gms | German Medical Science

26. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie e. V.

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie e. V.

11.09. - 13.09.2009, Leipzig

Does singing activity influence sexual maturation?


  • corresponding author presenting/speaker Götz Gelbrich - Universität Leipzig, Koordinierungszentrum für Klinische Studien, Leipzig, Germany
  • author Bianca Gelbrich - Universität Leipzig, Zentrum für Zahn-, Mund- und Kieferheilkunde, Abteilung Kieferorthopädie, Leipzig, Germany
  • author Sylvia Meuret - Universität Leipzig, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Abteilung für Phoniatrie und Audiologie, Leipzig, Germany
  • author Michael Fuchs - Universität Leipzig, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Abteilung für Phoniatrie und Audiologie, Leipzig, Germany

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie. 26. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie (DGPP). Leipzig, 11.-13.09.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09dgppP10

doi: 10.3205/09dgpp28, urn:nbn:de:0183-09dgpp284

Published: September 7, 2009

© 2009 Gelbrich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Introduction: The mechanisms of the onset of pubertal development are not fully understood so far. Any information about correlates of puberty may hence be useful to generate and examine hypotheses about this issue.

Methods: We investigated the relationships between singing activity of children and vocal parameters during the pubertal mutation of the voice in a cross-sectional case-control study [1]. Eighty-seven children regularly singing under professional conduct and 97 children without singing activity beyond usual music lessons at school were included. Subjects were aged 10.5-16 years. Sociodemographic data and Tanner stages of puberty were also obtained.

Results: Pubertal development was significantly more advanced in singers compared to age and sex matched non-singers (P=0.011). The adjusted mean difference of Tanner stages was 0.62 (95% CI: 0.14 to 1.11). In addition, possessing siblings was an independent predictor of less advanced puberty (P=0.034; difference –0.54 Tanner stages, 95% CI: –1.04 to –0.04).

Discussion: Singing activity is possibly associated with an earlier onset of puberty. Relationships between singing and neurohumoral activity, as well as influences of the social environment may be discussed to be explanatory. However, these approaches are hypothetical so far, but they may inspire further investigations aiming at a better understanding of the matter.



We present a surprising result from a study which was initiated with the primary goal to examine the relationship between singing activity of children, pubertal changes of vocal parameters, and social behaviour [1]. While correlations between voice training and vocal efficiency parameters as well as between singing in a choir and the development of social interactions are foreseeable, hardly anybody would expect that singing may influence sexual maturation. Here we report on differences of pubertal development between singers and non-singers.

Subjects and Methods


We recruited 102 boys and 82 girls aged 10.5 to 16 years, all of them attending the higher educational track (“gymnasium”). Eighty-seven of these children were regularly singing in a choir with professional conduct, the others had no regular singing activity beyond usual music lessons at school. The study protocol was approved by the Ethics Committee of the Medical Faculty of the University of Leipzig. All children and their parents gave their informed consent in writing prior to inclusion.


Age and gender of the participants and variables of their familial and social environment were recorded. The children completed a questionnaire and underwent physical examination. Pubertal development was characterised by genital size (boys), breast size (girls) and pubic hair stage (both genders), each assessed by a grading from 1 to 5 according to Tanner.

Statistical analysis

The Tanner sum (ranging from 2 to 10) was defined as the sum of both Tanner gradings for each subject. Multiple regression analysis was carried out to examine the dependency of the Tanner sum on regular singing activity, age, gender and covariables of the familial environment.


Pubertal development was more advanced in singers than in children without regular singing activity (see Figure 1 [Fig. 1]). The mean difference of the Tanner sums of singers and non-singers, adjusted for age and gender, was 0.62 (95% CI: 0.14 to 1.11, P=0.011). In addition, possessing siblings was an independent predictor of a lower stage of pubertal development. Table 1 [Tab. 1] displays the coefficients of the regression model.


In view of our finding of advanced pubertal signs of singers compared to non-singers, one may feel challenged to come up with brave explanations, keeping in mind, however, that causality should always be treated cautiously.

For example, singing enhances oxygen uptake. Exercise peak oxygen uptake has been shown to be positively correlated to serum concentrations of insulin-like growth factor 1 (IGF-1) in prepubertal girls [2]. IGF-1 is discussed to be involved in the onset of puberty [3].

Further speculation is related to the evidence that gamma-aminobutyric acid and glutamate play an important role in the neural input to the gonadotropin releasing hormone (GnRH) system [4], [5]. The action of both neurotransmitters in the learning processes associated with singing and the neurosignal transmission to the vocal motor area were studied - at least in songbirds [6], [7], so one may ask whether singing activity may generate some input to GnRH neurons. If this is the case, other learning and neuromotoric processes with intense hypothalamic-pituitary activity might be associated with pubertal development, too.

Another putative mechanism is based on social relationships. It has been demonstrated in dwarf hamsters [8] and humans [9] that living with siblings may inhibit puberty, while regular presence of unrelated individuals may accelerate it. These observations were explained by inhibiting or stimulating effects of pheromones [9]. The negative correlation of the presence of siblings with pubertal stage in our data is in line with those reports. Furthermore, singing in a choir is associated with a regular close contact to unrelated persons (with inevitable exposure to their pheromones). If this would be the essential pathway, other leisure activities associated with a similar exposure might also be correlated with accelerated puberty.

We should be aware that non-causal explanations must be considered and may be more likely. Certain biological or personality traits or conditions of the social environment may influence both timing of puberty and musicality or the decision to sing in a choir.

In summary, our data suggest that regular singing activity is associated with earlier onset of puberty, but the explanation remains in the dark at this time. The result should be seen as a finding which we considered worthwhile reporting, not a demonstration of the imperturbable belief that data do never lie. The honoured reader may feel invited to add his or her own speculation, which may be just entertaining, or may generate new hypotheses and give motivation for investigations on the mechanisms of the onset of puberty as well. However, our analyses do not imply that singing activity leads to larger postpubertal genital or breast sizes. We hence strongly discourage to believe in any advertisement with promises addressing this issue.

(The first two authors contributed equally.)


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