What Causes Aphonia (Loss of Voice)?...

Medically reviewed by Jordana Haber Hazan, MDMedically reviewed by Jordana Haber Hazan, MDAphonia is the medical term for losing your voice. This happens when your speech is very hoarse, strained, or no louder than a whisper, making it difficult for you to vocalize. Several factors can cause aphonia, such as allergies, respiratory infections (like the flu or COVID-19), and functional problems with your vocal cords.Aphonia is usually temporary, and the condition is common. Research suggests that at least one in 13 adults experiences losing their voice at least once in their lives. If you lose your voice, resting it, staying hydrated, and certain therapies can help it return.What Does Aphonia Feel Like?When you develop aphonia, it can become difficult to speak audibly or make your voice loud enough to be heard. Many people notice that their voice becomes raspy, hoarse, or breathy. If you try to speak when you have aphonia, speaking can cause fatigue and make the voice weak or labored. You may even try to avoid speaking at all.Depending on what caused you to lose your voice, the onset of these symptoms can happen suddenly or gradually. Generally, you'll only lose your voice for a few days, but speech disorders can cause aphonia to become chronic. In these cases, it can take weeks or months to get your voice back.What Causes You To Lose Your Voice?Vocal sounds are produced as air from the lungs pushes through the larynx (voice box) in the throat, which contains vocal cords. These vocal cords are bands of tissue and muscle that vibrate and create sound. As sound moves out of the larynx, the passages of the throat and nose help make sound louder.Several conditions and health factors can affect this process, which can cause you to lose your voice.AllergiesAlso known as allergy-related laryngitis, allergies can cause your vocal cords to become inflamed, leading to symptoms like hoarseness, weak voice, and, ultimately, aphonia. Factors like pollen and dust can trigger allergies and cause additional symptoms such as sneezing, coughing, itchy throat, watery eyes, nasal congestion, headache, and fatigue.Respiratory InfectionsInfections that affect the upper respiratory system, such as the common cold, influenza (the flu), COVID-19, or pneumonia, can also lead to aphonia. When you experience these infections, your throat can become inflamed and cause you to lose your voice or feel hoarse. Respiratory infections can also cause other symptoms, such as headaches, a runny nose, coughing, sneezing, and fatigue.Voice MisuseSome people develop aphonia due to the strain of talking loudly, yelling, or screaming too much. Think of this as the type of voice loss you get from cheering at a game or singing loudly at a concert. The vocal cords develop fatigue, affecting your ability to vocalize properly.People who work in environments that require you to overuse your vocal cords (such as teachers, professional speakers, or singers) may be more prone to aphonia.Structural IssuesStructural problems with the vocal cords, which may often occur with abnormal growths or cancer, can also lead to aphonia. Potential causes include:Edema (swelling): Reinke’s edema is when a noncancerous growth develops in the larynx, affecting the voice. This is a rare condition that can occur if you smoke often or experience frequent secondhand smoke. As a result, the condition makes it difficult for you to control your pitch and can cause long-term hoarseness or aphonia.Nodules: Vocal cord nodules, cysts, and polyps are noncancerous growths that occur due to vocal misuse, excessive and loud talking, smoking, and allergies. In addition to losing your voice, nodules can make your voice hoarse and scratchy, cause a feeling of a lump in your throat, and lead to neck pain. Aging: As you get older, your vocal cords naturally weaken and change structure. This can lead to aphonia, hoarseness, vocal fatigue, and a weak voice.Laryngeal cancer: Aphonia and voice hoarseness can also be early signs of laryngeal cancer, which causes cancer cells in your larynx. This condition is more common in people who use alcohol and tobacco. Alongside a loss of voice, this cancer can also cause painful swallowing, sore throat, ear pain, and swollen lymph nodes in the neck.Neurological ProblemsProblems with the parts of the brain or nerves that regulate vocal cords can cause a type of aphonia called neurogenic aphonia. Damage to your vagal nerves—found on either side of the neck—can lead to vocal cord paralysis, or the complete inability of the vocal cords to move.Several conditions can affect these nerve pathways and affect the voice through loss of motor control and