Shortness of Breath In Perimenopause: Causes and Solutions

Last updated 01.08.2024 | by Sabrina Johnson | 8 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

Shortness of breath is one of the most common conditions most individuals face at some point in their lives. If we were to distinguish by gender, women are more susceptible to shortness of breath than men since their respiratory muscles are weaker, and their lungs are smaller than their male counterparts. Several studies have even highlighted this aspect, stating that the absolute lung volumes in males are bigger than in females.

Shortness of breath can aggravate in women during pregnancy, mostly in the final trimester. You could even feel a little breathless just before your periods. In this context, we cannot miss menopause and the transition phase when women can experience shortness of breath alongside other symptoms as well.

Shortness of breath isn’t a common menopausal symptom, not as much as hot flashes experienced by around 80% of women when transitioning into menopause. As per estimations, around 20% of women have shortness of breath in perimenopause and menopause. If you have already experienced hot flashes, followed by shortness of breath, you will probably get the hint that the hormones are doing their job.

However, if the shortness of breath comes with other symptoms like chest tightness, chest pain, etc., do not pass it as a symptom of menopause. You must seek a doctor’s advice right away.

If you are in your late 40s and are wondering about the reason for your frequent bouts of shortness of breath, this article will help you. I have included facts like the reason for shortness of breath in perimenopause and the ways to manage the same. Read on to know more.

Why Do Women Experience Shortness of Breath in Perimenopause?

Anyone, irrespective of the fact whether they are in menopause or not, may get affected by dyspnea or shortness of breath. However, findings over the years have established a connection between estrogen and lung function.

In a study conducted in 2016, it was shown that women in the menopause transition and postmenopause stage experienced a rapid decline in their lung function. There are a few reasons behind the same. Let’s take a look:

  • Reduced estrogen levels could affect the lung tissue’s elasticity, where the lungs may not expand or contract in the way they used to before. A loss in elasticity lessens the size of the airways, making breathing a little difficult. Notably, not all women will encounter breathing difficulties in perimenopause and menopause.
    A lot depends on your overall health also. However, if you have any pre-existing cardiac or lung problems, menopause could aggravate it, especially if you do not take proper care of yourself.
  • Studies have shown that low estrogen levels cause increased inflammation. This affects several organs of the body and leads to the onset of chronic conditions. The lungs and respiratory system may also be at stake, especially in those with a weakened immune system. This could result in breathing difficulties.
  • Another research conducted in Norway mentioned that a woman’s lung function declined in the perimenopausal and postmenopausal stages, resulting in shortness of breath with reduced physical activity. The researchers even identified that the forced vital capacity of an individual was affected by menopause. The forced vital capacity is the measurement of air exhaled forcibly when you take a breath as deep as possible. Reduced force vital capacity increases the risk of breathing troubles.
  • Last but not least, yet another essential reason for breathlessness is an increased anxiety level. During times of stress, the muscles facilitating breathing tighten. The feeling could be like not sufficient air is entering into your lungs. This could cause further stress, making your breathing shallower.
    The reduced estrogen levels are one of the contributors to the stress women encounter in perimenopause and menopause. Moreover, symptoms like hot flashes, sleep problems, and restless leg syndrome could have an impact on your mood, triggering stress. My stress levels were pretty high at the time when I was transitioning into menopause. Sometimes, things would get so overwhelming that I would often feel breathless. Deep breathing helped me to get over this to a greater extent.

However, what you must remember is shortness of breath may not always be a symptom of menopause, even if you have reached the menopausal age. The onus lies on you to identify your symptoms and act accordingly. These are some of the red flags to watch out for:

  • Increased chest tightness
  • Labored breathing
  • Wheezing
  • Difficulty in breathing irrespective of the activity you do, a light or heavy one
  • Chest pain
  • Dizziness
  • Nausea and vomiting

So, if your shortness of breath is accompanied by one or many of the abovementioned symptoms, a doctor’s consultation is needed.

