In women the voice organ is influenced by sex hormones throughout the span of life. It starts from puberty, changes systematically in the reproductive period with the menstrual cycle, during pregnancy, in menopause and ageing. The atrophy of vocal cords, vocal muscles and articulatory apparatus occurs in menopause. The menopausal vocal syndrome is due to masculinization and is characterized by voice fatigue, lowered intensity and pitch with a decreased frequency range and loss of the high tones. Hormonal replacement therapy, vitamin supplementation and voice rehabilitation are useful in preserving good quality of voice in menopause, which is very important to many women, especially professional voice users. Voice alterations during menopause should indicate the necessity of phoniatric examination in supporting patients’ quality of life.