A noticeable bump on the throat often associated with males, known informally as the “Adam’s Apple,” is technically called the laryngeal prominence. This structure is simply the visible portion of the thyroid cartilage, which is present in every human being, regardless of sex or gender identity. While typically more pronounced in men, having a visible laryngeal prominence as a female is a recognized anatomical variation and not inherently a sign of a medical issue. Understanding the underlying anatomy and the influence of hormones during development can clarify why this structure might be more apparent in some individuals.
The Anatomy of the Larynx
The laryngeal prominence is an outgrowth of the thyroid cartilage, which is the largest of the nine cartilages that make up the larynx, or voice box. This shield-shaped cartilage structure serves a crucial function by protecting the delicate vocal cords, which are located directly behind it. The thyroid cartilage is formed by two flat plates, called laminae, that meet at an angle in the front of the neck.
The meeting point of these two laminae creates the protrusion seen externally as the laryngeal prominence. The larynx plays a major role in both breathing and voice production. Muscles attach to the thyroid cartilage, allowing it to move and change the tension of the vocal cords, which modulates the pitch of the voice.
How Hormones Influence Cartilage Size
The difference in prominence between sexes is primarily a result of hormonal changes during puberty. In individuals undergoing male puberty, a significant surge in testosterone causes the thyroid cartilage to grow larger and thicker. This growth typically results in the two cartilage plates meeting at a more acute angle, around 90 degrees, which pushes the prominence further forward and makes it more visible.
This laryngeal expansion also lengthens the vocal cords, which is the biological reason for the voice deepening into a lower pitch. Conversely, in female puberty, the primary sex hormones, like estrogen, do not trigger the same extent of cartilage growth. The two laminae of the thyroid cartilage typically meet at a wider angle, closer to 120 degrees, which keeps the structure smaller and less outwardly noticeable.
Causes of a Prominent Laryngeal Structure
A visible laryngeal prominence in a female may stem from several factors, ranging from normal anatomical variation to specific hormonal influences. For some, the visibility is simply a matter of natural genetic variation in the structure and shape of the cartilage itself. Individuals with a particularly slender neck or less surrounding subcutaneous fat may find their average-sized laryngeal prominence appears more defined because there is less soft tissue to conceal it.
Hormonal Conditions
A more pronounced laryngeal prominence can also be a sign of increased androgen exposure. Conditions that lead to elevated levels of androgens, such as testosterone, can cause the laryngeal cartilage to grow similarly to male puberty. Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders that can cause hyperandrogenism, potentially contributing to a more noticeable laryngeal structure, often alongside other signs like hirsutism or irregular menstrual cycles.
Hormone Therapy
Individuals assigned female at birth who are undergoing masculinizing hormone therapy will experience laryngeal growth due to the introduction of testosterone. This is an expected and intentional effect of the therapy, leading to a deeper voice and a more prominent laryngeal structure. The presence of a visible prominence is therefore not a singular diagnostic marker but a feature that must be considered within the context of a person’s overall physiology.
Medical Consultation and Management Options
Consulting a healthcare provider is prudent if the laryngeal prominence is accompanied by other physical changes that suggest a sudden or unexpected hormonal shift, such as rapid growth, voice changes, or new patterns of hair growth. A doctor may perform a physical examination and recommend blood work to check hormone levels, particularly androgens, to rule out underlying endocrine conditions like PCOS. Addressing any underlying hormonal imbalance is the primary medical management strategy.
If the prominence is purely a matter of cosmetic concern, there are elective options available. Voice therapy can assist in adjusting vocal pitch and resonance to align with personal goals. For physical reduction, a surgical procedure called chondrolaryngoplasty, commonly known as a tracheal shave, can be performed. This operation reduces the size of the thyroid cartilage protrusion, but it must be performed carefully to avoid damaging the vocal cords, which are located just behind the prominence.