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Vocal Hemorrhage (Vocal Health Issues)

Updated: Jul 31, 2019


The vocal folds (also known as the vocal cords) are located inside the larynx. They are made up of muscle, ligament and a special epithelial layer (tissue covering) which is the delicate outside lining of the vocal folds. The vocal folds vibrate at extremely high speeds of several hundred times per second when singing which means they can be easily stressed.

In order to produce sound, air travels through the vocal folds, sucks them together and they begin to vibrate. The vibrations that originate from the vocal folds are then amplified within the spaces above it (the vocal tract). When the vocal folds are brought together with extreme force, it can cause hemorrhaging in the vocal folds.

A Vocal Hemorrhage is blood that has leaked into the vocal folds from a ruptured blood vessel which leaves a bruise under the surface of the vocal folds. Some of the main causes of hemorrhaging in the vocal folds are; singing aggressively, screaming, shouting, singing with poor technique, singing in bad environments, throat clearing and coughing. Like Polyp’s, hemorrhaging in the vocal folds can happen as a result of a single episode of vocal trauma.

Some of the major signs to listen out for are:

- Acute loss of voice or vocal range

- Hearing two pitches at the same time

- Hoarseness of speaking and singing voice

- Throat discomfort, pain, tightness


Treatment depends on the cause, severity, and the diagnose time of the vocal hemorrhage. For example; If there is an early diagnose, usually complete voice rest for several days or even a week is all that’s needed. Medication may also be given to help assist in the blood absorption of the hemorrhage. Treatment after the hemorrhage has been resolved would most likely include voice therapy & voice hygiene interventions. This would involve voice production work, learning how to use the muscles involved in voice to create the best possible sound. As well as learning, how to take care of the vocal folds and keep them free from irritants. Surgery may also be required depending on the cause and severity of the hemorrhage.

A vocal hemorrhage is quite often a signal to a performer that vocal technique or the demands of the voicing environment may need to be adjusted.

If you ever experience any sudden changes in your voice, get checked out, don’t wait. The earlier you get checked out, the easier it would be to reverse any possible damage.

Please ensure that you see laryngologist which is an ENT surgeon that specialises in voice. Voice disorders can often be misdiagnosed by ENT’s that don’t have specialised expertise in the voice.

DM if you want the details of any good ENT’s that specialise in voice here in London or LA.

I hope that helps!


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