Breathwork for Perimenopause and Menopause: Why How You Breathe Affects How You Feel

10 Aug

If you've tried "just breathe" advice before and found it underwhelming, you're not alone. Most breathing advice is vague — take a deep breath, count to four, relax. It's not wrong, exactly. It's just incomplete.

Breathwork for menopause, done properly, is something more specific than that. It's a set of techniques — in my case, Buteyko and Oxygen Advantage — that work directly with your physiology, not just your mood in the moment.

As a menopause coach, this is the area of my work I get asked about most, and it's also the one that surprises people most. This post explains what breathwork actually is, why it matters more during perimenopause and menopause specifically, and what a practice looks like day to day.

What breathwork actually is (and isn't)

Breathwork for menopause isn't a wellness trend, and it isn't meditation with extra steps. It's training — specifically, retraining how you breathe day to day, because most of us breathe less efficiently than we think.

Chronic overbreathing — breathing faster or more heavily than the body actually needs, often through the mouth and into the upper chest — is extremely common, and it keeps the nervous system in a slightly more alert state than necessary. Most people don't notice it, because it's become their normal.

The methods I work with, Buteyko and Oxygen Advantage, both focus on nasal breathing and reducing that unnecessary overbreathing, in order to shift the nervous system toward a calmer baseline state.

It isn't a cure-all, and it isn't a replacement for medical care. It's a practical, physiological tool — one that happens to be significantly underused.

Why breathing changes matter more during perimenopause and menopause

Oestrogen has a moderating effect on your stress response. As it fluctuates in perimenopause and declines in menopause, that moderation reduces, and your nervous system runs closer to the edge than it used to.

On top of that hormonal shift, if your everyday breathing pattern is already keeping your nervous system slightly activated, the two compound each other. Smaller stressors feel bigger. Sleep is harder to recover from. Anxiety is quicker to spike.

Breathwork is one of the most direct ways to work with that reactive stress response, rather than just managing its symptoms.

The Buteyko method, in plain terms

The Buteyko method was developed by the physician Konstantin Buteyko and centres on nasal breathing and gently reducing breathing volume, with the aim of improving how efficiently your body tolerates and uses carbon dioxide — which plays a bigger role in oxygen delivery to tissues than most people realise.

In practice, it involves specific breathing exercises, breath-hold assessments to track progress, and a strong emphasis on nasal breathing throughout the day and during sleep.

Oxygen Advantage, in plain terms

Oxygen Advantage was developed by breathing coach Patrick McKeown, and it's built on similar underlying principles to Buteyko — nasal breathing, functional breath control, and improving carbon dioxide tolerance.

Where it differs is its original focus. Oxygen Advantage was designed primarily for athletic performance and recovery. It's widely used by runners, cyclists, and other athletes looking to improve endurance and breathing efficiency under exertion.

I haven't adapted it for menopause, and I wouldn't want to overstate what it does. Where it fits into my work is with clients who also want to keep performing athletically through this stage of life — anyone whose training goals haven't slowed down just because their hormones have shifted. For the broader nervous system work — sleep, anxiety, everyday stress reactivity — Buteyko is where most of my menopause-focused coaching sits.

What breathwork can support

Breathwork isn't a treatment for any specific menopause symptom, and I'd be doing you a disservice if I framed it that way. What it does is support the underlying nervous system state that influences several things at once:

Sleep — a calmer nervous system before bed makes it easier to fall asleep and stay asleep
Anxiety and stress reactivity — daily practice can lower your baseline reactivity over time, not just in the moment
Recovery from exercise — supporting the shift from a trained, activated state back to rest
General resilience — many women describe feeling like they have more capacity to handle what a day throws at them

Some women also notice an effect on hot flush intensity, though the evidence here is still developing and I wouldn't want to overstate it. What's consistently true is the nervous system benefit — and given how much perimenopause and menopause symptoms are amplified by a reactive stress response, that benefit matters.

What a breathwork practice actually looks like

This isn't sitting cross-legged for 40 minutes a day, unless you want it to be.

It starts with an assessment. In coaching, I use a simple breath-hold measurement to get a baseline for how efficiently you're currently breathing, and to track progress over time.
Daily practice is short. Most of the exercises take five to ten minutes and can be done at home, without equipment.
Nasal breathing becomes the default. This is often the biggest and simplest shift — many people breathe through their mouth without realising it, especially during exercise and sleep.
It gets applied in real moments. Not just as a formal practice, but as a tool you reach for at 4am, before a stressful meeting, or when a hot flush starts building.
It's personalised. Everyone's starting point is different. What I teach a client depends on their baseline, their symptoms, and what's realistic for their life.

