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What causes a prominent Adam's apple in some females?
Executive summary
A visible Adam’s apple in some females is a normal anatomical variation caused mainly by differences in the size, angle and visibility of the thyroid cartilage (laryngeal prominence); hormones (especially testosterone), genetics, body habitus, and rare neck masses can all contribute to greater prominence [1] [2] [3]. Medical authorities note that the laryngeal prominence is typically smaller and less protruding in women because of a broader internal laryngeal angle and less laryngeal growth during puberty, but individual variation means many women do have noticeable prominences without disease [1] [4].
1. Anatomy first: what the Adam’s apple actually is
The “Adam’s apple” is the laryngeal prominence formed where the two halves of the thyroid cartilage meet in front of the larynx; its purpose is to shield the vocal cords rather than to signal sex, and everyone has thyroid cartilage that can grow during puberty [1] [5]. The prominence you see on the outside is simply how much that cartilage protrudes toward the skin — which depends on cartilage size, angle (internal laryngeal angle), and the amount of soft tissue overlying it [1] [5].
2. Why it’s usually more obvious in men — and what that implies for women
Male puberty typically produces greater laryngeal growth under the influence of higher testosterone levels, increasing anterior angulation and producing a larger external bulge and deeper voice; women generally have a broader internal laryngeal angle and smaller larynx growth, so the cartilage tends not to push up against the skin as much [1] [2]. That said, the same biological structures exist in both sexes, so sex differences are about degree rather than a categorical presence/absence [1] [4].
3. Hormones and variation: the role of testosterone and other factors
Multiple sources link a more prominent laryngeal prominence to higher androgen exposure: increased testosterone during puberty or later-life androgen excess can enlarge the thyroid cartilage and deepen the voice, making the bump more visible [2] [6]. However, clinicians and educator-sites also emphasize genetics, neck thinness, and individual anatomical variation as common, independent contributors to a noticeable Adam’s apple in women [3] [7].
4. Genetics, body build and visible prominence — a common-sense explanation
Several clinical and surgical sources state that inherited cartilage size/angle and a thinner neck (less subcutaneous tissue) can make a laryngeal prominence visible even without elevated hormones; in other words, some women simply have anatomy that shows the cartilage more clearly [3] [7]. Authors caution this is usually a benign variation and “not a medical disorder” when unaccompanied by other symptoms [4].
5. When a sudden or unusually large prominence warrants medical attention
While most prominent Adam’s apples in women are anatomical, rare causes such as thyroglossal duct cysts and other neck masses can produce a new or rapidly enlarging midline neck prominence — these congenital cysts are common enough to be noted in case reports and sometimes require surgical treatment [8]. If a prominence appears suddenly, changes size, or is associated with pain, swallowing changes or voice change, clinical evaluation is recommended; the sources note differential diagnoses beyond simple cartilage prominence [8].
6. Cosmetic and surgical options — and why people pursue them
For people seeking a less prominent profile, chondrolaryngoplasty (“tracheal shave”) is a recognized cosmetic procedure to reduce the laryngeal prominence; surgical reports indicate the operation is generally effective with relatively few transient complications in published case series [4]. Sources also mention that some transmasculine individuals pursue augmentation, showing that desire to change the prominence cuts both ways depending on gender goals [4].
7. Limitations, disagreements and what the sources do not say
Clinical anatomy and patient-education pages broadly agree on mechanisms (cartilage size/angle, testosterone, genetics, body habitus) but differ in emphasis: some prioritize hormonal explanations [2] [6] while anatomical reviews stress the internal angle and structural differences [1]. Available sources do not provide population-level prevalence data for how many cisgender women have visibly prominent Adam’s apples, and they do not quantify the threshold of “prominence” versus normal variation (not found in current reporting).
Takeaway: a prominent Adam’s apple in a woman most often reflects normal anatomic variation amplified by hormonal exposure, genetics or body habitus; sudden changes or other symptoms should prompt medical evaluation, and cosmetic surgery is an established, elective option for those seeking alteration [1] [2] [8] [4].