To the Editor.—In their article "Effect of the Menstrual Cycle on Voice Quality," which appeared in the January 1978 Archives (104:7-10), Silverman and Zimmer came to the conclusion that "the data reported here do not support the contention that hoarseness is a feature of the premenstrual syndrome for the typical woman."
Both the methods of investigation and the interpretation of the literature by Silverman and Zimmer raise some doubts about the validity of this statement. The 20 patients in their report were tested by asking them to produce three vowel sounds at "comfortable" levels of volume and loudness. No pitch levels were given. During the premenstrual period, a woman may be able to produce such vowel sounds at comfortable levels but may have considerable difficulties at a higher range or larger volume. Connected speech or singing under more strenuous conditions may disclose cracking of tones or difficulty with high
FRIEDRICH S. BRODNITZ. Menstrual Cycle and Voice Quality. Arch Otolaryngol. 1979;105(5):300. doi:10.1001/archotol.1979.00790170070022