The coordinated activity of the respiratory system, the vocal folds and the vocal tract results in voice production or phonation. The vocal tract (or voice resonator) is the anatomical space consisting of the laryngeal vestibule, hypopharynx, oropharynx, oral cavity, nasopharynx and nasal cavities. The planar gap between the vocal folds is called glottis. The vocal folds are multilayer structures composed of a muscle (the vocalis muscle), a ligament (the vocal ligament) and a mucus membrane cover. The voice organ is composed of three different systems, namely, the respiratory apparatus, the vocal folds and the vocal tract. The purpose of the present literature review is to collect and discuss present knowledge about the influence of the sexual hormones on the human voice from childhood to senescence, both in males and in females. The larynx, as a secondary sexual organ, is also considerably influenced by sex hormones. Both in physiological conditions and in the case of endocrine disorders, the human voice can be strongly affected with consistent modifications. Hormones have a major influence on the voice organ, affecting both the larynx itself and the structures of the vocal tract. Through the vocal tract, the glottal sound is articulated and selectively amplified, obtaining a unique voice timbre.
The vibrating vocal folds, by rapidly oscillating and rhythmically contacting each other, generate a fundamental frequency (F0) perceived as sound pitch. Subglottal pressure is primarily responsible for sound pressure level (SPL) perceived as sound intensity. Functionally, the lungs represent the power supply, while the vocal folds (an oscillator) work as the sound source and the vocal tract acts as an active resonator. The voice is produced through the interaction of the lungs, the vocal folds and the vocal tract. The voice is one of the most complex and finely developed of human functions, being not only fundamental for social interaction and communication but also for self-recognition and gender identification.
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