title: The Effects of Hormonal Contraception on the Voice: History of Its Evolution in the Literature.
abstract: OBJECTIVE
  Women of reproductive age commonly use hormonal contraceptives, the vocal effects of which have been studied. Otolaryngologists should be aware of this relationship to make recommendations on hormonal contraception as it relates to each patient's voice requirements.
  
  
  METHODS
  A comprehensive literature review of PubMed was completed. The terms "contraception," "vocal folds," "vocal cords," and "voice" were searched in various combinations. Articles from 1971 to 2015 that addressed the effects of contraception on the vocal folds were included.
  
  
  RESULTS
  In total, 24 articles were available for review. Historically, contraception was believed to affect the voice negatively. However, more recent studies using low-dose oral contraceptive pills (OCPs) show that they stabilize the voice. However, stabilization generally occurs only during sustained vowel production; connected speech appears unaffected. Therefore, singers may be the only population that experiences clinically increased vocal stability as a result of taking hormonal contraceptives. Only combined OCPs have been studied; other forms of hormonal contraception have not been evaluated for effects on the voice. Significant variability exists between studies in the physical attributes of patients and parameters tested.
  
  
  CONCLUSIONS
  Hormonal contraception likely has no clinically perceptible effects on the speaking voice. Singers may experience increased vocal stability with low-dose, combined OCP use. Other available forms of contraception have not been studied. Greater consistency in methodology is needed in future research, and other forms of hormonal contraception require study.
authors.affiliation: Department of Otorhinolaryngology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Rodney
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address: journal@voicefoundation.org.
authors.forename: Robert Thayer
authors.initials: RT
authors.lastname: Sataloff
mesh_terms: D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects / Q000266:history; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000266:history; D004305:Dose-Response Relationship, Drug; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects; D018570:Risk Assessment; D012307:Risk Factors; D063346:Singing; D013061:Speech Acoustics; D014832:Voice Disorders / Q000139:chemically induced / Q000503:physiopathology; D014833:Voice Quality / Q000187:drug effects*
chemical_list: D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal
keywords: Contraception; Oral contraceptive; Oral contraceptive pill; Voice