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Presbyphonia: Aging Voice Changes

Updated: Jan 15

Did you know that as you age, you may experience voice changes simply as a result of the aging process, called presbyphonia (aging voice) or presbylaryngis (aging larynx/voice box). Age-related voice changes occur due to muscle loss of the vocal cords, weakened respiratory muscles or both. Often, the vocal cords become bowed or a little saggy so they do not close as efficiently as they used to which changes the vibration or sound they make. You do not have to struggle with poor projection, weak or breathy voice, rough or hoarseness, unsteadiness in the voice, higher pitch voice, or a voice that is easy to fatigue. Voice therapy can address many of the changes that occur due to aging voice changes.

Let's explore some of the voice therapy techniques that can address age-related voice changes.

Elderly woman shouting through a bullhorn

Voice Therapy Treatments for Presbyphonia (Aging Voice)


Phonation Resistance Training Exercises (PhoRTE)

PhoRTE is a voice program designed specifically to address changes related to the aging voice. This program targets techniques to energize the voice at a specific target volume. The exercises provided will attempt to improve respiratory strength, vocal cord closure, vocal cord flexibility for a voice. Seeks a Speech Language Pathologist (SLP) trained in PhoRTE will help you select the "just right" vocal level to target each week. Your SLP will continue to monitor your progress and change your targets in therapy each session. The SLP will also ensure you are using proper technique to energize your voice so you reduce or eliminate vocal strain.

Respiratory Muscle Strength Training (RMST)

This technique uses a pressure threshold device to incrementally strengthen the muscles of the diaphragm and intercostal muscles which play an important role in the inhalation and exhalation process. By engaging the respiratory muscles, individuals can improve lung function, increase respiratory efficiency, and enhancing overall endurance. Your SLP will ensure this type of device is not contraindicated, will help you choose the appropriate device and will help you set the appropriate training target each week.

Vocal Function Exercises (VFE)

These exercises were developed by a well-respected SLP and voice specialist, Dr Joseph Stemple. These structured exercises improve the function of the vocal cords by targeted breath support, pitch control, resonance and vocal range to improve vocal clarity and endurance.

Diaphragmatic Breathing Exercises

Engaging the muscles of the diaphragm and improve the breathing pattern helps to support the vibration of the vocal cords. When the muscles of the diaphragm are not engaged when speaking, it can result in muscular tension in the larynx (voice box) which results in changes to the voice. Using an efficient respiratory pattern can often improve the sound of the voice.

Vocal Fold Augmentation

This is a medical procedure typically performed by an ear, nose and throat doctor (ENT) or laryngologist. The technique is used when there is insufficient vocal cord closure. The technique injects a gel-like substance into the vocal cord to help the vocal cords to close more efficiently, therefore producing a stronger voice quality. This technique may be combined with behavioral voice therapy either before and/or after the procedure to optimize the voice.

Communication does not have to be a struggle.

Contact Lake City Speech & Voice Therapy to see how we can help at: or 773.234.2349

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