As a kid I was constantly being reminded to speak more quietly. In high school it was often noted that I had no trouble making myself heard when needed, and in choirs I was always considered a section leader because my voice carried and the other followed it.
Since ME/CFS hit, I constantly have to repeat myself because people can't hear me. I can't sing well anymore because my throat is really tight. I am not hoarse, but the volume and quality of sounds I can make has seriously suffered.