Women have the anatomical structure commonly referred to as the “Adam’s apple,” though it is typically not prominent or easily visible. The term “Adam’s apple” is a non-medical description for the laryngeal prominence, a protrusion formed by the thyroid cartilage in the neck. This structure is present in all humans, regardless of sex, as it is an integral part of the voice box, or larynx.
Anatomy: What is the Laryngeal Prominence?
The laryngeal prominence is an outward bump created by the front edges of the thyroid cartilage. This cartilage is the largest piece of the laryngeal skeleton, a framework of tough, flexible tissue that forms the voice box (larynx). The thyroid cartilage is shaped like a shield, protecting the delicate structures of the larynx behind it.
Its primary function is to safeguard the vocal folds, or “vocal cords,” stretched across the interior of the larynx. The movement and tension of these vocal folds, regulated by small muscles, allow for the production of sound and speech. Adjusting the angle of the thyroid cartilage is a key mechanism for modulating vocal pitch.
The thyroid cartilage involves two flat plates, called laminae, which join together at an angle in the front of the neck. This junction forms the recognizable protrusion.
How Puberty Creates the Difference
The visible difference in the laryngeal prominence between sexes arises primarily during puberty due to sex hormones. In individuals assigned male at birth, the surge in testosterone triggers a significant growth spurt in the larynx. This causes the thyroid cartilage to grow larger and its two plates to fuse at a sharper angle, typically around 90 degrees.
This change in size and angle creates the noticeable protrusion known as the Adam’s apple. The cartilage enlargement also causes the vocal folds inside to lengthen and thicken. The resulting longer, thicker vocal folds vibrate at a lower frequency, which leads to the characteristic deepening of the voice.
In contrast, estrogen in individuals assigned female at birth does not trigger the same extent of laryngeal growth. While the larynx grows slightly during female puberty, the thyroid cartilage plates join at a wider, more obtuse angle, generally closer to 120 degrees. This wider angle and smaller overall size mean the laryngeal prominence does not push outward noticeably, keeping the structure virtually invisible.
When Women Have a Visible Prominence
Although a prominent Adam’s apple is not typical for women, a visible laryngeal prominence can occur due to non-standard factors. One cause is natural anatomical variation, where some women possess a slightly larger or more acutely angled thyroid cartilage due to genetics. In these cases, the prominence is simply a difference in cartilage structure, not related to a medical condition.
A more common medical reason is hyperandrogenism, an elevated level of male hormones (androgens) in the body. Polycystic Ovary Syndrome (PCOS) is the most frequent cause, affecting up to 10% of women of childbearing age. Excess androgens can lead to symptoms like hirsutism and a deepening of the voice, which may be accompanied by a more visible laryngeal structure.
Rare Causes and Treatment
Other rare causes of hyperandrogenism include certain adrenal conditions or androgen-producing tumors. If a woman experiences the rapid onset of a deepening voice, this warrants medical investigation for extremely high androgen levels. For individuals wishing to reduce the appearance of prominent laryngeal cartilage, a surgical procedure called chondrolaryngoplasty, or “tracheal shave,” is an option.