Menopause and the Singing Voice - Breaking the Silence with Jessica Rose Cambio

 

Samantha Nahra
Apr 2, 2026

For many singers, the voice is inseparable from the body that produces it. Training, technique, and careful lifestyle choices are all part of maintaining a healthy instrument. Yet one natural stage of life has historically been shrouded in silence in the opera world: menopause. For soprano Jessica Rose Cambio, that silence became impossible to ignore when she was diagnosed with early menopause at the age of 37.

“What we have in front of us is you’re 37 years old, you’re in menopause,” her doctor told her. “We have to treat it because you’re way too young.”

The diagnosis initially came as a shock. Like many women, Cambio had always associated menopause with a much later stage of life.

 

Challenging Long-held Myths

One of the biggest surprises for Cambio was not the diagnosis itself but the cultural baggage surrounding treatment. As a young singer, she had absorbed warnings about hormone replacement therapy (HRT) when a voice teacher of hers had implied that using it to manage menopause was somehow an unfair advantage when it came to singing.

“I grew up thinking that if you take hormone replacement therapy, you’re cheating,” she says. “Like you’re using something to be able to sing longer.”

Over time, she realized how misguided that belief was.

“If you’re diabetic, you take insulin. If you have a thyroid problem, you take thyroid medication,” she says. “If you have menopause, you might need hormone replacement therapy. It’s pretty much a no brainer.” She now believes these misconceptions stem from a broader cultural reluctance to discuss women’s health openly.

“What I had been told was that hormone therapy was taboo and that it causes breast cancer,” she says. Those assumptions, she believes, are rooted in generations of misinformation. “We’ve been living in a patriarchy that knows nothing about menopause,” she says. “So we’ve been misleading each other for centuries.”

 

The Road to Diagnosis

Cambio’s diagnosis came after consultations with multiple doctors when she was trying to freeze her eggs. At one point she wondered whether the fact that she had begun menstruating early, around age 10, might have contributed to early menopause. Doctors reassured her that it likely wasn’t connected. “What matters is how many eggs you release over time,” she explains. “You don’t get them back.”

Menopause typically occurs around age 50 to 52, but the timing varies widely. Some women experience it earlier or later depending on a variety of factors. Like many people facing unexpected medical changes, Cambio initially wondered if she had somehow caused the condition. “I thought maybe it was my fault,” she says. “But the doctor said basically, no, it’s not your fault. This is a natural, normal thing that we all go through, even opera singers.”

 

Hormones and the Singer’s Body

Following the diagnosis, doctors recommended hormone replacement therapy to help stabilize her estrogen levels. Her treatment was/is a progesterone pill and estrogen gel. There was an adjustment period though after treatment started.

“It took me a really long time to regulate again, like three years,” she says.  Still, the changes were noticeable quickly. “The very first day after starting the medication, I had pink again in my cheeks.” Hormone therapy can also help address broader health concerns associated with early menopause, including bone density loss and muscle changes. Both factors are particularly important for singers whose bodies function as their instruments.

How Menopause Affects the Voice

For singers reading about menopause, the most pressing question is usually the same: what will happen to my voice? According to Cambio, the answer varies widely. “Each woman experiences it very differently,” she says.

Some people experience hot flashes or heart palpitations. Others struggle with insomnia, weight changes, or fatigue. Sleep disruption has been one of the most noticeable changes for her. “Throughout my career I slept eight or nine hours before performances,” she says. “Now sometimes I sleep four or five hours, and that definitely affects singing the next day.”

Hormonal changes interact with many other factors that singers already navigate, including allergies, asthma, reflux, and environmental conditions. “It’s not just one element,” she explains. “Hormones are part of it, but there are many factors.”

During the period when doctors were still adjusting her hormone dosage, Cambio noticed something unusual in her singing. At first, she described the sensation as an unstable vibrato, but later realized that wasn’t quite accurate. “It wasn’t actually my vibrato,” she clarifies. “It was that my larynx felt unstable.” Searching for answers, she reached out to colleagues and discovered resources like Peri thru Post by Susan Eichhorn Young.

 

Technique as the Anchor

Through all of these changes, Cambio credits one thing above all for helping her continue singing: strong vocal technique. “The best remedy for not experiencing vocal changes is having your technique in order,” she says. Over the course of her career, technique has carried her through numerous personal and physical challenges.

“I’ve gone through a car accident with my technique and still sung,” she says. “I went through menopause with my technique, and I still sang.” In fact, the experience reinforced her confidence in the fundamentals of singing. “At the beginning I thought, Oh God, my voice is ruined,” she recalls. “But that’s just ridiculous.” Instead, she encourages singers to trust their training to support them through life’s inevitable changes. “What you’ve learned and set up in your body will help you,” she says. “It will serve you.”

 

Opening the Conversation

For Cambio, one of the most important outcomes of sharing her story is helping normalize conversations about menopause within the singing community. She did talk with her mother about menopause, but those conversations had limits. “My mom isn’t a singer,” she says. “So while it was helpful to talk to her about menopause in general, it didn’t answer the questions I had about singing.” 

That gap is one reason she now speaks openly about the topic with colleagues and students. “It would have been really useful for me to speak to someone who was actively singing through it,” she says. By sharing her experience, she hopes to offer the kind of perspective she once needed. “That’s why I’m so open about it now,” she says. “As a voice teacher, I can help singers navigate their own changes because I’ve lived through it.” Previous generations of singers experienced the same transition but rarely discussed it publicly. Today, that silence may finally be breaking. And in doing so, singers may discover something reassuring: their voices and their artistry can continue to evolve long after menopause begins..