Menopause is a significant transition in a woman's life, bringing about many changes. You might be noticing shifts in your body and emotions, and it's important to know that you're not alone in experiencing these. Often, menopause can impact your autonomic nervous system, which controls many of your body's automatic functions, including heart rate, breathing, and digestion.[1]

One of the common challenges women face during and after menopause is increased anxiety.[2] Research indicates that anxiety can be prevalent during the menopausal transition and in the early postmenopausal period.[2] You might also be concerned about your lung health, as studies suggest that menopause is associated with an accelerated decline in lung function.[3] Additionally, changes during this time can contribute to hypertension or high blood pressure.[4]

But there's good news! Research is increasingly showing the power of breathwork as a natural and effective tool to support women during menopause. Let's explore how it can help.

Autonomic Function in Menopausal Women

The autonomic nervous system regulates many bodily functions without conscious control, operating through two primary branches: the sympathetic ("fight-or-flight") and parasympathetic ("rest-and-digest") systems. During menopause, this delicate balance often shifts, with many women experiencing a dominance of sympathetic activity and a reduction in parasympathetic function. Research has shown that perimenopausal and postmenopausal women with hot flashes frequently demonstrate an unfavorable autonomic profile. A study by Fu and colleagues revealed that women experiencing greater anxiety and depressive symptoms during menopause showed lower levels of parasympathetic (“rest-and-digest”) activity.[1]

The autonomic dysfunction during menopause doesn't just affect mood; it has far-reaching implications for physical health as well. Women often experience changes in blood pressure regulation, with a tendency toward hypertension emerging during this life phase. Lung function may also decline more rapidly during menopause, contributing to respiratory complaints and reduced exercise tolerance. These physical changes, coupled with anxiety and mood disturbances, create a complex clinical picture that requires thoughtful, multi-faceted approaches to management.

Breathwork: A Direct Link to Your Nervous System

Slow, deep breathing, often called paced breathing or diaphragmatic breathing, has a remarkable ability to influence your autonomic nervous system.[5] When you breathe slowly and deeply, especially using your diaphragm (the muscle below your lungs), it helps to reduce central sympathetic activity – that's the "fight or flight" response that can fuel anxiety and raise blood pressure.

Breathwork affects the autonomic nervous system through several mechanisms. Deep, slow breathing stimulates stretch receptors in the lungs, which signal to the brain via the vagus nerve to enhance parasympathetic activity. This parasympathetic activation produces a cascade of relaxation responses: heart rate slows, blood vessels dilate, blood pressure decreases, and stress hormones like cortisol are reduced.

Several studies highlight the benefits of slow breathing:

Lowering Blood Pressure: Research has shown that slow abdominal breathing can significantly lower both systolic and diastolic blood pressure in individuals with prehypertension. One study found a decrease of 8.4 mm Hg in systolic and 3.9 mm Hg in diastolic blood pressure when slow abdominal breathing was combined with EMG biofeedback in postmenopausal women with prehypertension. Even slow abdominal breathing alone significantly decreased systolic blood pressure.[4]
Increasing Heart Rate Variability (HRV): HRV is a measure of the variation in time between heartbeats. Higher HRV generally indicates a healthier and more flexible autonomic nervous system. Studies on slow breathing techniques, often at a rate of around six breaths per minute, have found reliable associations with an increase in HRV power, suggesting a shift towards increased parasympathetic activity – the "rest and digest" system.[6] This can help your body manage stress more effectively.
Reducing Anxiety: Multiple studies have demonstrated the effectiveness of breathing practices in reducing anxiety.[7] A systematic review of clinical trials found that breathing practices are a valuable tool for stress and anxiety reduction, especially when they avoid fast-only breathing, last for at least 5 minutes, include human guidance, involve multiple sessions, and encourage long-term practice.[8] Diaphragmatic breathing specifically has been shown to lead to a significant reduction in state anxiety.[7]

The power of breathwork lies in its ability to directly influence the physiological processes within your body:

Vagal Nerve Stimulation: Slow, deep breathing stimulates the vagal nerve, a major component of the parasympathetic nervous system.[2] Stimulating this nerve helps to slow down your heart rate, lower cortisol (the stress hormone), lower blood pressure, and promote a sense of calm and relaxation.[9]
Nasal Breathing Connection: Research suggests that nasal breathing, often emphasized in breathwork practices, has a unique link to brain activity, particularly in areas related to emotions and cognitive function.[6]
Emotional Regulation: By influencing your nervous system, breathwork can help you better manage your emotional responses to stress and anxiety. The focus on breathing can provide a sense of control and help to interrupt patterns of negative thoughts and feelings.[7]
Stress Hormone Reduction: Studies have shown that breathing exercises can have a reducing effect on stress hormones like cortisol and epinephrine.[9] This can contribute to a greater sense of well-being and resilience.

Breathwork and Menopause: Specific Research

While more research is always valuable, several studies directly address the benefits of breathwork for menopausal women:

Hot Flashes: Paced breathing (slow, deep, diaphragmatic breathing) has been specifically studied for its ability to reduce hot flashes, a common and often disruptive symptom of menopause.One study compared paced breathing with usual breathing in women experiencing hot flashes and found that paced breathing led to a decline in hot flash frequency.[5] Participants in a randomized trial of slow-paced respiration for hot flashes also had their anxiety and depressive symptoms and cardiac autonomic function measured.[1] This highlights the connection between breathing, menopausal symptoms, and emotional well-being.
Cognitive Function: Interestingly, a study on middle-aged postmenopausal women found that a single session of slow-paced breathing improved cognitive functions such as simple reaction time and reaction accuracy.[10] This suggests that incorporating breathwork could have immediate benefits for focus and mental clarity during menopause.

