Hormones and Singing: An Interview with Nancy Bos

Hey singers! Earlier today I had the pleasure of interviewing Nancy Bos. Nancy has been a voice teacher for over 25 years. She has a podcast called Every Sing and she has written 3 books, all of which have been Amazon bestsellers. And in my interview with her today, we talked about hormones and our changing voices throughout our lives. I really hope that you enjoy this interview and that you learn a lot from it.

So hi, Nancy.

Hi.

Nice to have you here.

It is great to see you.

Great to see you again too. So I'm super excited because this is an interview that we've talked about doing for many months now and we held off a little bit because of your new book. Yes. And I do want to spend some time talking about that and I'm super excited. Tell us a little bit about the book, please.

The book that I've just released with my co-authors, Joanne Bosman and Kate Fraser-Neely, is called Singing Through Change: Women's Voices in Midlife, Menopause, and Beyond. And so it's a book that's about the hormones and the life journey that women go through between the ages of, I don't know, late 30s— midlife technically starts at age 40— all the way through the end when we all have this incredible passion for singing But our hormones are messing with our voices in some cases at an unprecedented level, and we have complicated lives. Things are always changing underneath us, either with aging parents or with our children or with our marriages or life or careers. It just seems like it never settles down, which impacts the voice. And then eventually, for most of us, some health issues come in that impact the voice. So that's what that book is about.

Exciting.

Yeah.

Great. So for those of you who are thinking that this conversation might not be exactly relevant to your situation, we're gonna address that a little bit later. So I hope that you'll hang in with us for a little bit, and I think that you're gonna find some really wonderful information that's going to be relevant to you. So yeah, stick around for that, I hope. So Nancy, let's talk about hormones. Let's define hormones. What are hormones?

Hormones. This is a great question because most of us think of hormones as being the sex hormones, or excuse me, also known as reproductive hormones. Estrogen, testosterone, that's what we think of. But there are so many more words that we're familiar with that we don't actually realize are hormones, like insulin is a hormone, and melatonin for sleeping, and dopamine, and the androgens is the same as testosterone, and relaxin, and prolactin. And there's so many different hormones. I don't even know the number. It's got to be at least 25 different hormones created by different glands in the body, and some of those have a really dramatic impact on the singing voice. And so those would be the thyroid hormones and the reproductive hormones. So that's mostly, I think, what we should focus on when it comes to how the singing voice works. All women have a little bit of testosterone, and All men have a little bit of estrogen. So when we talk about these reproductive hormones, it isn't like, "Oh, you're a testosterone, you're an estrogen." No, we're all a little bit of both. And of course, we know that the population varies dramatically on how much of those hormones is their normal amount that they have in their bodies.

Right. Yeah, that sounds great. That sounds great. So thank you. I think that puts it in context a little bit and helps us understand sort of the scope of the influence of hormones on our bodies. Yeah, so that's a great segue into how hormones influence our singing.

Yep, the, the male reproductive hormone testosterone, that has an impact on men and women. And you know, the most dramatic moment in a male vocal life is when they have their adolescence to teenage years voice change. And that is a complex— that, that voice change, which for some boys is over in a couple days, and for some boys it can last for a long, long time. That very dramatic voice change is partially because their body is now flooding with testosterone, which is changing the length of their neck and the shape of their neck and their jaw and the shape of the vocal folds. And this causes this machinery inside the throat to all just get out of alignment. And so they simply don't have the control that they'll have later on once things settle down. And you know, it's sad, a lot of men, boys, stop singing when their voice hits this extreme chaos. And it's just that hormone, darn it. And those, those men who do come out of that singing, I'm so happy for them because they have this huge part of their life and their passion and their joy that they get to express through their voices. So you guys who are doing doing that. You're singing. You had a tough vocal change, but you sang through it. Way to go.

Yeah, it's one of those cases where you just sometimes have to just kind of wait it out a little bit. Wait it out, and there's a period of extreme awkwardness. Yeah. And then eventually the voice does settle. It starts to find, you know, what it is and what it's going to be. And then, yeah, and then it's, you know, we, we in the voice world, we often talk about how the pubescent voice is kind of like a brand new voice.

It is.

You have to learn how to use a new voice.

It's like a toddler again, you know, where it's learning to walk. And it's, it's a really awkward, tough time in a guy's life. And but if they just stick it out and they just learn to walk again, it, it really pays off in the end.

