After puberty, most people’s voices remain more or less the same for about 50 years. But we all use our voices differently, and eventually we experience the symptoms associated with aging larynxes, known as presbyphonia. First, the collagen in our folds stiffens and the surrounding elastin fibers atrophy and decay. This decreased flexibility increases the pitch of older voices. But for people who have experienced the hormonal effects of menopause, the higher pitch is countered and outweighed by swollen vocal folds. The folds' increased mass slows their vibrations, resulting in deeper voices. All these symptoms are further complicated by having fewer healthy laryngeal nerve endings, which reduces precise muscle control and causes breathy or rough voices. Ultimately, these anatomical changes are just a few of the factors that can affect your voice. But when kept in good condition, your voice box is a finely tuned instrument, capable of operatic arias, moody monologues, and stirring speeches.