Medical conditions which can result in voice problems

Have you ever lost the use of your voice, maybe after a long bout of coughing, or after a late night out clubbing when you spoke for hours over loud music? If so, you are not alone. In most cases, the voice is restored to normal within a couple of days, but for some people, the problem may persist, affec​ting their ability to speak with ease.

"Voice problems can arise from certain medical conditions, or be caused by the way a person uses his or her voice," says Deirdre Tay, Head of Speec​h Therapy​ at Singapore General Hospital​ (SGH), a member of the SingHealth​​​ group.​​

Laryngopharyngeal reflux disease (LPRD) / Gastroesophageal reflux​ disease (GERD)

Reflux disease refers to the flow of acid from the stomach into the oesophagus and even to the throat. When stomach acid refluxes into the throat, it can cause throat irritation. As a result of that irritation, chronic or intermittent hoarseness can occur.


Laryngitis is an infection which causes the vocal folds to swell up. An upper respiratory tract infection is the most common cause of infection of the vocal folds. When the vocal folds become swollen, they move and vibrate differently, leading to changes in voicing. Someone with laryngitis will typically sound hoarse. During this period, you should rest or reduce the use of your voice and stay well hydrated to prevent your voice from worsening.

Throat cancer

Throat cancer can affect the voice and requires immediate medical attention. When cancer attacks the vocal folds, voice quality deteriorates due to the changes in the movement of the folds. Voice quality may become hoarse or raspy.

In the absence of medical conditions, voice function can still be affected by the way someone uses the voice.

Vocal misuse/ abuse

Vocal misuse or abuse is the use of the voice in ways which can cause vocal fold injury. Some examples include:

Vocal abuseVocal misuse
Shouting or screamingSpeaking too loudly
Speaking forcefullySpeaking with an unnatural pitch
Talking for long periods without voice restTalking over background noise
Constant coughing, throat clearingSpeaking without proper breath support
Changing the voice to sound more authoritative 

These patterns of voice use can lead to significant injury to the vocal folds. Imagine the vocal folds as your hands, and in order to voice, these “hands” have to clap. If you clap your hands hard, they may start to hurt and you may experience some redness and irritation. If you continue this hard clapping, you might get swelling on your hands.

Likewise, when the vocal cords come together in a hard and forceful way, vocal pathologies such as nodules and polyps may develop. These vocal cord pathologies can affect the quality of your voice.

You should consult an otolaryngologist (ear, nose and throat doctor) should there be persistent hoarseness or change in the voice for longer than four weeks. Prompt attention to voice changes can help facilitate early diagnosis and subsequent early treatment of voice problems.

Ref: T12