You got it. But there is a further complication. Because after that massive growth spurt and the voice seems to have settled down, it's still changing slowly over the next 10 years. You can tell the difference when you're talking or listening to the singing voice of a 16-year-old versus a 26-year-old male. You can kind of tell that person's age by their voice, right? And so a 16-year-old may be identified as, oh, you're a tenor, you're a bass, you're a baritone. You're a mezzo, I guess, a contralto. But moving on through time, maybe even if that person majors in voice in college, they might come in at 18 as a different voice type than they come out at age 22, just because of the hormones.

Yeah, and that's important for singers to remember, is that there is a certain maturation, um, that needs to happen with their voices for both males and females. And even though they're with, with guys, their voices may have gone through the voice change, that doesn't necessarily mean it's settled into what it will be. That's really important. Yes. So I always tell my, you know, late teens, early 20s, and even into their late 20s that their voice is still kind of settling a little bit.

Exactly. I've got a pop singer I'm working with right now who's 32. And he is really nervous because his voice is getting richer and he has found that his whole voice has moved down by a whole step. But he wants to stay a pop singer and he doesn't want to be a rich baritone voice. And so he's working on his technique for how he can live authentically in his 30-some-year-old voice but still follow his passion for the kind of music that he's known for. Yep, and that's hormones. So following testosterone through the male journey, sometime around mid-50s, the male testosterone starts to decrease. And by the time you're 80 or 90, we aren't producing much of that hormone at all for the men. And well, for women either. And so that is why at the other end of life you'll hear Grandpa on the phone and you might notice that Grandpa's voice is thinner, maybe higher than it was 10, 20 years before. And that has to do with that decrease of testosterone, which means that the vocal fold muscles are going to be losing some bulk and mass. That's the biggest change, I think, for men in adult life is post-50s. Some men do a great job of keeping those muscles strong by vocalizing every day and using their voice at full strength. Other men, they retire from their jobs, so they're no longer talking as much, they don't sing as much, they become weekend warriors when it comes to singing, and those muscles just get weaker and weaker. Now, I did have A Jewish cantor who worked with me once in singing lessons, he was in his late 60s, and the music that a cantor sings is in the tenor range. And he was having a very hard time because suddenly his voice was now cracking, right? And that's because the testosterone was changing the mass of his vocal folds. So at this age, he had to relearn his voice as a new instrument, and by balancing the whole voice so that he was singing in his head voice, or high voice, some people call falsetto, I had him working out up there, and that balanced the whole voice so that he got that easy transition again. And so again, just like the 13-year-old has to learn a new voice, this man in his 60s had to learn a new voice as well.

Well, you bring up an important point there, and I've made a video on this a few years ago, this idea of use it or lose it.

Yes.

And I think it's relevant, relevant to all singers because as we age, you're right, we do tend to— our voice use changes. And we often think that it's just a given that we're all going to experience extreme voice changes as we get older, but a lot of that really has to do with lack of use, right? We're not using our voices as much or in the same ways. We're not demanding as much of them, so they do become weaker. And also sometimes underlying health issues that can affect the voice. And people kind of think of it as— singers sort of think of it as almost a death sentence for their voices, but it doesn't have to be. I think if the voice is maintained and if we continue to use the voice and demand enough of it, I think that we can actually get through the voice changes a lot more easily.

Absolutely. And I will say it's just like all the muscles in the body. When we reach a certain age, we have to spend more time on muscle tone and than we did when we were younger. And this, this is built on muscles and cartilage, and that is just the physics of it, is the physiology that we have to work out those muscles perhaps more than we did before in order to maintain the same sound. But it can be done. We've all heard it done by amazing singers.

Yes.

So should we talk about women a little bit?

I was just gonna say, yeah, I thought you were. Yeah, we're— yes, because obviously that's what the book is is focused on, and that's what you and your co-authors have spent so much time researching. This is years in the making, this book.

