Menopause & Shortness of Breath: Causes & Solutions

Shortness of breath, or dyspnea, is a subjective perception of difficulty breathing. According to The Journal of Allergy and Clinical Immunology, 34% of women going through menopause may experience respiratory symptoms like dyspnea.⁽¹⁾ Changes occurring in the body during menopause, such as hormonal imbalances, increased inflammation, or decreased lung function, can cause shortness of breath. 

While breathlessness can be a symptom of menopause, many other conditions may also contribute. Understanding the common causes of breathlessness and the various treatment options available can help manage dyspnea effectively.

Is shortness of breath common during menopause?

Research shows that some women going through the menopausal transition may experience decreased lung function and are more prone to breathlessness compared to premenopausal women. Certain menopause-related factors, especially declining estrogen levels, may increase the risk of dyspnea. However, it's important to note that many women may go through menopause without experiencing any respiratory problems.⁽¹⁾

What causes shortness of breath during menopause?

Some of the common causes of breathlessness during menopause include the following:

Hormonal Changes

Studies indicate that progesterone helps support the movement of the breathing muscles and keep the airways open, while estrogen enhances progesterone’s positive effects on respiratory function. As levels of both hormones decline during menopause, the respiratory muscles may not function as well as they should. Low progesterone levels may also result in a compression of the airway. All these factors can contribute to breathing problems.⁽²⁾⁽³⁾

Increased Inflammation 

Estrogen has a protective role against inflammation, and low estrogen levels, as seen during menopause, could result in a heightened inflammatory response in the body. Researchers have also observed an increase in the prevalence of inflammatory lung conditions like asthma during menopause, which can affect lung function and cause shortness of breath.⁽⁴⁾⁽⁵⁾

Respiratory Health Deterioration

Aging gradually reduces lung function. Menopause is believed to amplify age-related lung changes and increase the prevalence of breathlessness. Results of various studies have shown a decrease in FVC (Forced Vital Capacity) during menopause, which measures the maximum amount of air an individual can exhale after a deep breath.⁽²⁾⁽³⁾

Other Common Causes of Shortness of Breath

Menopause may also increase the likelihood of developing conditions that cause shortness of breath, such as the ones listed below:

Respiratory Diseases

• Asthma: Research suggests that menopause may increase the prevalence of asthma in some women. Common asthma symptoms include shortness of breath, tightness in the chest, and wheezing.⁽⁵⁾

• Chronic Obstructive Pulmonary Disease (COPD): This is a long-standing respiratory condition in which the obstruction of the airways is irreversible. Studies have highlighted that women who enter menopause before the age of 40 are at a higher risk of developing COPD compared to those who enter menopause at or after the age of 54.⁽⁶⁾
  

Mental Health Conditions

• Anxiety and Panic Attacks: Anxiety and breathing have a two-way relationship where each one affects the other. During menopause, the risk of anxiety can increase, and increased anxiety can cause rapid and shallow breathing. This reduces oxygen delivery to the body's cells. When cells don't get enough oxygen, they send distress signals to the brain, further exacerbating anxiety.⁽⁷⁾

• Depression: Breathlessness can sometimes occur alongside depression, which is another common mood disorder experienced by women during menopause.⁽⁷⁾ 

Obesity

Obesity may cause fat accumulation around the airways, which may restrict lung movement, especially the lungs’ ability to expand. This restricted lung function can result in a shallow breathing pattern and breathlessness. 

Studies suggest that obesity may also create an inflammatory environment in the body, which increases the risk of breathing problems like asthma.⁽⁸⁾

Heart Diseases

The heart pumps blood through the blood vessels to supply the body's organs. Estrogen plays a vital role in maintaining the elasticity of the blood vessels, reducing the heart’s workload in pumping blood throughout the body.

As estrogen levels decline during menopause, blood vessels may lose their elasticity and become rigid, forcing the heart to work harder. This increased strain on the heart can raise the risk of cardiovascular disorders, with shortness of breath being a potential symptom.⁽⁹⁾

Other Conditions

Health conditions that may cause shortness of breath can also become more common with menopause. These may include the following:

• Anemia: Researchers have observed an increased incidence of iron deficiency anemia in some menopausal women. Iron is an important component of hemoglobin, a protein in red blood cells that carries oxygen to the body’s cells. When the number of red blood cells decreases due to anemia, the oxygen content delivered to the body’s cells also drops, causing shortness of breath.⁽¹⁰⁾

• Hot Flashes: This is one of the most common menopause symptoms and may be accompanied by a rapid heartbeat and chest tightness, which can lead to breathlessness.⁽¹¹⁾

• Osteoporosis: Low levels of estrogen during menopause can increase the risk of osteoporosis in some women. Osteoporosis can reduce the height of the vertebrae in the chest area, restricting lung movement and potentially causing shortness of breath.⁽⁴⁾

Diagnosing Shortness of Breath During Menopause

Severe shortness of breath can significantly impact an individual’s ability to carry out daily activities and reduce their quality of life. In such cases, individuals should consult a physician who can recommend tests, such as respiratory function assessments and X-rays, to determine the underlying cause and suggest the best treatment approach. Managing breathlessness can improve overall quality of life and make the menopausal transition easier. 

Managing Shortness of Breath During Menopause

Effective strategies for managing shortness of breath during menopause depend on the underlying cause and the severity of the problem. Here are a few recommended treatment approaches:

Managing Anxiety 

Deep breathing exercises can help soothe anxiety and improve lung function. Box breathing, a technique in which an individual slowly inhales and exhales to the count of four, is a beneficial exercise for managing anxiety during menopause.⁽¹²⁾

Staying Cool 

A hot environment can aggravate hot flashes, a common contributor to shortness of breath. Managing hot flashes with a fan or air conditioner can help reduce breathlessness. These devices can also lower humidity, boost air circulation, and improve airflow throughout the body.

Exercising Regularly

While it may sound counterintuitive, studies suggest moderate-intensity exercises can strengthen respiratory muscles and improve breathing.⁽¹²⁾ Some effective exercises include swimming, running, and cycling. 

Maintaining a Healthy Weight 

Maintaining a healthy weight prevents fat accumulation around the airways and supports normal breathing. An active lifestyle and a balanced diet can help individuals keep their weight within the normal range for their height and age.⁽¹³⁾ 

Quitting Smoking 

Since smoking accelerates lung damage, experts recommend quitting. 

How can HRT slow the decline in lung function?

A 2017 study of more than 3,000 women found that menopausal women who took HRT for over two years had better lung function than women who never took it. HRT works by replacing low hormone levels and preventing body changes that may accelerate age-related declines in lung function.⁽¹³⁾

When to See a Doctor Immediately

While occasional breathlessness may be manageable, sudden or severe breathing problems may need immediate medical attention. In such cases, individuals should consult their doctor right away. These symptoms may indicate a worsening condition:

• Wheezing, chest pain, or blood in the cough

• Breathlessness accompanied by chills or fever

• Shortness of breath that worsens when lying down

Experiencing shortness of breath during menopause? Discover if HRT is right for you.

If you’ve entered the menopause transition and are struggling with shortness of breath, you don’t have to suffer in silence. Shortness of breath can be a symptom of menopause, but it may also signal other conditions, such as asthma. Consulting a physician is essential to pinpoint the exact cause and determine whether your shortness of breath is primarily related to menopause or something else.

If your problem is related to menopause, HRT can be a viable option. Take our brief menopause quiz to see if you’re an eligible candidate for HRT. Get started with Winona to take the first step toward feeling better.