Hot flashes, heart palpitations, mood changes, and disrupted sleep affect millions of women in midlife. Over three-quarters of women report uncomfortable symptoms during the menopause transition, and for many, these issues persist for years. While shifting hormone levels are a key driver, researchers are beginning to explore another contributor: the vagus nerve.(1)(2)
The role of the vagus nerve in regulating the body's stress response and many other bodily functions has received increasing attention. As interest in alternative therapies grows, many are asking: Could supporting vagus nerve function help ease common menopausal symptoms?(3)
Although research on the vagus nerve and menopause is still developing, understanding this nerve’s role in regulating essential body systems may offer new insight into symptom management. This article explores how hormonal changes may be linked to vagal tone, where symptom overlap exists, and how lifestyle strategies can support this powerful neural pathway.
Understanding the Vagus Nerve: The Body's Master Regulator
What is the vagus nerve?
The vagus nerve is the longest cranial nerve in the body, extending from the brainstem down through the chest and abdomen. It connects the brain to multiple organs, allowing it to monitor and regulate internal functions. The vagus nerve connects to the following organs:(3)
Heart
Lungs
Stomach
Intestines
Reproductive organs
As a core component of the parasympathetic nervous system, the vagus nerve promotes rest, digestion, and recovery. It slows heart rate, supports gastrointestinal function, reduces inflammation, and helps regulate mood. About 80% of vagus nerve fibers send signals to the brain rather than from it. This constant feedback helps the brain monitor inflammation, digestion, and organ function, forming the basis of the gut-brain axis.(3)(4)(5)
One important way the vagus nerve works is by releasing acetylcholine, a chemical that helps nerves send signals to organs. This facilitates the nerve’s calming and healing effects.(6)
Vagal Tone As a Marker of Resilience
Vagal tone is a way to describe how strong and effective the vagus nerve’s signals are. When vagal tone is high, the body usually handles stress better, digests food more easily, and keeps a steady heart rate. It also helps lower inflammation.(5)(6)
Low vagal tone, on the other hand, has been linked to anxiety, cardiovascular dysfunction, and chronic stress.(5)
Vagal tone can fluctuate based on physical health, emotional stress, and hormone levels. It’s also affected by daily habits like how a person breathes, moves their body, and connects with others.(5)
Menopause and the Vagus Nerve: Connecting the Dots
What the Science Says About the Vagus Nerve & Menopause
Research clearly supports the vagus nerve’s role in several key bodily functions:(2)(4)(5)
Mood regulation
Inflammation control
Cardiovascular health
Digestion
Several studies show that when estrogen levels drop, it can affect the body’s automatic functions and lower vagus nerve activity. But there isn’t much research yet that directly connects vagus nerve issues to specific menopause symptoms.(8)
Still, the idea makes sense: The vagus nerve affects many parts of the body that also change during menopause. Because of this, scientists are starting to look more closely at how supporting the vagus nerve might help with menopause symptoms.
How Menopausal Changes Might Relate to Vagal Function
The Hormonal Influence: Estrogen helps support the part of the nervous system that manages automatic body functions, like heart rate, blood pressure, digestion, and breathing. When estrogen levels drop during perimenopause and postmenopause, this balance can shift. The “fight-or-flight” response may become more active, while the “rest-and-digest” system slows down. Studies show that lower estrogen levels may contribute to vagal tone impairment and increased inflammatory response in the body.(4)(6)(7)
The Stress Factor: Midlife can be a stressful time, with career demands, caregiving roles, aging parents, and shifting identity. Chronic stress raises levels of cortisol and adrenaline. These stress hormones can weaken the vagus nerve’s signals, making it harder for the body to calm down. When vagal tone is low, the stress response sticks around longer, making it harder for the body to relax.(5)
The Inflammation Link: Estrogen helps regulate inflammation by acting on multiple pathways. As estrogen declines, signs of inflammation often increase. The vagus nerve plays an anti-inflammatory role through the “cholinergic anti-inflammatory pathway,” sending signals that slow down the immune response. If the vagus nerve isn’t working as well, the body may find it more challenging to ease inflammation, which can lead to ongoing or worsening symptoms.(4)(5)(6)
Symptom Overlap: Vagus Nerve Function and Menopause Meet
Note: While more research is needed to directly link vagus nerve dysfunction with menopausal symptoms, overlapping effects offer potential clues.
