title: Functional Voice Testing Detects Early Changes in Vocal Pitch in Women During Testosterone Administration.
abstract: OBJECTIVE
  To determine dose-dependent effects of T administration on voice changes in women with low T levels.
  
  
  METHODS
  Seventy-one women who have undergone a hysterectomy with or without oophorectomy with total T < 31 ng/dL and/or free T < 3.5 pg/mL received a standardized transdermal estradiol regimen during the 12-week run-in period and were then randomized to receive weekly im injections of placebo or 3, 6.25, 12.5, or 25 mg T enanthate for 24 weeks. Total and free T levels were measured by liquid chromatography-tandem mass spectrometry and equilibrium dialysis, respectively. Voice handicap was measured by self-report using a validated voice handicap index questionnaire at baseline and 24 weeks after intervention. Functional voice testing was performed using the Kay Elemetrics-Computer Speech Lab to determine voice frequency, volume, and harmonics.
  
  
  RESULTS
  Forty-six women with evaluable voice data at baseline and after intervention were included in the analysis. The five groups were similar at baseline. Mean on-treatment nadir total T concentrations were 13, 83, 106, 122, and 250 ng/dL in the placebo, 3-, 6.25-, 12.5-, and 25-mg groups, respectively. Analyses of acoustic voice parameters revealed significant lowering of average pitch in the 12.5- and 25-mg dose groups compared to placebo (P < .05); these changes in pitch were significantly related to increases in T concentrations. No significant dose- or concentration-dependent changes in self-reported voice handicap index scores were observed.
  
  
  CONCLUSIONS
  Testosterone administration in women with low T levels over 24 weeks was associated with dose- and concentration-dependent decreases in average pitch in the higher dose groups. These changes were seen despite the lack of self-reported changes in voice.
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Grace
authors: G
authors: Huang
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Karol M
authors: KM
authors: Pencina
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Jeffry A
authors: JA
authors: Coady
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Yusnie M
authors: YM
authors: Beleva
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Shalender
authors: S
authors: Bhasin
authors: Section of Men's Health: Aging and Metabolism (G.H., K.M.P., Y.M.B., S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts 02115; and Department of Speech, Language, and Hearing Sciences (J.A.C.), University of Colorado, Boulder, Colorado 80309.
authors: Shehzad
authors: S
authors: Basaria
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008593:Menopause / Q000097:blood / Q000187:drug effects; D008875:Middle Aged; D010052:Ovariectomy; D013018:Sound Spectrography; D013739:Testosterone / Q000008:administration & dosage*; D014831:Voice / Q000187:drug effects* / Q000502:physiology*; D014832:Voice Disorders / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D013739:Testosterone; D004958:Estradiol