Abstract:
The objective of this study was to evaluate the effect of intranasal estrogen therapy on female vocal quality.
Thirty-two women who had surgically induced menopause were included into the study group and examined through
hall year for this study. Estrogen treatment was proposed to all of the patients. Twenty-three of them accepted the treatment
protocols including oral (n ¼ 12) (2 mg estradiol; Estrofem; Novo Nordisk, Denmark) and intranasal (n ¼ 11)
(300 mcg 17beta-estradiol; Aerodiol; Servier, Chambray-les-Tours, France) form of estrogen. The rest of patients refused
estrogen treatment and those patients constituted the control group (n ¼ 9). Vocal changes were evaluated with
Voice Handicap Index (VHI) and acoustic analysis of voice variations (fundamental frequency [F0], SD F0, jitter, shimmer,
normalized voice energy, and harmonics-to-noise ratio) at baseline and after 1-year follow-up. According to VHI,
while voice improvement was not clear in oral estrogen group, it was significant at intranasal estrogen group. Voice
quality in patients treated with hormone replacement therapy (HRT) was significantly higher than patients without
HRT. But between two treatment groups, there were no any statistical discrepancy. According to acoustic analysis, vocal
stability among the women who use HRT was significantly better than those who did not use. Intranasal estrogen exerted
the most significant effects on vocal stability. The data of our study support that voice undergoes changes in lack of
estrogen in surgically induced menopausal women. Taken together with the relevant studies, while oral estrogen replacement
therapy shows a favorable influence on voice quality, it seems to be more pronounced with intranasal estrogen
than oral form.
