Miley Cyrus is opening up about yet another health challenge, one that’s played a major role in her decision to step away from touring.

Miley Cyrus’ raspy voice is no accident. The Grammy winner, 32, revealed that her signature music sound is actually the result of having a vocal cord disorder called Reinke’s edema. In her May 21 interview with Apple Music’s Zane Lowe, Cyrus described the disorder as “abuse of the vocal cords.”