World Menopause Day provides a chance to talk openly about the changes this stage of life brings. Most people know menopause can bring hot flashes, mood changes, and sleep problems. But here's one symptom you might not expect: changes in your breathing.
So, can perimenopause and menopause cause shortness of breath? Yes, they can. Shifting estrogen and progesterone levels can change how your body drives and senses breathing, and hot flashes, anxiety, and poor sleep can add to it.
In this article, you'll find out why this happens, the common breathing issues during perimenopause and menopause, and how to manage and improve your breathing with the help of the Buteyko Breathing Method.
The Hormonal Link Between Menopause and Shortness of Breath
Menopause occurs when menstruation spontaneously and permanently ceases. It is a natural stage in a woman's life, typically occurring around age 51, marked by hormonal changes and symptoms like hot flashes, mood swings, and sleep changes. But hormonal shifts during this stage can also affect the way we breathe.
Perimenopause, the transition before menopause, can begin several years earlier. This is often when breathing changes first appear, because estrogen and progesterone levels rise and fall unpredictably before they decline.
Estrogen and progesterone, two key female hormones, play a role in regulating breathing. Progesterone, in particular, stimulates the breathing centers in the brain. This is why breathing can feel faster or harder in the second half of the menstrual cycle, when progesterone is higher. As these hormone levels change during perimenopause and menopause, the way your body controls breathing can change too.
These hormones don't just regulate the menstrual cycle; they also play a role in lung health. A 2020 systematic review found that menopause is generally associated with reductions in lung function, although aging, hormone therapy, and metabolic changes during this period make the effect hard to separate.
Lower progesterone levels can also reduce the brain's drive to breathe, which may raise carbon dioxide levels in the blood and contribute to sleep-disordered breathing.
These hormonal changes can lead to menopausal breathing problems, such as shortness of breath, wheezing, or a feeling that you can't take a deep breath.
In some women, especially those who experience early menopause, lung function may decline more quickly, increasing the risk of respiratory issues later in life.
Please note that while menopause can impact lung function, other life factors may also contribute to this effect, and further research is needed to understand these connections fully.
Common Perimenopause and Menopause Breathing Issues
A number of breathing problems can develop during perimenopause and menopause due to hormonal changes. Below are some of them:
Shortness of breath
Some women experience shortness of breath in perimenopause and menopause, which can range from mild breathlessness to feeling like they can't catch their breath, especially during physical exertion.
There might be difficulty breathing, a sensation of chest tightness, or an inability to take a full breath. This may be linked to anxiety, hormonal changes in breathing drive, changes in lung function, or changes in respiratory muscle function.
Air hunger (oxygen hunger)
Air hunger, sometimes called oxygen hunger, is the uncomfortable feeling that you need to breathe more. Many women describe it as "I can't get a satisfying breath," often with frequent sighing or yawning.
Air hunger appears when your brain's drive to breathe is high compared with the breathing you are actually achieving. It can be triggered by rising carbon dioxide, low oxygen, exercise, or changes in blood acidity. How strong it feels also depends on attention, emotion, and past experience.
This is why air hunger in perimenopause can happen even when oxygen levels are normal. Hormonal shifts can change your breathing drive, while anxiety and poor sleep can make the brain more alert to breathing sensations.
Shortness of breath with hot flashes
Many women notice breathlessness during or just after a hot flash. During a flash, heart rate often rises and breathing can speed up. The sudden heat and racing heart can also trigger anxiety, which tends to make breathing faster and higher in the chest.
Mouth breathing
Menopausal women may notice they start breathing through their mouths more often during menopause, especially at night. This can be due to nasal congestion, changes in sleep patterns, or increased anxiety.
Mouth breathing in menopause can create a cycle of problems: dry mouth, disturbed sleep, and snoring. Nasal breathing is healthier, as it filters, warms, and humidifies the air before it reaches your lungs.
Sleep-disordered breathing
Sleep-disordered breathing, such as snoring and sleep apnea, becomes much more common after menopause. A study of 774 women aged 40 to 67 found that women with lower estrogen and progesterone levels were more likely to snore and report sleep apnea symptoms. These hormones help keep the airways open and support healthy breathing during sleep.
Menopause can also alter body fat distribution, leading to an increase in fat accumulation in the neck, tongue, and abdomen, which can narrow airways and reduce lung volume. These changes, along with obesity, raise the risk of breathing problems at night and make airway collapse during sleep more likely.
Shallow breathing
Shallow breathing refers to taking quick, shallow breaths that don't fully fill the lungs. During menopause, this can happen more often due to hormonal changes, stress, or muscle tension in the chest and shoulders.
Lower progesterone can reduce your natural breathing drive, while stress and anxiety can cause you to breathe faster and higher in your chest unconsciously.
Wheezing
Wheezing is a high-pitched, whistling sound made while breathing, usually caused by narrowed or inflamed airways. In menopausal women, it can occur more frequently if there is a history of asthma, allergies, or other respiratory conditions, as hormonal changes may influence airway reactivity.
Triggers such as colds, environmental allergens, air pollution, or even stress can worsen wheezing, and postmenopausal decreases in estrogen and progesterone may reduce airway protection, making symptoms more noticeable. New wheezing should always be checked by a doctor.
Many of these breathing problems can also arise during perimenopause, as fluctuating estrogen and progesterone levels affect breathing well before periods stop.
Medical and Lifestyle Factors That Worsen Menopause Breathing Problems
While hormonal changes are a big part of the picture, other health and lifestyle factors can make menopause and the breathing difficulties associated with it worse.
