International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 4 , ISSUE 2 ( July-December, 2014 ) > List of Articles


Cepstral Characteristics of Voice before, during and after Menopause: A Cross-sectional Study

Radish Kumar Balasubramanium, Jayashree S Bhat

Citation Information : Balasubramanium RK, Bhat JS. Cepstral Characteristics of Voice before, during and after Menopause: A Cross-sectional Study. Int J Phonosurg Laryngol 2014; 4 (2):50-54.

DOI: 10.5005/jp-journals-10023-1082

Published Online: 01-06-2011

Copyright Statement:  Copyright © 2014; The Author(s).



Previous studies on effects of menopause on voice characteristics have not compared the voice characteristics before, during and after menopause. It is also possible that these voice changes cannot be captured by traditional acoustic measures such as frequency and amplitude perturbation measures. Hence a robust acoustic tool such as cepstrum was chosen to capture these vocal changes before, during and after menopause and hence the present study was attempted.


The present study followed a cross-sectional study design. The participants consisted of 25 premenopausal women, 25 perimenopausal women and 25 postmenopausal women. Sustained production of/a/ and narration was recorded using Z tool and cepstral peak prominence (CPP) and smoothened cepstral peak prominence (CPPS) was analyzed.


The results of one-way ANOVA revealed that there was a significant main effect of the group at p < 0.05 for all the cepstral measures targeted in the study. Post hoc analysis indicated that there was no significant difference between pre and perimenopausal women for all the cepstral measures at p < 0.05. However, there was a significant difference between pre and postmenopausal women and peri and postmenopausal women at p < 0.05. These results suggests that postmenopausal women had overall good voice quality than pre and perimenopausal women.


Results indicated that post menopausal women had increased cepstral measures when compared to pre and perimenopausal women. Further, studies are required to correlate laryngeal examination and hormonal levels with that of the voice changes before, during and after menopausal women.

How to cite this article

Balasubramanium RK, Bhat JS. Cepstral Characteristics of Voice before, during and after Menopause: A Cross-sectional Study. Int J Phonosurg Laryngol 2014;4(2):50-54.

PDF Share
  1. Does a hormonal vocal cord cycle exist in women? Study of vocal premenstrual syndrome in voice performers by videostroboscopy-glottography and cytology on 38 women. J Voice 1989;3(2):157-162.
  2. Clinical analysis of voice change as a parameter of premenstrual syndrome. J Voice 2001;15(2):278-283.
  3. Identification of thyroid hormone receptors in the human larynx. Laryngoscope 2003;113(11):1931-1934.
  4. Vocal behavior during menstrual cycle: perceptual-auditory, acoustic and self-perception analysis. Rev Bras Otorrinolaringol 2004;70(3):331-339.
  5. Sex hormones and the female voice. J Voice 1999;13(3):424-446.
  6. Female voice changes around and after menopause—an initial investigation. Mauritas 1996;23(1):15-21.
  7. Voice impairment and menopause. Menopause 2004;11(2): 151-158.
  8. Phonoarticulatory variations of women in reproductive age and postmenopausal. J Voice 2003;18(3):369-374.
  9. Comparison of postmenopausal voice changes across the professional and nonprofessional users of the voice. South African J Communication Disorders 2010;57(1):76-81.
  10. The impact of the menopause on vocal quality. Menopause 2011a;18(3):267-272.
  11. Vocal characteristics of middle-aged premenopausal women. J Voice 2011b;25(3): 360-366.
  12. Comparison of fundamental voice frequency between menopausal women and women at menacme. Maturitas 2006;55(2):195-199.
  13. The impact of hormone therapy on vocal quality in postmenopausal women. J Voice 2012;26(5):671-677.
  14. The relation between body mass index and speaking fundamental frequency in premenopausal and postmenopausal women. Menopause 2011;18(7):754-758.
  15. Comparison of speaking fundamental frequency between premenopausal women and postmenopausal women with and without hormone therapy. Folia Phoniatr Logop 2013;65(2):78-83.
  16. Cepstral peak prominence: a more reliable measure of dysphonia. Ann Otol Rhinol Laryngol 2003;112(4):324-333.
  17. The relationship between cepstral peak prominence and selected parameters of dysphonia. J Voice 2002;16(1):20-27.
  18. Reliability of calculating the cepstral peak without linear regression analysis. J Voice 2004;18(2):203-208.
  19. Cepstrum analysis in voice disorders. Folia Phoniatr Logop 1994;47(4):210-217.
  20. Psychoacoustic evaluation of voice: GRBAS Scale for evaluating the hoarse voice. Clinical examination of voice, Springer Verlag. 1981.
  21. Development and validation of a voice disorder outcome profile for an Indian population. J Voice 2010;24(2):206-220.
  22. The impact of hormonal fluctuations on female vocal folds. Current opinion in otolaryngology and head and neck surgery 2004;12(3):180-184.
  23. Laryngeal cytological aspects in women with surgically induced menopause who were treated with transdermal estrogen replacement therapy. Fertility and Sterility 2000;74(6):1073-1079.
  24. The aging adult voice. J Voice 1997;11(2):156-160.
  25. Acoustic and long-term average spectrum measures to detect vocal aging in women. J Voice 2011;25(4):411-419.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.