A few days ago, TGB reader and my good friend Wendl left a comment wondering about her recent vocal changes:

”...weaker, cracky, hoarse, reedy, phlegmy, etc. I think my vocal cords actually started changing when I retired and stopped talking all day. Use 'em or lose 'em?”

We all know what Wendl is talking about – I call it old people's voice - and she has done a good job of describing it in almost the same words as the medical professionals do. They call it presbyphonia which just means “changes associated with the ageing voice.”

I spent way too much time online looking for an audio example for us and found mostly actors doing impressions of old people's voices so that will have to do.

Here is a pretty good one titled: Older Woman: Voice Acting. There are three variations. The closest to what we're discussing today is the first and it ends at :45 seconds. You can skip the rest of the video.

Geriatric otolaryngology is the study of the ear, nose, mouth, throat, larynx and pretty much anything else from the neck and above as it relates, in this case, to old people.

Otolaryngologists used to be called “ear, nose and throat doctors: or ENT for short.

The Australian website entwellbeing is remarkably consistent with Wendl's description of this condition of the voice,

”...the inability to produce adequate sound using the vocal mechanism. People with presbyphonia may experience:

• Occasional or frequent breaks in their voice
• A breathy vocal quality
• Laryngeal tension
• Sudden interruptions in the normal flow of speech – stoppages in phonation
• Reduced pitch and loudness

NBC News explains the underlying causes:

”When we age, our vocal chords weaken and become drier...Weakened and dry vocal chords become stringy, which prevent normal vibration, causing higher pitched voices that sound thin.

“And the transformations in the respiratory system and chest mean we have less power behind our voices. Even the joints in our vocal chords can become arthritic, contributing to problems.”

There are good descriptions of the five ways our voices change at the verywell website. Here's their take on how pitch changes:

”According to Clark Rosen, professor of otolaryngology at the University of Pittsburgh and director of the University's Voice Center, a woman's pitch typically drops over time, whereas a man's pitch actually rises slightly with age.

"'We don't know exactly why this occurs,' says Rosen. 'Like other vocal shifts, changes in pitch may also be due to atrophy of the muscles in the vocal folds, and in women it may be thanks in part to hormonal changes leading up to and past menopause. We do know there's quite a consistent pitch change by gender.'"

You will find equally clear explanations for the other four changes at verywell.com.

Although benign vocal changes are common as we age, Rosen says they can occasionally be a warning:

”If you're hoarse for more than two weeks - especially without a trigger like a cold or flu or if you are a long-time smoker - seek out the advice of your doctor since you may be at risk of a more serious problem like vocal cord nodules or even laryngeal cancer.”

Disease aside, there are treatments for “old people's voice.” Otolaryngologist and Director of the Johns Hopkins Voice Center Lee Akst says that “Good vocal hygiene, such as staying well-hydrated and not yelling or screaming is a must,” and speech therapy can be effective:

”Akst notes that most patients improve with voice therapy alone. While they may not sound like they did when they were 40, voice therapy helps promote a stronger voice.

“For those still struggling to be heard, a procedure called vocal cord augmentation involves injecting a synthetic filler into the deepest muscle layer of the vocal folds. This more invasive therapy can last from just a few months, to a permanent change in the case of a surgical implant.

"'It's an uncomfortable procedure, with a risk of side effects like bleeding,' says Akst. 'It works best in conjunction with voice therapy, and if you were to choose only one course of treatment, you'd do better with just voice therapy.'”

Or, unless people really cannot hear you, you could just live with it. I know quite a few people with presbyphonia and have no trouble understanding them.