These include:
- Pre-existing conditions like asthma, COPD, or heart disease
- Sleep apnea, which becomes more common after menopause
- Heavy periods during perimenopause, which can lead to low iron (anemia) and breathlessness
- Weight gain, particularly around the abdomen and neck
- Smoking or exposure to air pollutants
- Poor posture
- Chronic stress and anxiety
Addressing these factors can reduce breathing issues with menopause and improve overall wellbeing.
How to Manage Shortness of Breath During Menopause
If you've noticed changes in your breathing during perimenopause or menopause, there are practical ways to help restore balance. One effective approach is the Buteyko Method, a breathing technique developed by Dr. Konstantin Buteyko in 1952.
This breathing technique helps restore healthy breathing patterns by:
- Encouraging nasal breathing (day and night)
- Reducing over-breathing so your breathing better matches what your body needs
- Helping you feel more comfortable with the sensation of air hunger
- Calming the nervous system, which may ease anxiety and help you cope with hot flashes
For many women, Buteyko breathing exercises have helped reduce breathlessness, improve sleep, and ease other menopause-related symptoms by calming the nervous system and encouraging lighter, nasal breathing.
Breathing Exercises for Menopause Relief
Slow, light, and controlled breathing may help some women manage hot flashes and night sweats, although research results are mixed. In a 2013 pilot study, women who practiced paced breathing twice a day reported a 52% drop in hot flashes. Women who practiced their usual breathing also improved by 46%, so the researchers called for larger trials.
Where breathing exercises may help most is with breathlessness, anxiety, and sleep. Techniques from the Buteyko Method, such as breathing light, small breath holds, and nasal breathing, can help reduce stress and support a calmer, more efficient breathing pattern.
Check your Control Pause: Breathe out normally through your nose, hold your nose, and count the seconds until you feel the first clear urge to breathe. This is not a diagnostic test, but it gives you useful feedback to track over time. Try our free breathing test.
Breathe light: Sit comfortably and gently soften and slow your breathing through your nose until you feel a light, tolerable air hunger. Start with one minute of breathing light, then one minute of normal breathing. If you feel stressed or dizzy, return to normal breathing.
Some women find additional benefit from using nasal breathing aids, such as MyoTape, during sleep to discourage mouth breathing and support more restful sleep. If your nose is blocked or you suspect sleep apnea, talk to your doctor first.
You can find out more in our guide to Buteyko breathing exercises.
Other helpful strategies
Breathing exercises work best when combined with other healthy habits, such as:
- Yoga and mindfulness: to improve posture and stress resilience.
- Regular cardiovascular exercise: such as walking, swimming, or cycling, to strengthen respiratory muscles and boost circulation.
- Avoiding triggers: like cigarette smoke, strong chemical fumes, or extreme air pollution, which can worsen breathing issues.
When to seek medical help for shortness of breath
While mild breathlessness can be a normal part of perimenopause and menopause, you should speak to a healthcare professional if you experience:
- Persistent or worsening shortness of breath
- Breathlessness and low blood pressure
- Breathing problems that interfere with daily activities or sleep
- Breathlessness with asthma that isn't well controlled
- Palpitations with breathlessness or dizziness
- Very heavy periods, especially with tiredness
These could be signs of an underlying condition that needs medical attention.
Call emergency services right away if you have chest pain or pressure, sudden or severe shortness of breath, fainting, or sudden breathlessness with a painful or swollen leg.
Experience Better Breathing During Menopause
Menopause is a natural stage of life, but the changes it brings that affect breathing don't have to hold you back. With the right tools, you can take control of your breathing, calm your nervous system, and feel more energetic and balanced every day.
The online Buteyko Breathing for Menopause Relief course will give you a supportive, step-by-step approach to managing hormonal changes through targeted breathing exercises. Taught by experienced breathing instructors, you'll learn techniques to reduce stress, improve sleep, and enhance vitality during menopause.
World Menopause Day offer: This weekend only, use code MENOPAUSE10 for 10% off the Buteyko Breathing for Menopause Relief course. Learn simple daily breathing exercises to help you feel calmer, sleep better and breathe more comfortably through perimenopause and menopause. The offer ends Sunday at midnight.
Get more online breathing courses here: Buteyko Online Breathing Courses
FAQs
Q: Can perimenopause cause shortness of breath?
A: Yes. Changing estrogen and progesterone levels can affect how your body drives and senses breathing. Hot flashes, anxiety, poor sleep, and low iron from heavy periods can add to it. Always have new breathlessness checked by a doctor to rule out other causes.
Q: What is air hunger or oxygen hunger in perimenopause?
A: Air hunger is the feeling that you can't get enough air or a satisfying breath. It happens when your brain's drive to breathe is high compared with the breathing you achieve. In perimenopause, hormonal changes, anxiety, and poor sleep may make this sensation more noticeable.
Q: Can low estrogen or progesterone cause shortness of breath?
A: They may contribute. Progesterone stimulates breathing, so its swings in perimenopause can change your breathing drive. Lower estrogen and progesterone are also linked with more snoring and sleep apnea symptoms in midlife women.
Q: Can breathing exercises help with menopause symptoms?
A: They may help. Research on breathing exercises for hot flashes is mixed, but gentle breathing practices like the Buteyko Method can help manage breathlessness, anxiety, and sleep disruption during the hormonal transition.
Q: Is snoring more common after menopause?
A: Yes. Snoring and sleep apnea become more common after menopause, partly due to the loss of hormonal support for the airway muscles. Women with loud snoring, observed breathing pauses, or heavy daytime tiredness should seek a professional sleep evaluation.
