Aphonia (Loss of Voice)

Aphonia is the medical term for loss of voice. It means you’re so hoarse that you can’t make yourself heard. You may not be able to speak above a whisper. Or you may be unable to speak at all.

Aphonia is a type of voice disorder. These conditions impact your ability to speak and be heard. There are lots of possible causes, and they can affect anyone. But aphonia most commonly affects people who use (or raise) their voices a lot.

Voice therapy with a speech-language pathologist (SLP) helps most people get their voices back.

Symptoms of aphonia

The most common — and most obvious — symptom is not being able to speak up so people can hear you when you talk. Suddenly losing your voice is another symptom.

Aphonia causes

Using your voice normally may sound easy to do. But in real time, it relies on the muscles in your throat and voice box (larynx), vocal cords, throat, nose and mouth all working together to help you make and project sound. If something is “off,” you can lose your voice.

Common causes of aphonia include:

• Voice misuse or overuse (phonotrauma): Things like bellowing nonstop during an hour-long soccer match will take a toll on your voice. Using your voice so much that it tires out (vocal fatigue) can also cause you to lose your voice.
• Emotional or psychological stress: You can suddenly lose your voice if you’re going through a particularly stressful event or time in your life. This is called functional aphonia.

Risk factors

You’re more likely to develop this condition if you:

• Are female: Females are much more likely to have aphonia than males.
• Have anxiety or depression: You’re more likely to have a functional voice disorder with these conditions. Related to sex-based risk factors, females are more likely than males to have these diagnoses.
• Have a job where you use your voice a lot: Examples include teachers, singers, public speakers and people who work in factories and speak over machinery.

How doctors diagnose this condition

Your healthcare provider will review your medical history and ask questions about your voice issues. (They’ll find ways you can tell your story even though you can’t speak as you normally would.) They may ask when you lost your voice and if it comes and goes. They’ll try to learn more about how you use your voice each day.

Your provider may do a laryngoscopy to see your vocal cords up close. This test uses a scope with a camera to record images of your vocal cords.

A special type of this procedure called a videostroboscopy may be especially useful. It can show how your vocal cords move when you talk or sing. It can help your provider rule out physical issues with your vocal cords.

How is aphonia treated?

Voice therapy is the main treatment. You’ll likely need to work with a speech-language pathologist (SLP) who specializes in voice disorders. Your SLP will tailor treatment to your specific situation. Treatment may include:

• Breathing exercises
• Vocal rest
• Voice exercises
• Education on vocal hygiene, or caring for your voice
• Instruction on using ways to communicate that don’t rely on your voice

If your condition relates to stress or anxiety, speaking to a counselor or therapist may help. Many people benefit from getting therapy for both their voice and mental health.

When should I see my healthcare provider?

If your voice isn’t back to normal in two weeks, see your provider. They can recommend treatment or refer you to a specialist who can help.

What can I expect if I have this condition?

Voice loss that happens after lots of shouting the day before may take a day or two to resolve. If it doesn’t, something more serious may be going on. It’s important to get an accurate diagnosis.

Most people who have aphonia recover their lost voices after voice therapy. An SLP can pinpoint the cause and tailor treatment based on that.

Is there anything I can do to feel better?

Be sure to follow your healthcare provider’s treatment plan for you. There are also general things you can do to care for yourself, like:

• Resting your voice
• Drinking lots of water to keep your vocal cords hydrated
• Using a humidifier to keep your throat moisturized
• Sipping on warm drinks made with water and honey to soothe your throat

What’s the difference between aphonia and dysphonia?

Aphonia is complete voice loss while dysphonia is a problem with the quality of your voice. With dysphonia, your voice pitch (how high or low it sounds) may sound off, or your voice may sound hoarse, raspy or too quiet.

It may also help to think of these conditions on a continuum. Aphonia is a more extreme version of voice loss than dysphonia.

What is psychogenic aphonia?

Psychogenic aphonia is the same as functional dysphonia. But “functional dysphonia” is the more recent, correct term to describe this condition. It happens when you suddenly lose your voice due to emotional or psychological stress. You may be able to speak but only in strained whispers.

What’s the difference between hysterical aphonia and psychogenic aphonia?

There isn’t one. They both describe losing your voice because of emotional or psychological distress.

“Hysterical aphonia” isn’t a term healthcare providers use anymore. While some providers may still sometimes use “psychogenic aphonia,” the more accurate term is functional dysphonia.