The answer to whether women can have an Adam’s apple is yes, they possess the underlying anatomical structure, but it is typically not visible. This structure, known clinically as the laryngeal prominence, is present in all individuals, regardless of sex. The difference lies in the size and angular projection of the cartilage that forms this prominence. The degree of its visibility is determined by hormonal influences during puberty, as well as genetic and physical variations in the neck. The structural disparity between sexes explains why the protrusion is a near-universal feature in adult males but is rarely noticeable in adult females.
Anatomy of the Laryngeal Prominence
The structure commonly called the Adam’s apple is the laryngeal prominence, a protrusion formed by the anterior junction of the two plates of the thyroid cartilage. This cartilage is the largest of the nine cartilages that make up the larynx, or voice box. Its primary function is to provide a protective shield for the vocal cords and other delicate structures within the larynx.
The thyroid cartilage is a foundational framework for the voice mechanism, serving as the attachment point for muscles and ligaments that control the tension of the vocal cords. In all humans, the two halves of this cartilage meet in the front, forming a midline ridge. The extent to which this ridge juts forward is what determines how visible the laryngeal prominence becomes.
In the typical adult female anatomy, the two plates of the thyroid cartilage meet at a wider, more obtuse angle, generally measuring about 120 degrees. This broad angle prevents the cartilage from projecting sharply outward, keeping the prominence hidden beneath the skin and soft tissues of the neck.
The Role of Hormones in Laryngeal Development
The primary difference in laryngeal prominence visibility is initiated by hormonal changes that occur during puberty. In males, the surge in testosterone triggers a significant growth spurt in the larynx. Testosterone stimulates the thyroid cartilage to grow larger and to change its angle, causing the two laminae to fuse at a more acute angle, typically closer to 90 degrees.
This sharper angle is what physically pushes the cartilage forward, creating the prominent projection associated with the Adam’s apple. This growth is also responsible for the lengthening and thickening of the vocal cords, which causes the voice to deepen by approximately a full octave. The structural changes in the larynx and vocal cords are permanent secondary sex characteristics resulting from this androgen exposure.
Conversely, the female hormonal profile, dominated by estrogen and progesterone, does not trigger the same extent of laryngeal growth. While the female larynx does grow during puberty, it remains significantly smaller than the male larynx. The vocal cords also lengthen and thicken, but the resulting voice change is much more subtle, typically lowering the pitch by only about one-third of an octave.
The lack of high-level androgen exposure during development ensures the thyroid cartilage retains its wider, more rounded angle. This developmental path results in a smaller larynx that does not protrude as a visible prominence.
Factors Leading to Increased Visibility in Women
Although a prominent Adam’s apple is not typical for adult women, its visibility can be increased by several factors, including natural genetic variation. Some women are born with a thyroid cartilage that naturally forms a slightly sharper angle or a neck structure with less subcutaneous fat or muscle. This minor anatomical variation can result in a laryngeal prominence that is visible, though it is often still less pronounced than the average male structure.
Hormonal conditions that elevate androgen levels can also lead to a more visible laryngeal prominence. For instance, Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that can cause hyperandrogenism, or an excess of male hormones. Similarly, Non-Classic Congenital Adrenal Hyperplasia (NC-CAH) can cause the adrenal glands to overproduce androgens.
While the primary effect of these conditions is often the development of male-pattern hair growth or acne, a high degree of virilization can lead to structural changes in the larynx, causing a permanent deepening of the voice. This voice change is a direct result of laryngeal enlargement and thickening, which would also increase the physical size and potential visibility of the laryngeal prominence.
Furthermore, women undergoing masculinizing gender-affirming hormone therapy, which involves taking exogenous testosterone, will experience the same irreversible laryngeal changes seen in male puberty. The administration of testosterone stimulates the thyroid cartilage to grow and change its angle, resulting in a more prominent Adam’s apple and a permanently deeper voice.