It was. And one of the key things that, that we found that isn't going to surprise anybody is that people judge older women singers sometimes inaccurately, just like, oh, she's in her 60s, she's not going to be any good, or she's in her 50s. And that's because We have this, this easy answer that a woman's voice after 50 is not going to be interesting. She's going to have vibrato problems. She's maybe no longer sexy, or who knows. I'm sorry, I'm still sexy and I'm over 50. But at any rate, um, the, the thing is, is that it may be different. The voice post-menopause may be different, but it's still wonderful. And there's still a huge message that can be shared. And you can watch anyone who's a celebrity who's over 50, and there are hundreds of those women now who are singing, who were superstars in the 1980s, 1990s, and they're still singing brilliantly. The leader of the pack is Mavis Staples, and such a story to tell. And what would we do without those women? So yes, maybe reevaluating what you expect from those voices, but cherishing those women's voices. Don't shut the door, don't close them out. Just because you have a backup singer who is maybe— for instance, there is a woman who sang on Weird Al Yankovic's international tour last year who's 62 years old. She's fit, she's beautiful, she did a great job with the backup vocals. If Weird Al would have had a concept in his head that he needed a 25-year-old singer, the door would have been closed on her. But instead, he got a super talented woman who really knows her stuff singing his backup vocals. So I think there's a lot of gifts that are brought by listening to and hiring women who are midlife and beyond. So that was one of the key concepts going into the book is women are being discriminated against because of their vocal ages. And sometimes women are discriminating against each other and against themselves. They're making a choice that my voice isn't what I thought it would be. When I was 22, I had this light, beautiful, airy voice, and now that I'm 52, I don't— this isn't me. I've always had this this low voice. But this is an identity crisis that women go through. So maybe I should back up a little bit and talk about the actual hormones that we're talking about.

Yes, please.

Yeah, so girls, just like boys, go through a voice change in their middle school years. We generally do it gradually, and we don't have voice cracks, but some of us do have voice cracks. And I was one of those, that I went from a child's voice to this voice. And over, I don't know, 2 weeks, my voice was cracking. And of course, I had gender identity issues because apparently no female in the history of the world's voice had ever cracked at age 12. And so I just was silent for a couple of weeks until it settled down, right? This is tough stuff. But what it turns out is that there were a lot of girls and always have been, who go through something similar. And again, it's because our necks are growing and our change of our shape of our face, and the hormones impact the shape of the vocal folds. So that happens to girls as well. Now boys generally lose— or gain, I'm sorry, drop an octave as a rule. Girls generally— now this isn't what I've seen in my studio, but the scientific studies show that girls generally drop a third. I don't know about you, Karen, but what I've seen in my studios is that girls generally drop a whole step. Have you noticed any kind of trend with teenage girls?

I primarily work with adults. I have very few teenagers in my studio, and they're older teenagers, so it's— I can't really say that I, I know.

Yeah, I wrote the book The Teen Girl Singing Guide, and, and I thought about including this information in that book. And I didn't, and I think I'm going to go back with a summary right now and include this because it's just really important for girls to realize they're not alone in their voice changes. So that being said, unlike the boys, with the influence of estrogen on the vocal folds being really strong in the late teen years, the female voice usually matures in the late teens, early 20s, and it's pretty stable except for monthly cycles. So from, say, age 20 to 40, that voice is going to be pretty consistent, and we can literally map out when our good voice days are going to be and when our bad voice days are going to be based on our monthly cycles. And there is a tradition in some areas of singing that women do not sing on 2 or 3 days during their menstrual cycle because they know they're going to have vocal fold swelling and that the mucus is going to be extra thick and it's just not going to go well.

And doesn't that make them more susceptible to things like vocal hemorrhage?

There is a period— there's a period, I shouldn't use that word— there is a time right before the period when any screaming or high belting, any— the voice is simply more susceptible to a breakthrough bleed on the vocal folds, which can be career-ending if it's not handled appropriately. So It doesn't happen to most of us, but it is more likely to happen to any women on a couple days right before their period. So the key thing to take away is if your voice suddenly goes from singing to hoarse, or if you feel like something pops in your throat— oof, what a terrible idea that is— but you go from, I was singing along fine, I hit that, you know, that high G, I belted that puppy out, and suddenly I didn't have a voice. That is very possibly a vocal fold hemorrhage and it requires an immediate trip to either an ear, nose, and throat doctor, or if you don't have any of those around you or you're not connected to one, then going to an emergency room where a doctor can quickly diagnose it. And then with a couple of weeks of what they call voice rest but actually means 100% silence, odds are pretty good that you will recover just fine and never have another problem. So Getting that out of the way. Yes, more, more vulnerable then. There is another thing though, that some cultures and some people believe that we go through 7-year cycles, that the voice kind of is one way for 7 years, the whole body, and then the next 7 years kind of identifies a new way, and then a new way. And I think if we think of ourselves as humans as always being in transition like that, rather than I've finally arrived at who I am, and I need to maintain this and stay this person for the rest of my life. You know, accept that we flow, we change.

Yeah, I like that. I think it gives us permission a little bit to accept that this is normal, and it gives us permission to allow that voice to change.

