I'm neither middle aged nor a lady, but I personally find that the smaller horn pierces more and actually hurts the eardrum. It's true that the bigger one is louder, however.
So, if you're looking for something that will hurt someone's ears standing in the vicinity, the small one is the aswer. If you're looking for loundness, the bigger one is a better option.
Personally, I use 4 large and 5 small ones, not couting the ones on the console. It's a mad house when the system gets tripped by accident or when I test the system.