Why I work this way

I'd been experimenting with breathwork for years, but without much rhyme or reason — mostly following the usual "breathe out longer than you breathe in" advice you see everywhere.

Then I had my CO2 tolerance tested, and I fell well short. As I always do when something doesn't add up, I went and investigated — and that's how I found Oxygen Advantage. I trained in it hoping to improve my running. Once I started learning, I realised there was a whole world beyond performance and recovery that breathing could help with. That's what led me to train in Buteyko as well. Buteyko is where most of my menopause-focused nervous system work sits now — Oxygen Advantage comes in for clients who also want to keep performing athletically through this stage of life.

When to consider a menopause coach for breathwork support

You don't need to be in crisis to benefit from this. In fact, starting before things feel unmanageable tends to produce the best results.

It's worth considering support if:

You're curious about breathwork but don't know where to start or whether you're doing it "right"
Anxiety, poor sleep, or stress reactivity are part of your picture and you want a tool that addresses the physiology directly
You've tried generic breathing apps or videos and found them too vague to stick with
You want breathwork integrated with the rest of your approach — nutrition, sleep, movement — rather than as a standalone add-on

As a perimenopause and menopause coach, breathwork is something I teach directly and personally — it's part of what makes the coaching I offer different from a generic lifestyle programme. If you're wondering what that looks like more broadly, this guide on what a perimenopause and menopause coach actually does covers the full picture.

And if you're still working out whether what you're feeling is hormonal at all, the hub post on why menopause can feel overwhelming is a useful starting point.

What to do if this sounds like you

Notice your current breathing pattern. Are you breathing through your mouth? Into your upper chest rather than your belly? Faster than feels necessary? Awareness is the first step.
Start with nasal breathing. Simply keeping your mouth closed — during the day, during light exercise, and especially during sleep if you can manage it — is a meaningful place to begin.
Try a short daily practice. Even five minutes of slow, nasal breathing, done consistently, shifts your baseline over time. Consistency matters more than duration.
Consider proper guidance. Breathwork is simple in principle but genuinely more effective with personalised instruction — particularly if you're dealing with specific symptoms like anxiety or poor sleep.

At Fabulous in Midlife, breathwork is woven into how I coach — alongside nutrition, sleep, and movement, because none of these things work in isolation. If this is an area you'd like support with, I'd love to talk.

What to do next

How you breathe is something you have far more control over than most of what's happening hormonally right now. That's worth something.

Book your free consultation here

Or if you'd rather start smaller: practical guides, now and then. No pestering.

Frequently asked questions

What is breathwork for menopause?

Breathwork for menopause refers to structured breathing techniques — such as Buteyko and Oxygen Advantage — used to support the nervous system during perimenopause and menopause. It works by retraining breathing patterns that keep the body in a more reactive state, helping shift toward a calmer baseline.

Does breathwork help with hot flushes?

Some women report an effect on hot flush intensity, though the evidence in this specific area is still developing and I wouldn't want to overstate it. What's better established is breathwork's effect on nervous system reactivity generally, which plays a role in how intensely symptoms are experienced.

What's the difference between Buteyko and Oxygen Advantage?

Buteyko, developed by physician Konstantin Buteyko, focuses on nasal breathing and reduced breathing volume to improve carbon dioxide tolerance. Oxygen Advantage, developed by Patrick McKeown, shares similar underlying principles but was designed primarily for athletic performance and recovery. In my coaching, Buteyko is the foundation for menopause-focused nervous system work; Oxygen Advantage comes in for clients who also want to maintain athletic performance during this stage of life.

How often should I practise breathwork?

Short daily practice — around five to ten minutes — tends to be more effective than occasional longer sessions. Consistency is what shifts your baseline nervous system state over time.

Can breathwork help with sleep during menopause?

Yes, for many women. A calmer nervous system before bed makes it easier to fall asleep and to settle back down after waking. It works well alongside the other sleep strategies covered in the post on perimenopause and menopause sleep problems.

Do I need in-person sessions to learn breathwork?

Not necessarily, though personalised guidance tends to produce better results than generic videos or apps, particularly if you're working with specific symptoms. Coaching sessions can be done remotely, with a baseline assessment and a plan tailored to you.

About the author

Paola is a certified women's health and nutrition coach and breathwork practitioner at Fabulous in Midlife, trained in the Buteyko Method and Oxygen Advantage, helping women navigate perimenopause and menopause with practical, evidence-based support. Follow along on Instagram and Facebook @fabulousinmidlife or visit fabulousinmidlife.com.

Jayde Lee