Breathwork Techniques for Menopausal Women

Several breathwork techniques have shown benefit for menopausal symptoms:

Slow-paced breathing, sometimes called resonant breathing or coherent breathing, involves slowing the breath to about 5-6 breaths per minute. This rate maximizes heart rate variability and promotes parasympathetic activation.

Diaphragmatic breathing focuses on engaging the diaphragm rather than the chest muscles during inhalation. This deeper breathing pattern increases lung capacity and oxygen intake while promoting relaxation.

Extended exhalation involves making the exhale longer than the inhale, which enhances vagal tone and parasympathetic activation. A common pattern is to inhale for a count of four and exhale for a count of eight.

These techniques share common elements: they slow the breath, encourage fuller lung expansion, and promote mindful attention to the breathing process. Regular practice appears to offer cumulative benefits, with improvements in autonomic function building over time.

Introducing Breth: Your Partner in Consistent Breathwork

Maintaining a regular breathwork practice can be challenging, especially during the busy midlife years when many women are juggling multiple responsibilities.However, to truly experience the benefits of breathwork, consistency is key. Research has shown that doing at least 5 minutes of daily breathwork practice over the long-term is associated with the anxiety reduction benefits of breathing practices.[8] That's where Breth comes in. Breth is designed specifically to make regular breathwork easy and effective for women in all stages of life.

Breth incorporates gentle vibrations to guide you through slow, rhythmic breathing patterns. This tactile feedback can enhance the sensory experience of breathing and can help you stay focused. This, in turn, helps you to maintain a consistent pace, making it easier to adopt a slow deep breathing technique. Whether you're new to breathwork or have practiced before, Breth can be a valuable tool to:

Stay on track with daily practice.
Ensure you're breathing at an optimal rate for relaxation and nervous system regulation.
Make breathwork a simple and enjoyable part of your routine.

By incorporating regular breathwork into your life, especially with the support of a tool like Breth, you can take a proactive step towards easing anxiety, supporting your cardiovascular health, and enhancing your overall well-being during and after menopause. It's a natural, accessible, and empowering way to find balance and feel your best.

Conclusion

The autonomic nervous system plays a crucial role in the experience of menopause, with imbalances contributing to many common symptoms like hot flashes, anxiety, and cardiovascular changes. Research suggests that breathwork represents a promising, non-pharmacological approach to restoring autonomic balance during this transitional phase.

By practicing slow, controlled breathing techniques regularly, women may be able to increase parasympathetic activation, reduce sympathetic dominance, and experience improvements in both physical and psychological symptoms. Technologies like the Breth device can support this practice by providing guidance and enhancing consistency.

As our understanding of the relationship between menopause and autonomic function continues to evolve, breathwork stands out as an accessible, effective tool that women can incorporate into their daily lives. For those navigating the menopausal transition, the simple act of mindful breathing may offer profound benefits for both immediate comfort and long-term health.

Citations

Fu P, Gibson CJ, Mendes WB, Schembri M, Huang AJ. Anxiety, depressive symptoms, and cardiac autonomic function in perimenopausal and postmenopausal women with hot flashes: a brief report. Menopause. 2018 Dec;25(12):1470-1475.
Kandasamy G, Almaghaslah D, Almanasef M. A study on anxiety and depression symptoms among menopausal women: a web based cross sectional survey. Front Public Health. 2024 Dec 16;12:1467731.
Triebner K, et al. Menopause Is Associated with Accelerated Lung Function Decline. Am J Respir Crit Care Med. 2017 Apr 15;195(8):1058-1065.
Wang SZ, Li S, Xu XY, Lin GP, Shao L, Zhao Y, Wang TH. Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. J Altern Complement Med. 2010 Oct;16(10):1039-45.
Sood R, Sood A, Wolf SL, Linquist BM, Liu H, Sloan JA, Satele DV, Loprinzi CL, Barton DL. Paced breathing compared with usual breathing for hot flashes. Menopause. 2013 Feb;20(2):179-84.
Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, Gemignani A. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci. 2018 Sep 7;12:353.
Ma X, Yue ZQ, Gong ZQ, Zhang H, Duan NY, Shi YT, Wei GX, Li YF. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017 Jun 6;8:874.
Bentley TGK, D'Andrea-Penna G, Rakic M, Arce N, LaFaille M, Berman R, Cooley K, Sprimont P. Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sci. 2023 Nov 21;13(12):1612.
Örün D, Karaca S, Arıkan Ş. The Effect of Breathing Exercise on Stress Hormones. Cyprus J Med Sci. 2021 Dec;6(1):22-27.
Masmoudi K, Chaari F, Ben Waer F, Rebai H, Sahli S. A single session of slow-paced breathing improved cognitive functions and postural control among middle-aged women: a randomized single blinded controlled trial. Menopause. 2025 Feb 1;32(2):158-165.