Meditative breathing exercises for perimenopausal symptoms

During perimenopause and postmenopause, hot flashes can make your body and your life feel out of control. Studies have shown that slow, controlled breathing (paced respiration) or "relaxation response" exercises can help if you practice often. Exercises to calm your breathing are an effective way to make hot flashes less frequent and less intense. These techniques may also help curb such emotional symptoms as agitation, anxiety, and depression.

Meditative breathing exercises are cost-free and have no known side effects. They are a good first-choice treatment for hot flashes and emotional symptoms and can safely be combined with another type of treatment, if you need further relief.

Paced respiration

With regular, paced respiration women reportedly achieve a noticeable drop in the number of hot flashes they have, as well as a lower average skin temperature (used to measure hot flashes).1

Paced respiration takes practice. Try to do paced respiration twice daily, for 15 minutes at a time. If you can, when you first feel a hot flash coming on, stop what you are doing, find a quiet place, and practice paced respiration until you are feeling comfortable again.

  • Sit in a comfortable, quiet place.
  • As you breathe, keep your rib cage still. You will be lowering and raising your diaphragm to fill and empty your lungs.
  • Inhale for 5 seconds, pushing your stomach muscles out.
  • Exhale for 5 seconds, pulling your stomach muscles in and up.
  • Repeat this cycle of breathing until you feel calm and relaxed or your time is up.

To reduce stress, you can also use paced respiration for 1 to 2 minutes in the middle of a busy day.

Relaxation response exercise

After several weeks of daily relaxation response exercise, women may notice a drop in hot flash intensity as well as decreased tension, anxiety, and depression. For 10 to 20 minutes each day, take time to produce a relaxation response in your body and mind.

  • Sit in a comfortable, quiet place. Close your eyes.
  • Relax all of your muscles, starting with your feet and moving up to your face. Stay loose and relaxed.
  • Focus on your breathing. Breathe through your nose at a natural rate.
  • Inhale. Exhale. At the end of your exhale, quietly say to yourself, "One."
  • Repeat this cycle of breathing until your time is up.

While breathing, do not worry about achieving complete relaxation. It will happen naturally over time. When thoughts intrude, try to ignore them by focusing again on your cycle of breathing.

Instead of using a timer, occasionally check your clock or watch. When you are done, open your eyes, gradually focus them, and sit quietly for a few minutes before standing.


  1. Freedman R, et al. (1995). Biochemical and thermoregulatory effects of behavioral treatment for menopausal hot flashes. Menopause: The Journal of the North American Menopause Society, 2(4): 211–218.

Last Updated: May 16, 2008

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