HealthSmart Q & A-14

Dear HealthSmart,

I recall my mother’s voice was very hoarse and forced in the last years of her life. I’m now in my 60s and my voice is also changing. What’s going on?

HealthSmart asked Dr. Clark Rosen, M.D. Professor of Otolaryngology at the University of Pittsburgh School of Medicine and Medical Director at University of Pittsburgh’s Voice Center. Here’s his response:

What your mother experienced—and you’re experiencing now–is a natural deterioration of the voice. This aging voice manifests a change in quality and volume. The main reason is the loss of muscle bulk and elasticity in the vocal cords. In humans, we produce sound through the vibrations of the vocal cords, along with oxygen. When these cords lose strength and elasticity, the result is a softer voice. With age, some people face more deterioration than others and we don’t know why. But we know that the current generation of baby boomers—many of whom are very active—are more intent on keeping vocal quality longer.


Dear HealthSmart,

I live in a rural town and my insurance doesn’t provide good coverage. I’ve heard there are a lot of resources out there to help with anxiety relief, as well as education. Do you have any recommendations?

HealthSmart asked Dr. Debra Kissen, Ph.D. and Clinical Director of Light on Anxiety Treatment Center in Chicago. Here’s her response:

There are numerous online and print resources—including workbooks–available to help you cope with your anxiety. One book I recommend is ‘Get Out of Your Mind and into Your Life’ by Stephen C. Hayes. Because these materials include exercises, I recommend you work through them with another person so you’ll be held accountable to follow through. There are also many useful apps that you can install on your smart phone to help train your mind to deal with stressful situations. But the most effective long-term treatment for anxiety involves Cognitive Behavioral Therapy. To learn more about CBT or to find a therapist trained in this approach, I recommend visiting the website of the Anxiety and Depression Association of America:


Dear HealthSmart,

My sister didn’t get married until she was 40 and she’s worried she may not be able to have children because of her age. At what age is a woman too old to have children?

HealthSmart asked Dr. Richard J. Paulson, M.D., Director of University of Southern California Fertility. Here’s his response:

Fertility rates in women start to decline at age 35. That’s when the quality of her eggs starts to diminish. It’s the strength and quality of the egg that determines the potential for a healthy pregnancy, not the woman’s age. It’s relatively easy for many women in their mid-forties to get pregnant using donor eggs or their own frozen eggs. But trying naturally could be problematic because of weaker egg quality. While many women today are waiting longer to get pregnant, the average age for having a first child is still in the 20s. As long as she’s healthy, there’s no reason a woman in her 40s can’t have children, especially with donated eggs or her own frozen eggs.


Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021


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