Is the opera house hot or is it just me? Menopause, which can mean disaster for a diva at her peak, is opera's last taboo by Tamara Bernstein
/ December 1, 2000
The "Modigliani Women" is the most susceptible to menupause.
I believe La Callas suffered from post-menauposal syndrome.
It's the opening night of a production of Don Carlos -- one of
Verdi's most popular operas --conducted by Herbert von Karajan at the Salzburg
Festival. The role of Princess Eboli -- the femme fatale who loves Don Carlos --
is being sung by one of the greatest mezzo-sopranos of the century, who has
performed the part about 50 times over the last two decades.
Near the end, she launches into Eboli's show-stopping aria, O
don fatal et deteste (O fatal, hated gift), in which she curses her god-given
beauty and resolves to save Don Carlos, who has rejected her. As she reaches one
of the aria's climactic high notes, her voice cracks.
It's one note, out of thousands, in a three-hour opera, and
millions more over the course of her career. But in the brutal world of opera,
that's all it takes for tongues to wag and knives to come out, and for a
singer's sense of self-worth to crumble. Devastated and ashamed, she slinks out
of town without finishing the run, and never sings Eboli again. "A star has
fallen from the heavens," the newspapers announce.
Sound far-fetched? Well, the mezzo-soprano was Christa Ludwig
-- a singer celebrated for her "powerful humanity" (The Guardian) as well as a
"full, ripe, voluptuous" voice, as Opera, a respected English journal, has
described it. Ludwig recalled the experience during a recent conversation about
one of the great taboos of the singing world: menopause.
Hot flashes, memory loss, vanishing libido, vaginal atrophy,
fatigue, insomnia, mood swings, anxiety -- many people can recite the classic
symptoms of menopause. But for divas and non-singers alike, there's no standard
road map through "the change." Half the battle is realizing what's going on: the
cessation of menses is the last event of menopause, and hormonal changes can
kick in when a woman is in her late 30s, with all the power of an earthquake.
Hormonal changes begin shortly before menopause, when the
ovaries start winding down production of the female hormones oestrogen and
progesterone. But the body's production of male hormones (androgens) stays at
the same level, so these now play a more dominant role in the hormonal scene.
The higher proportion of androgen, among other things, thickens the vocal cords
and causes the voice to drop -- the same thing, on a smaller scale, as what
happens to a boy at puberty. The reduction in female hormones causes swelling or
dehydration of the vocal folds, which can directly or indirectly affect the
vocal mechanism. This change is irreversible.
A controversial, but widespread, way of controlling the
earthquake is hormone replacement therapy (or HRT), which usually involves
administering a combination of oestrogen and progesterone. But many women --
those with a personal or family history of gynaecological cancers, for instance
-- cannot take HRT. And finding the right level is tricky. Jean Marmoreo, a
family physician who treats large numbers of menopausal women at Toronto's
Women's College Hospital, estimates that about 70% of women come off HRT because
they're given an incorrect dose.
Every woman has her own oestrogen threshold, explains
gynaecologist Morris Notelowitz, founder of the Woman's Medical and Diagnostic
Center in Gainesville, Fla. "That is why some women can go through menopause
without a single hot flash, while others are very sensitive to minute changes of
Ironically, there's some truth to all those jokes about fat
ladies and singing. Jean Abitbol, a world-renowned French otolaryngologist and
laser surgeon who specializes in the female voice, explains that fat cells store
oestrogen and convert male hormones to oestrogen. So women with a little extra
padding may in fact have an easier menopause, and require less HRT, than the
We call it "la merde," Ludwig laughs. She did, in fact, sing
for many years after that infamous Don Carlos in Salzburg; she retired in her
late 60s after a series of ecstatically reviewed farewell recitals. But like
many of her colleagues, Ludwig had a rough ride through menopause.
From her home on the Cote d'Azur, Ludwig speaks with humbling
candour and warmth. Her voice is relaxed and melodious, her German accented
English vivid and direct. "It was a hell of some years," she recalls. "Sometimes
I had the impression that my vocal cords were made of glass, they felt so
fragile. Sometimes I would be afraid to sing a forte tone. There was a real
fear, every day, whether the voice was there."
When, in her early 40s, Ludwig went to doctors with vocal
problems, they told her that she was singing or talking too much. It turned out
she was having an early menopause -- brought on, she believes, by turmoil in her
personal life. ("I had a new love and an old divorce.") Ludwig tried innumerable
hormone-related medications, none of which worked longer than six weeks.
Finally, in desperation, she tried a drug called ovestin, an estradiol hormone
that gynaecologists assured her would not make any difference. It did the trick.
Abitbol notes that menopausal singers often come to him because
they're losing their top notes, and find that their voice is less supple and
sensual. They may have more trouble singing softly; and their vibrato -- the
warm, controlled pulsing that's used constantly in most opera singing -- may
start to wobble.
"Typically," Abitbol says, menopausal sopranos fear that they
are going to lose their femininity if their voice lowers. "I tell them that
they're still a Strad -- I'm just the luthier [the violin restorer]."
