The Effects of a Third Generation Combined Oral Contraceptive Pill on the Classical Singing Voice * Filipa M.B. La ˜, †William L. Ledger, *Jane W. Davidson, ‡David M. Howard, and §Georgina L. Jones *§Sheffield, †Sheffield, Yorkshire, and ‡York, North Yorkshire, United Kingdom Summary: The success of professional operatic singers depends upon the quality of their vocal mechanism. This is known to be sensitive to changes in the endocrine environment. Despite a widespread belief among singers that vocal quality changes according to the stage of the menstrual cycle, this has received little attention. In particular, the possibility that use of the contracep- tive pill might stabilize vocal quality by ‘‘dampening’’ hormonal fluctuations has not previously been studied systematically. Here, we show that drospire- none containing oral contraceptive pill (Yasmin, Schering AG, West Sussex, UK) with antiandrogenic and antimineralocorticoid properties demonstrates a significant reduction in the irregularity of the pattern of vibration of the vocal folds during the performance of highly trained classical singers. This study con- stitutes the first double blind, randomized placebo controlled trial to assess the effects of the contraceptive pill on the patterns of vibration of the vocal folds during the performance of Western classical singing repertoire. Key Words: Third generation combined oral contraceptive pill—Sexual hormones—Singing vocal performance—Electrolaryngograph. INTRODUCTION Few studies have assessed the effects of oral con- traception on voice quality and no research has been carried out specifically concerning the singing voice. Previous reports concerning the effects of oral contraception on the speaking voice have sug- gested a predominance of adverse effects. Voice virilization (ie, changes in the deepness and steadi- ness of the vocal timbre, and frequent and rapid changes between voice registers) has been associ- ated with the androgen-derived progestogens of some oral contraceptive pills (OCPs). Professional female voice users were advised in the 1980s to avoid the intake of OCPs, and those who were tak- ing an OCP were advised to have regular phoniatric examinations. 1–5 This was because testosterone and other androgenic substances have adverse effects on Accepted for publication May 22, 2006. From the *Music Department, University of Sheffield, Shef- field, UK; †Academic Unit of Reproductive and Developmen- tal Medicine, University of Sheffield, Sheffield, Yorkshire, UK; ‡Department of Electronics, University of York, Heslington, York, North Yorkshire, UK; and the §School of Health and Re- lated Research (SCMARR), University of Sheffield, Sheffield, UK. Address correspondence and reprint requests to Filipa M. B. La, Music Department, University of Sheffield, 38 Taptonville Road, Sheffield, S10 5BR, UK. E-mails: filipasoprano@gmail. com or w.ledger@sheffield.ac.uk or j.w.davidson@sheffield.ac. uk or dh@ohm.york.ac.uk or g.l.jones@sheffield.ac.uk Journal of Voice, Vol. 21, No. 6, pp. 754–761 0892-1997/$32.00 Ó 2007 The Voice Foundation doi:10.1016/j.jvoice.2006.05.009 754