Updated

Grammy-winning singer Adele has canceled a series of U.S. tour dates due to a vocal-cord hemorrhage.

As she wrote on her blog this week, she was first diagnosed with a hemorrhage in May, then rested and recovered.

But recently, she was diagnosed with another hemorrhage. “My voice yet again went … it just switched off,” she wrote.

That sort of “instantaneous hoarseness” is typical of hemorrhages of the vocal cords, which are also called vocal folds, says Kenneth Altman, an associate professor of otolaryngology at the Mount Sinai School of Medicine.

The change in voice is often accompanied by pain on one side of the throat, says Altman, who is also director of the Eugen Grabscheid, M.D. Voice Center.

The cause is a bleed from a microscopic blood vessel in the cord, most commonly in the jelly-like layer directly under the skin. That can “impair the vibration” of the cord, which is what changes the voice, says Altman. If the blood isn’t reabsorbed, it can form a polyp and cause scarring that can permanently affect the vibration of the vocal cords, he says.

Vocal cord hemorrhages, like other voice issues, can be caused or exacerbated by voice overuse, acid reflux, cigarette smoking, alcohol use, lack of hydration, allergies and other issues, says Altman.

The treatment is “strict voice rest until it resolves” and then careful voice use after it’s healed to prevent a repeat injury, says Altman.

Click here to read more on this story from The Wall Street Journal.