"Menopause always brings a fear in high sopranos that they will
cease to be high sopranos," says William Riley, a leading New York voice trainer
whose clientele includes many famous opera singers. "But it doesn't always
happen that way. Sometimes the quality of the voice changes and the range stays
the same. Sometimes range changes and the quality stays the same. Sometimes both
change significantly. Sometimes the changes may be harbingers of tragedy, but
they may bring new, wonderful things -- like a better quality in the voice." A
diva's hearing may change as she enters middle age; this too can upset the
finely-tuned mechanism of singing. And, of course, there's also the possibility
of memory loss, for an opera singer one of the most terrifying symptoms of "the
Ageing is a major phobia in the opera world. For one thing, the
juiciest female roles tend to be sex symbols -- steamy heroines like Carmen, or
Aida's passionate rival, the Princess Amneris. Just as our society as a whole
values beauty and youthfulness over age, the opera world is rarely willing to
forgive a few less-than-perfect notes in exchange for the wisdom that age.
Stories of sopranos past their prime receiving bouquets of dried flowers strike
chills into the doughtiest heart.
"I always tell young singers that if you're going to survive in
this profession, you need to have the hide of an elephant and the soul of a
butterfly," says soprano Evelyn Lear, who was a regular at the Metropolitan
Opera during her illustrious career, and was especially famous for her sizzling
incarnations of the title role of Alban Berg's Lulu, another operatic femme
fatale. Lear, now 74, sums up her menopause this way: "You're not singing on
your interest any more. You're singing on your capital. And that can be
Brigitte Fassbaender, the great German mezzo-soprano, speaks of
" the horrible vocal indispositions" of menopause, and of "the cruelty of public
and agents" that emerges during that time. "You have one evening when five tones
are not so under control," she said on a CBC profile in 1994, "and you're out."
Because singers rarely discuss menopause, Fassbaender said, few learn to cope
with the vocal problems it can cause. "And they stop singing much too early."
Deborah Rosen, a Philadelphia-area medical psychologist who
works extensively with performing artists, points out that HRT is not yet
sophisticated enough to replicate a singer's premenopausal hormone levels. "As
with birth control pills, sometimes they overshoot, sometimes they undershoot,"
says Rosen. A woman's vocal mechanism is "exquisitely sensitive to fluid
balance," she adds, and oestrogen therapy can upset that. In any case, "with or
without hormone replacement therapy, the menopausal singer has a different
instrument, and she has to learn to use it" without developing bad compensatory
habits and injuring her voice. Rosen generally recommends that menopausal
singers find a top-notch voice teacher who isn't inhibited by the client's fame
and will take her back to the the fundamentals of excellent singing
That's precisely what Lear did when menopause provoked a major
vocal crisis in her mid-40s. She withdrew from the stage, found a good teacher,
and rebuilt her technique from scratch. She made a triumphant comeback in 1970,
aged 48, and enjoyed a robust career until she was over 60. Asked about hormone
replacement therapy, she says, "I never went to the doctors. How would a doctor
know about singers?"
It seems she's right. Researchers only started to look at
singers and menopause less than two decades ago, says Margaret Baroody, a singer
and voice teacher who works at the American Institute for Voice and Ear Research
in Philadelphia. "We have a lot of theory and anecdotal evidence, but not a lot
of hard-core facts."
When Jean Abitbol began working with singers and hormones in
the early 1980s, a number of coloratura sopranos complained to him that they
couldn't sing for several days before their menses. At first, Abitbol delivered
the classic patriarchal medical response: It's all in your head.
But his wife, gynaecologist Beatrice Abitbol, took a different
view, and gave her husband a remedial course in pre-menstrual syndrome. The
couple then collaborated on a ground-breaking study. Abitbol did a smear test of
women singers' vocal folds at different stages of the menstrual cycle. After
each test, he'd send the patient down the hall to his wife, who'd do a cervical
"When we put the two [sets of] slides together, we could not
tell whether it was the vocal fold or the cervix," he said. In other words, the
cellular changes in the vocal folds over the course of the menstrual cycle
mirrored those of the cervix. So they proved that the larynx is indeed a "target
organ" for hormonal changes. Ludwig cuts through the medical jargon. "The vocal
cords are very much like the vagina -- it is the same tissue," she explained.
"And when the one is dry, the other also is." A humbled Jean Abitbol, meanwhile,
learned that "when we say 'it's psychological,' that's garbage. It means: 'We
don't know.' "
Riley encourages singers to see menopause as just another stage
in the lifespan of the voice, which matures throughout a singer's career. "We
tend to think that any change in the status quo is a bad thing," he said. "But
in art, change is a good thing. If we can use menopause as an infusion of new
ideas or new energy into an artistic career, it should be viewed as a new
chapter, and not as a death knell. What can a Brigitte Fassbaender do when her
voice changes? Well, there are lots of things she can do, because she is a
performer of the highest quality. So we were very happy to see her step into a
slightly different repertoire, and other aspects of the industry, such as
There are spiritual dimensions, and a tremendous potential for
dignity in this phase of life, as well. "One of the things I try to help singers
to do," says Rosen, "is to realize they are not merely their voices. I see it as
an enormous opportunity to discover roundness and the beauty of wisdom, as
opposed to the angularity of life."
Ludwig, once again, goes to the heart of the matter. "It was
good for me in the end," she said. "This is a sign of maturity, that you start
to know that for a certain time, a singer has a voice," she said. "Singing is
not everything in life."
Originally published in The National Post, May 10, 1999.
Reprinted and condensed with permission. © Tamara