4 Things That Make You Lose Your Voice

— -- I haven’t had a cold in months, but I keep losing my voice. What’s going on?

Laryngitis (the most common cause of hoarseness or voice loss) happens when your voice box becomes irritated or inflamed, leading to swelling that keeps your vocal cords from being able to open and close smoothly. (This vocal cord movement is what creates sound.) A flu.htm" id="ramplink_viral infection_" target="_blank">viral infection, like a cold or the flu, is the usual culprit, but it’s not the only one.

Strain is also a top cause of laryngitis; just one night of cheering at a sporting event or concert can bring it on. Voice strain should go away on its own with rest and lots of fluids. But you really have to rest your voice, especially if you’ve lost it entirely: Not only will staying quiet help you heal faster, but taxing your voice during laryngitis can damage vocal cords further and can lead to the formation of polyps or nodules that may require surgery.

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If hoarseness persists beyond a few weeks or keeps coming back, there may be something else going on. One possibility is acid reflux. When stomach acid comes back up the esophagus, it can cause irritation of the vocal cords. The type of reflux most associated with voice issues is called laryngopharyngeal reflux disease, and it often doesn’t cause heartburn or nausea. Your doctor can prescribe antacids and other medication (like steroids) that can help your voice if it’s not getting better.

Another possible cause is a yeast infection in your throat, also called oral thrush. This appears most often in people with depressed immune systems, like those with HIV or cancer, but people using a corticosteroid inhaler to treat their asthma are also more prone. That’s because the steroid can locally decrease your immune function, which allows the overgrowth of yeast. Oral antifungals can solve it.

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To get a diagnosis, see an ear, nose and throat specialist (ENT), who can take a look at your vocal cords with a scope to determine if acid reflux or yeast is robbing you of your voice. An ENT can also rule out something more serious, like laryngeal cancer, which often occurs with ear pain and a sore throat on top of voice issues.

Health‘s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine and co-founder of Tula Skincare.

This article originally appeared on Health.com.