Exactly, the voice and everything else, um, that we don't have to try to be 28 for 30 years, that we are changing because of the way that our body works and the hormones that are put through our bodies. So when we reach perimenopause, is a word that a lot of women have never heard before, it is approximately 10 years before menopause. And so just a quick definition of menopause. This gets really kind of ugly. I mean, not ugly in a sick way, but ugly in like, this is complicated. Yeah, menopause, with the moment of menopause, is 12 months after the woman has had her last period. That's just a weird number to me. So you— the average age for it being 12 months since you had your last period is 51 in Europe, Canada, and the United States. So yeah, that's the average age. Now in the book, the youngest person that we interviewed hit menopause at 37. I'm sorry, the youngest menopause that we interviewed in the book, she hit it at 37. The oldest menopause that we interviewed hit it at 60. So there is a 23-year gap there. I believe that early onset menopause is— oh shoot, there are hard numbers on this, I don't remember, so let me just generalize. Early onset menopause is early 40s. Standard menopause would be anything between 45 and 55, and anything 55 and above is late menopause. And there are plenty of women in both those groups. So back to perimenopause. Perimenopause is 10 years or so before your last— before you hit menopause. So if the average age is 51, perimenopause starts at 41. And why this is interesting— who cares about perimenopause? That is when our hormones are fluctuating like a freaking roller coaster. Our estrogen is up and down and our progesterone is up and down, not just on a monthly cycle cycle like it was for the last 20 years, but on a day-to-day cycle, our estrogen and progesterone— it's like the— I don't know what's going on, but it's like the hormone is on the fritz and it's just like popping up crazy and then sometimes decreasing crazy. So on any one day, your voice might be great and not great on another. And having that incredibly unreliable instrument— whoa, so frustrating. But most women power through. They think something's wrong with them. They maybe go back to voice lessons to find out what's wrong with their technique, or they change careers, they stop singing. And like I indicated earlier, life gets complicated and they decide suddenly they don't have time to sing. Clearly it's not going well and it's not working right anyhow, so I'm just gonna stop. That is super sad, right? Yeah, so that's the perimenopause mess that most women don't know about. It also shows up in our body with sleep problems, anxiety, starting to grow chin whiskers and lose eyelashes. This is all perimenopausal symptoms. There is any symptom— if you type in menopausal symptoms and you see that long list of like 30 different symptoms, any of those are also perimenopausal symptoms. It's the same list. All right, I've been rambling on for a while.

What you got? No, no, This has been fantastic. The only thing I was wondering about, I'm curious about, is in your research, did you come across any indication that like early menopause, for example, is consistent with those who maybe started going through puberty earlier?

I don't know. We did not go into that in our research, I'm sorry to say. Yeah, I'm sorry, I don't have a fact on that one.

I've always been curious about it. Yeah.

I bet it's out there. There is one more thing though to talk about with that early menopause. Chemotherapy often puts people, women, into menopause. So it can be temporary menopause or permanent menopause, but the impact on the voice is exactly the same. The chemotherapy is shutting down the estrogen, and so you're going to have that voice change that menopausal women have. And that can be at 25, 35, 45.

How about chemotherapy with men?

With men, I don't know the research on that. I don't know the impact of chemotherapy on testosterone. I would imagine though that it would do something similar and that muscle wasting is definitely something that comes along with chemotherapy and those are muscles in the vocal folds. So if If you are unfortunate enough or fortunate enough to be able to do chemotherapy, that's something to keep in mind for your singing voice. Yeah.

So speaking of changing women's voices, it seems to be assumed that all women as they get older are going to develop a vocal wobble. What do you say about that?

I could literally go on about this for an hour, but let me try to be really succinct. There's— it's complicated is the answer. The changes as we age, our shape of our face and our neck continues to change. You know how that a person in their 60s, their nose seems to be a different size than it was when they were in their 30s or 20s, and that is going on inside the whole body. So that being said, the human instrument is changing, the shape of the instrument, and we've already talked about how the muscles are changing in mass. A lot of people still expect to hear what they sounded like with the old instrument. And they make these little muscle tweaks, these little changes that cause tension in their throat or in their breathing that can set us up for this wobble because it's not an efficient machine. And so it's a great idea for anybody who's experiencing a wobble in their voice to go get voice lessons from a functional teacher who is going to help them find out what their voice's optimal sound is now not what it was 30 years ago. But there are other issues that you can control without having to go see a voice teacher. One is, do you have any abdominal strength? If you don't, start doing your sit-ups, start doing your crunches and your planks, because that abdominal strength can be an issue with creating the wobble. Another one is tongue tension. If we're holding our tongue really tight or if we've got a really big sound in the back of our throats, that can make this wobble sound more pronounced than a natural vibrato would be. So it is complicated and it's worth talking to an expert about to get to the bottom of it.