How to Manage Shortness of Breath in Perimenopause?

How to Manage Shortness of Breath in Perimenopause

If it has been identified that the shortness of breath is a play of the hormones, and you don’t have any other underlying condition, then you could manage it in several ways. Let’s take a look at them:

1. Exercise Regularly

When you are physically fit, your body efficiently absorbs oxygen into the bloodstream, transporting it to the working muscles with ease. That is why exercising regularly boosts your heart and overall fitness. It will help if you include strength training and cardiovascular exercises like squats, jogging, walking, swimming, dancing, etc in your daily schedule.

I took special care of my fitness in my 40s. My physical trainer advised cardiovascular exercises, which included running, walking, jogging, and swimming. He said that I would always have to be on the move. This would help me stay fit. On days when I wouldn’t get time to go for a walk or on a jog, I would climb the stairs several times. That’s a good cardio as well.

2. Quit Smoking

Smoking isn’t good, and its effect on menopause is worse. It aggravates the symptoms like hot flashes, sleep problems, mood swings, etc. Moreover, smoking will affect your lung function and make breathing worse, triggering shortness of breath. That’s why it is advisable to stay away from smoking always, and even more, if you have hit the menopausal age.

3. Maintain a Healthy Diet

A nutritious diet is a mandate for keeping your lungs and heart healthy. There are some nutrients like vitamins, healthy fats, complex carbs, proteins, and fiber that help to boost your lung function. When choosing healthy fats, nuts, olive oil, avocado, and eggs are good choices. Research has found that people who add more fiber to their diet have better lung function than those who don’t.

Foods like baked beans, quinoa, chia, whole-wheat spaghetti, broccoli, peas, lentils, black beans, etc., are fiber-rich. Avoid triggers like processed meat, sugary drinks, and excessive alcohol, as they may take a toll on your lung health. The moment I gave up on binge eating, it improved my overall health significantly. I began to feel the change slowly and gradually.

4. Go For Deep Breathing Techniques

When you practice deep breathing exercises, it helps to improve your lung capacity. It benefitted me immensely. Here are some tips for healthy breathing. You can try belly breathing where you must:

  • Lie or sit back with relaxed shoulders
  • Keep one hand on the chest and the other on your stomach
  • Inhale and exhale for two seconds each. When inhaling, you should feel the air traveling to your abdomen, with your stomach moving out.

You could even breathe through pursed lips to slow your breathing. Here are some tips to follow:

  • Breathe in slowly through the nostrils
  • Keep your lips in a way as if you are to blow
  • Now, exhale at a longer pace than it took to inhale.


Will hormone replacement therapy help with shortness of breath in perimenopause?

Hormone replacement therapy has been known for its effectiveness in dealing with different menopausal symptoms like hot flashes and vaginal dryness. It is even said to help improve lung function and ease breathing. You will succeed in getting maximum benefits when you choose the right HRT of the most appropriate dosage. So, it would help when you consult your doctor.

When to see your doctor regarding shortness of breath?

You should not take shortness of breath lightly if it is recurrent and comes in the way of your daily living. You should see a doctor if you have associated symptoms like wheezing, labored breathing, chest pain, and dizziness.

What is the effect of menopause on the respiratory system?

With perimenopause, women experience a steep decline in their lung function due to hormonal imbalances that increase when they are in the menopause stage. For instance, perimenopausal women lose around 10mm of FVC (forced vital lung capacity) every year.
In menopause, this number increases by an additional 12.5 mm/ year. So, when the function of the lungs is affected, it is clear that the respiratory system will be impacted. That’s why it is essential to follow a proper lifestyle to ensure better heart health and improved lung function.


Shortness of breath due to perimenopause won’t last long. Once the hormones stabilize post the menopause phase, your breathlessness will also lessen in severity and intensity. When you opt for a healthy lifestyle by exercising and eating well, you can take charge of many of the menopausal symptoms, including breathlessness.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.