Sex Hormone Receptors in Vocal Fold Tissue: A Theory about the Influence of Sex Hormones in the Larynx

Abstract

Objective: The larynx is considered a secondary sexual organ. To demonstrate that sex hormones can directly influence laryngeal function, specific receptors in the vocal cord must be identified. Materials and Methods: We searched for estrogen, progesterone and androgen receptors, using an immunohistochemical method, in normal human vocal cords (from 3 cadavers) and in samples of healthy vocal cords and of laryngeal carcinomas from 15 live subjects. Breast and prostate carcinoma were used as controls. Results: In all the normal samples tested, the results were negative; there was only a nonspecific cytoplasmatic response in the subepithelial glands (false positives). In the neoplastic tissue, 2 samples had a weak nuclear focal positivity for estrogen and progesterone receptors; all 15 subjects studied were negative for androgen receptors. Conclusions: Since our data show that sex hormone receptors are absent in the vocal cords, other theories must be considered to explain the fact that hormones influence the quality of the voice. This study discusses the possibility that the changes of voice according to gender and throughout life might be linked with a different expression of some growth factors in the laryngeal tissue and that this expression might in turn be influenced by hormonal variations.

The assessment of the impact of anorexia nervosa on the vocal apparatus in adolescent girls – A preliminary report

“…As it has been mentioned before, girls suffering from AN present with a characteristic clinical picture of endocrine dysfunction, such as amenorrhoea, abnormal temperature regulation, abnormal levels of the growth hormone, thyroid stimulating hormone (TSH) or corticotropin-releasing hormone (CHR) [5,6,12,15]. Still, it is known that the voice is particularly sensitive to hormonal changes [7,12].…”

“…The majority of immunohistochemical studies clearly demonstrate that there are hormone receptors on the vocal folds [26][27][28]. However, some papers prove just the opposite [29]. Therefore, other theories explaining the undisputed influence of hormone on voice quality are also considered.…”

“…Therefore, other theories explaining the undisputed influence of hormone on voice quality are also considered. For instance, voice changes dependent on the sex/age throughout one's lifetime may occur due to a different expression of growth factors in the laryngeal tissue, which may account for the fact that the expression could in turn have an impact on hormonal variations [29].…”

“…The endocrine activity in males is responsible for voice break in puberty [2,8,[12][13][14], while in women, the timbre and pitch of voice may undergo cyclic changes in relation with the menstrual cycle [1,2,7,12]. It should be noted, however, that the anatomy of the larynx and the timbre of voice are the secondary sex characteristics, as well as the structural proportions, increased muscle mass, the skeletal structure and the growth of body hair [1,7,8,15]. Nevertheless, one should take into consideration the fact that the vocal efficiency of the larynx is influenced by many factors, such as rest or body hydration [7], and voice, as an individual feature, depends on a number of individual properties of man: personality, emotional state, diseases and mental disturbances (depression, anhedonia, anxiety) [7,8,16].…”

Effect of Pregnancy on Vocal Cord Histology: An Animal Experiment

“…Brunings et al (16) found estrogen and progesterone receptors in the biopsy specimens of the benign vocal fold lesions to be expressed in conjunction with edema. On the other hand, Nacci et al (17) showed that sex hormone receptors were absent in the vocal cords and concluded that the different expression of some growth factors in the laryngeal tissue influenced by hormonal variations might result in vocal changes.…”