Mood and Anxiety: Low vagal tone is linked with increased anxiety and depression, both of which are common in perimenopause. Disrupted communication along the gut-brain axis and reduced parasympathetic activity may contribute to these conditions.(9)
Sleep Disturbances: Vagus nerve activity supports the ability to wind down. Chronic stress and poor vagal tone may affect sleep quality, potentially worsening hormonal insomnia.(2)(8)(9)
Hot Flashes (Vasomotor Symptoms): Some research suggests that thermoregulatory instability (fluctuating body temperature) during menopause may involve vagal dysfunction. Since the vagus nerve helps regulate cardiovascular function and blood pressure, it may influence how well the body reacts to temperature signals processed by the hypothalamus. Drops in vagal tone may amplify the body’s heat response, contributing to hot flashes. However, this remains an emerging area of study.(2)(5)
Digestive Issues: The vagus nerve regulates digestion, including stomach acid production, motility, and gut-brain signaling. Individuals may experience bloating, constipation, or indigestion during menopause — symptoms that may be linked to lower vagal activity.(4)(5)
Inflammatory Symptoms: Joint pain and other inflammatory complaints are common in postmenopause. Reduced vagal signaling could play a role in sustained inflammation.(4)
Heart Health & Palpitations: Estrogen affects heart function, and a decrease may contribute to feelings of skipped beats or palpitations. Changes in heart rate or blood pressure may also be a sign that the body’s stress response is more active and the calming signals from the vagus nerve are weaker.(5)
The Benefits of Supporting the Vagus Nerve During Menopause
Even without menopause-specific studies, strengthening vagal tone can offer general benefits that align with common midlife concerns. These include the following:(2)(4)(5)(7)
Lowering cortisol and adrenaline levels
Improving emotional regulation and mood
Supporting digestion and gut health
Reducing inflammatory responses
Enhancing cardiovascular balance
Together, these benefits can improve resilience and quality of life, helping women navigate the menopause transition with greater stability.
Practical Strategies: Supporting Vagal Tone for Potential Menopause Relief
While more research is needed on menopause-specific applications, the following practices are known to support vagal tone:(2)(4)(5)
Breathwork Techniques: Slow, deep, diaphragmatic breathing stimulates vagal activity and promotes relaxation.
Cold Exposure: Brief exposure to cold water — such as a cold splash on the face, cold showers, or cold plunge — may enhance vagal tone.
Sound and Vibration: Humming, chanting, singing, and sighing can all stimulate vagal pathways through the vocal cords and the ear.
Mindfulness and Meditation: Regular mindfulness practice has been shown to improve vagus nerve function and reduce stress.
Gentle Movement and Exercise: Activities like yoga, tai chi, and walking support parasympathetic activation.
Diet and Gut Health: A fiber-rich, anti-inflammatory diet can support the gut microbiome, which interacts closely with the vagus nerve.
Social Connection and Laughter: Positive social interactions and laughter increase vagal activity and emotional resilience.
These techniques are most effective when practiced consistently and tailored to individual needs. What works well for one person may be less effective for another. Finding the most helpful combination may take time and experimentation.
Managing Expectations and When to Seek Professional Advice
While vagal toning techniques can be a helpful addition to a wellness plan, they’re not a replacement for medical care. Women experiencing severe or persistent menopausal symptoms should speak with a healthcare provider about evidence-based treatments.
HRT and Vagal Support Combo for Best Relief
Hormone replacement therapy (HRT) remains the most effective treatment for many menopause symptoms. For women who choose HRT or are good candidates, combining hormonal therapy with lifestyle strategies that support vagal tone may enhance both physical and emotional resilience.
Vagus Nerve as a Supportive Tool for the Menopause Journey
The vagus nerve is a powerful regulator of balance, healing, and recovery across multiple systems. While menopause presents complex challenges, understanding and supporting vagus nerve function may help reduce stress, improve sleep, support gut health, and enhance mood regulation.
Vagal toning strategies, when paired with personalized medical care, may offer meaningful support for women navigating menopause. These accessible, low-risk practices can be part of a broader, evidence-informed approach to maintaining well-being through midlife and beyond.
