The Vagus Nerve and Perimenopause: Simple Ways to Calm Your Nervous System

You're Not Overreacting. Your Nervous System Is Under Pressure.

You used to be able to handle stress pretty well. Now small things send you into overdrive. Your heart races at odd moments. You feel wired but exhausted. You snap at people you love and don't understand why.

This is not a character flaw. Perimenopause puts real pressure on the systems that regulate stress, calm, and recovery. Your vagus nerve is central to all of those, and supporting it can make a measurable difference to how you feel day to day.

What the Vagus Nerve Does

The vagus nerve is the longest nerve in your body. It runs from the brainstem down through the neck, chest, heart, lungs, and abdomen, touching nearly every major organ. It is the main pathway of the parasympathetic nervous system, the branch that creates the 'rest and digest' response, the physiological counterpart to 'fight or flight'.

When your vagus nerve is well-toned (meaning it activates and responds efficiently), you move smoothly between states of alertness and calm. You can feel stress, respond to it, and return to baseline without lingering in a state of high alert.

Heart rate variability, or HRV, is the main measurable marker of vagal tone. Higher HRV indicates a more flexible, resilient nervous system. Lower HRV indicates one that is chronically stressed and slow to recover.

How Perimenopause Affects Vagal Tone

Oestrogen has a direct protective effect on the autonomic nervous system, including the vagus nerve. It supports higher heart rate variability, better parasympathetic tone, and more efficient recovery from stress.

As oestrogen fluctuates and begins to decline during perimenopause, vagal tone often decreases. Research has found that HRV drops measurably during the menopause transition. This is one physiological reason why anxiety, stress reactivity, heart palpitations, and that persistent feeling of being 'on edge' are so common during this period.

The good news is that vagal tone is trainable. It responds to specific practices in ways that are measurable and meaningful, even when hormones are in flux.

Evidence-Based Ways to Stimulate the Vagus Nerve

Several approaches have research support for improving vagal tone and parasympathetic activation:

Slow, extended exhale breathing. Your breathing pattern directly affects the vagus nerve. Inhaling activates the sympathetic system slightly; exhaling activates the parasympathetic. Making your exhale longer than your inhale stimulates the vagus nerve measurably. A simple practice: inhale for 4 counts, exhale for 6-8 counts. Repeat for 5-10 minutes. Even shorter sessions have an effect.

Cold water exposure to the face and neck. The diving reflex, triggered by cold water on the face, is mediated by the vagus nerve and produces a rapid drop in heart rate. Splashing cold water on your face, or using a cold compress on the back of the neck, can provide a quick parasympathetic boost when you're dysregulated.

Humming, singing, and gargling. The vagus nerve innervates the larynx and pharynx. Humming, singing, or gargling activates it. This sounds odd but is well-supported. Even a few minutes of humming can shift your nervous system state.

Slow rhythmic movement. Yoga, tai chi, and walking at a comfortable pace all tend to increase vagal tone over time. The regularity and rhythm matter more than the intensity.

Deep diaphragmatic breathing. When you breathe shallowly into the chest, you keep the sympathetic system activated. Breathing slowly into the lower abdomen activates the vagus nerve and the parasympathetic response.

Building a Daily Vagal Tone Practice

You don't need an elaborate routine. Two or three consistent practices done daily will produce more benefit than an occasional elaborate session.

A simple morning approach: before getting up, spend three to five minutes on extended exhale breathing. This sets a more regulated baseline for the rest of the day.

A midday reset: if you're feeling tense or overwhelmed, step away briefly. Splash cold water on your face, take five slow breaths, or hum quietly for a minute. These micro-practices cost almost nothing and create a genuine physiological shift.

An evening wind-down: slow movement, gentle yoga, or simply sitting and humming while the day winds down signals to your nervous system that threat time is over. This supports the transition into sleep.

Tracking patterns in PeriPlan can help you notice which days feel more regulated, so you can see whether your vagal tone practices are correlating with steadier mood and energy over time.

The Vagus Nerve Is One Piece of the Picture

Vagal tone practices work alongside, not instead of, other support. Hormone therapy addresses the underlying hormonal context. Good sleep, regular movement, and reduced chronic stress all support the nervous system. If anxiety is significantly affecting your life, talking therapy, particularly CBT, has strong evidence.

But adding vagal tone practices to your day gives your nervous system tools to use in real time. When the anxiety surges at 2 a.m., or the heart palpitations arrive out of nowhere, having a physical anchor (a breathing technique, a cold splash, a few minutes of humming) is genuinely useful.

Your nervous system is not broken. It is responding to real physiological change. Give it the conditions to regulate itself, and it will.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.