And that was actually one more question I wanted to ask. How important is it, do you feel, for singers to continue to study with a voice teacher? Or if not, if not continuously, but periodically resume voice lessons as they go through those different changes? You mentioned 7 years, how some people believe that the voice kind of changes every 7 years. So maybe every 7 or so years taking a year or two of voice lessons. How important is that for singers?

I think that is essential, but there is one little asterisk beside this one. I'm sure that doesn't surprise you. The teacher that you are seeing needs to not have a preconception of how you sound. One of the women in our book had been studying with a teacher— this, the, the woman in the book, um, I can't remember her name in the book, we made up names for them and I can't remember it— she, um, She was 52 and she still had in her head her 22-year-old voice. And the teacher that she was studying with was trying to help her maintain that 22-year-old voice. That wasn't gonna work. That was gonna fail. That was totally gonna fail. So instead, she switched over to a new teacher with a new set of ears who said, "I hear tension in your sound. What happens if you relax all these muscles? What happens if you breathe with a rib cage now that isn't flexible with soft cartilage, but it's more rigid, this is going to change how you breathe. So perhaps finding a teacher who's either got the concept in their mind that I knew your voice before but you're different now, or a whole new teacher who doesn't know your voice at all. Checking in, I think, for a series of 6 or more lessons every 7 to 10 years is a great idea, or any time that you are running into like, what is this voice coming out of me? Go work with somebody, a new set of ears.

Thank you. I guess the only other thing that I'm curious about is, um, I'd love to know how we can tie this all in for singers, because I promised at the beginning that this would be relevant for everyone, and I think there's been some fantastic information that you've shared, so thank you. Um, so how do we cope with this, male, female? How do we, how do we get through those 80 years. Well, however many years it ends up being in the end, right?

Yeah. And, and I, I personally think that one of the biggest things— I know you agree with me— one of the most challenging things about being a singer is our, our egos. Putting ourselves on the line and becoming vulnerable for other people to listen to, that is because it's our hearts and our souls when we sing. And if you don't have confidence in your own voice, or if you think the listener doesn't have confidence in you— and so I think that for me, one of the biggest takeaways from this information is that we need to support each other and understand that we are all changing beings, but that doesn't decrease our value. We're not robots who are gonna sing the same from day to day. We can somewhat control our hormones through hormone therapy. Men can take testosterone as their own testosterone levels start to decrease. As women's hormone levels start to decrease, they can take hormone therapy. All women who are in the middle range know that birth control pills help them level out and predict what's going to happen. There are tools that are available if you're willing to take pharmaceuticals for this. But either way, We are flexible, changing human beings. We are not immortals and we're not robots. And if we can support each other with that kind of love and caring, I think that'll really make a big difference for singers.

Good. Thank you. I love that message. That's really encouraging, I think, for everyone. Thank you so much. I think this has been wonderful. I enjoy hearing you talk about this because it's kind of an awkward conversation a little bit. I love that you and your co-authors put up this book. I love that it was something that was— you were so passionate about, because you're right, it's something that is not talked about a lot in the voice world, and it needs to be, because again, it's just— it's not just something that affects the perimenopausal and menopausal women. It affects men. It affects teenagers, middle school children as they go through puberty. It affects all of us throughout our lives. And I think it's important for us to understand that our bodies are always in flux.

Yes.

Largely due to these hormones. And you know, you're right, just life circumstances sometimes too. And the stress that we feel there, it impacts everything. And I think it's important for singers in general to know these things, to understand them, and to embrace the fact that sometimes their voices will not always be what they used to be or what they expect them to be, but that doesn't necessarily minimize their contribution to the singing world, or, um, it definitely should not make them stop singing, right? I mean, like, I know that's a big thing for you is that everyone should be singing. Everybody deserves to sing, um, whether they do it as a career or not, whether it's just their bathroom, like, shower singers. I mean, everybody should be singing because it's such an important thing.

Yeah, it's a huge part of who we are as human beings. And when, when our voices maybe start to do things that we don't expect them to do, the first thing that we do is blame ourselves. And if we don't blame ourselves, maybe we blame our old teacher. But that old teacher was teaching a different person than who we are now. And to accept that this may not be my fault This may not be anything I'm doing wrong. This may just be the state of my body today. Work with your best technique in that day, in that moment, and you'll find the gold and the freedom there to express that message that you need to put out to the world.

Thank you. I love that message. Thank you so much for taking the time to have this conversation with me and my audience. I really appreciate it.

I'm so thrilled to be here and to give this information to your audience, because like you said, I think it's so important. So thank you so much, Karen.

Thank you.