Along with obvious changes in physical appearance, the voice will start sounding a whole lot different in boys and to a lesser extent in girls. As the body goes through puberty, the larynx grows larger and thicker. It happens in both boys and girls, but the change is more evident in boys. Girls’ voices only deepen by a couple of tones and the change is barely noticeable. Boys’ voices, however, start to get significantly deeper.
When a person speaks, air rushes from the lungs and makes the vocal cords vibrate, which in turn produces the sound of the voice. The pitch of the sound produced is controlled by how tightly the vocal cord muscles contract as the air from the lungs hits them. If you’ve ever plucked a small, thin rubber band, you’ve heard the high-pitched twang it makes when it’s stretched. A thicker rubber band makes a deeper, lower-pitched twang. It’s the same process with vocal cords.
In infants the laryngotracheal complex lies at a higher level. It gradually descends. During puberty in males this descent is rapid, the larynx becoming larger and unstable and on top of it the brain is more accustomed to infant voice. The boy may hence continue to use a high pitched voice or it may break into higher and lower pitches.
As a boy’s body adjusts to this changing equipment, his voice may “crack” or “break.” This process lasts only a few months. When his larynx grows bigger, it tilts to a different angle inside the neck and part of it sticks out at the front of the throat. This is the “Adam’s apple.” In girls, the larynx also grows bigger but not as much as a boy’s does, which is why girls don’t have prominent Adam’s apples.
Man speaking like a girl? Puberphonia
The persistence of adolescent voice even after puberty in the absence of organic cause is known as Puberphonia. It is also known as mutational falsetto in medical terms. The high-pitched voice persists despite normal growth of the larynx and completion of puberty. These patients hence suffer from lack of resonance in voice, breathiness of voice and lack of pitch variations. Puberphonia is more common in adolescent males and may also occur rarely in females.
Causes of Puberphonia: Emotional stress, psychological causes and delayed development of secondary sexual characters
Symptoms of Puberphonia: The most common symptoms include pitch breaks, hoarseness, breathiness, difficulty in vocal projection, and visible laryngeal muscle tension. Several reasons have been cited in literature regarding the development of Puberphonia, such as increased laryngeal muscle tension causing laryngeal elevation, embarrassment of the newly achieved vocal pitch, failure to accept the new voice, social immaturity, etc.
Management of Puberphonia
Examination of these patients should include a complete physical examination including a genital examination also. Secondary sexual characters should be assessed, hypogonadism should be ruled out. A complete psychological profile of the patient in question should be built to rule out psychological causes. If psychological causes could be identified they treating it should take precedence over other modalities.
Most of the times it is correctable by speech therapy. However, when not, surgery called Thyroplasty type 3 can be done with very good results.