paralysis, such as:Multiple sclerosisParkinson's diseaseStrokeTremors (shaking)Muscle tension dysphonia (tight vocal cords)Paradoxical vocal fold motion (vocal cords close when they should be open)Psychological FactorsLosing your voice can also be a purely psychological reaction. Stress, trauma, extreme fear, and severe anxiety can sometimes cause you to lose your voice, especially if you lose your voice when an underlying condition isn't the cause of your aphonia.People with the following conditions and symptoms can be at a higher risk of developing psychogenic aphonia:DepressionAnxietyMotor difficulty or uncontrolled movements (tics)Difficulty swallowing (dysphagia)Trouble walkingHallucinationsDementia or memory lossWhen to Contact a Healthcare ProviderLosing your voice can affect your everyday activities and your overall quality of life. You should contact your healthcare provider if you:Notice your voice is raspy or hoarseCan't speak at allAren't able to sing notes that you once were able toHave a sudden lower, deeper pitch to your voiceFeel your voice is wavering or weakExperience a raw, scratchy, or sore throatDevelop fatigue when speaking or have difficulty talkingAre constantly clearing your throatYour healthcare provider will refer you to an ear, nose, and throat (ENT) specialist to diagnose and treat aphonia. At your appointment, your ENT will ask about your medical history, perform a physical exam, and complete a laryngoscopy.There are two options for a laryngoscopy: rigid and flexible. A rigid exam runs a tube that's attached to a tiny camera down your throat to assess inflammation and signs of nodules. A flexible exam involves accessing the larynx through the nose, which helps your provider observe your larynx while you talk, sing, or cough.TreatmentThe treatment for aphonia depends on the underlying cause. If you lose your voice due to allergies, a temporary infection, or speaking too loudly, it's important to get rest, stay hydrated, and avoid using your voice when possible.If an underlying health condition such as cancer or an autoimmune disorder causes your aphonia, your healthcare provider will treat the whole condition and offer other therapies if your aphonia doesn't improve. These therapies may include:Speech therapy: If your ENT suspects a neurological concern or function issue as the cause of your aphonia, they may refer you to a speech-language pathologist (SLP). An SLP will use vocal and breathing exercises that can improve the function of your vocal cords. They can also show you exercises to do at home to maintain your vocal health.Psychotherapy: If your aphonia is due to psychological reasons, such as stress, anxiety, or trauma, your provider may refer you to a mental health specialist, such as a psychologist or therapist, for counseling and therapy. Your therapist may suggest talk therapy, such as cognitive-behavioral therapy, to help you identify and work through stressors.How To Prevent AphoniaYou can do several things to lower your risk of losing your voice. Consider these preventative strategies: Drink enough water throughout the dayAvoid or quit smokingConsume a diet high in whole grains, fruits, and vegetables to maintain good vocal healthLimit spicy foods and alcohol, which can trigger acid reflux and affect your throatWash your hands frequently to limit the risk of respiratory infectionsGet enough sleep to protect your voiceTry not to scream, yell, or talk and sing too loudly to avoid putting strain on your vocal cordsRest your voice, especially when you're sickA Quick ReviewAphonia is the medical term for losing your voice. When you develop aphonia, you may experience difficulty speaking, hoarseness in your voice, and a sore throat, among other symptoms. Several underlying factors can cause you to lose your voice, such as straining your voice, contracting a respiratory infection, experiencing allergies, or living with a chronic health condition, such as cancer.Most cases of acute (short-term) aphonia that occur with a respiratory infection, after straining your voice, or due to recent stress resolve with several days of rest and hydration. Psychotherapy and speech therapy may be indicated if you have a long-term case of aphonia.Reach out to a healthcare provider if symptoms persist or if you have other risk factors or associated symptoms. Seek immediate medical attention if you have symptoms like shortness of breath, chest pain, difficulty swallowing, or drooling. This may indicate further testing and visualization through a laryngoscopy. For more Health.com news, make sure to sign up for our newsletter! Read the original article on Health.com.

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