Miley Cyrus voice has changed over the years due to a few reasons:

• Reinkes edema: Miley was diagnosed with Reinkes edema, a chronic disease caused by vocal fold irritation from voice misuse, smoking, and/or conditions that irritate the vocal folds. The symptoms can range from hoarseness to a deeper voice and difficulty singing high notes. She underwent vocal cord surgery in late 2019 to treat this condition.

• Vocal trauma: Miley has also attributed her voice change to vocal trauma caused by talking and smoking too much. She has said that "having the surgery was a gift because I was able to understand my instrument" and that her voice "collects wrinkles and tells a story".

• Age: As expected, everyones voice changes over time, typically becoming lower as we get older. Mileys voice is no exception to this rule, and her overall pitch is noticeably lowered compared to before.

• Smoking: Miley has admitted to smoking heavily in the past, which can damage the voice box and cause a low, raspy, or rough voice.

Miley has been open about her changed voice and has explained that she has learned to take better care of her vocal cords. She has also said that she views her voice the same and that it still allows her to present a range of emotions through her music and unique pitch.