The term “Adam’s Apple” describes the prominent bulge sometimes visible on the front of the neck, often considered a distinct feature of male anatomy. This protrusion is the external manifestation of the laryngeal prominence, an anatomical structure present in all humans. It is essentially the thyroid cartilage protecting the voice box. While the structure exists in everyone, its visible size and shape differentiate the sexes, a difference rooted in hormonal changes during adolescence.
The Anatomy of the Laryngeal Prominence
The structure commonly referred to as the Adam’s apple is technically the laryngeal prominence, the forward-facing angle of the thyroid cartilage. This large, shield-shaped cartilage is the biggest of the nine cartilages forming the larynx, or voice box. Its primary function is to serve as a protective casing for the vocal cords and provide structural support for the muscles and ligaments that enable voice production.
The cartilage is formed by two flat plates, or laminae, that join together in the center of the neck. This junction creates the distinct prominence that can be felt and sometimes seen. Everyone, regardless of sex, is born with this structure because everyone possesses a larynx that needs protection.
Before puberty, the size and shape of the thyroid cartilage are similar in all children. Girls possess this underlying structure, even if it is not externally visible. The difference in appearance only becomes apparent when the laryngeal framework is stimulated by sex hormones during adolescence.
Puberty and Hormonal Development
The visibility of the laryngeal prominence is affected by the surge of sex hormones during puberty, particularly androgens like testosterone. In males, the significant increase in testosterone drives a substantial growth spurt in the entire laryngeal structure. This hormonal stimulation causes the thyroid cartilage to enlarge significantly, and the angle where the two plates meet becomes more acute, approximately 90 degrees in adult males.
This enlargement causes the cartilage to tilt and protrude more sharply forward, creating the distinct, visible Adam’s apple. This growth also causes the vocal cords inside the larynx to lengthen and thicken. The lengthening of the vocal cords is responsible for the characteristic deepening of the voice observed in males.
Females also experience laryngeal growth during puberty, but the changes are less dramatic due to lower levels of androgens. The female thyroid cartilage grows, but the two laminae join at a wider angle, typically around 120 degrees. This less-acute angle prevents the cartilage from protruding as far forward, keeping the prominence smaller and less externally visible. The vocal cords also lengthen, resulting in a moderate voice drop rather than a significant deepening.
Variations and Medical Context in Females
The laryngeal prominence is less visible in most females, but natural anatomical variation exists across all people. Some females may naturally have a slightly larger or more angled prominence due to genetic factors, making it noticeable without a medical cause. A slender neck with less surrounding soft tissue can also make a normal-sized cartilage appear more prominent.
A more pronounced Adam’s apple in a female can sometimes indicate hyperandrogenism, a medical condition characterized by elevated levels of androgens. Conditions like Polycystic Ovary Syndrome (PCOS) or Congenital Adrenal Hyperplasia (CAH) can cause excess testosterone production. This increased hormonal exposure stimulates thyroid cartilage growth, leading to a more visible prominence, often accompanied by signs of virilization like a deepening voice.
Individuals undergoing female-to-male gender transition who receive testosterone hormone therapy will experience changes similar to typical male puberty. The administration of testosterone stimulates the growth and forward tilt of the thyroid cartilage over time. This hormonal effect results in the development of a noticeable laryngeal prominence, along with the lengthening of the vocal cords and subsequent voice deepening.