal vocal cord cycle exist in women? Study of vocal premenstrual syndrome in voice performers by videostroboscopy-glottography and cytology on 38 women

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      This study sought to objectively determine whether changes in voice accompany biological and/or hormonal changes during the menstrual cycle. Dynamic vocal exploration (DVE) and vocal cord smears were performed on each of the 38 women during the ovulation phase and the premenstrual phase for two consecutive cycles, offering four samples each. Each subject's singing was videotaped and a DVE was performed. DVE offers three kinds of data, all synchronized: acoustic, visual, and glottographic. Cytological smears of vocal cord epithelium were collected through the operating channel of a fibroscope with a micro-brush. We found significant similarity between laryngeal and cervical smears in nine cases. Recently, estrogen target cells were identified in the larynx. Estrogen/progesterone level alterations cause laryngeal water retention, edema of the interstitial tissue, and venous dilatation. Of 38 women, 22 had vocal premenstrual syndromes, presenting with a hoarse voice and voice fatigue. All of the 22 had luteal insufficiency confirmed by smear. Sixteen women did not have any particular voice change at the premenstrual phase; two of them had a luteal insufficiency, and 14 had normal hormonal levels.

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