MyMTℱ Blog

Menopause and Shortness Of Breath

Does menopause affect your breathing and lung function 
 especially when you are exercising?

My recent holiday in France was a phenomenal test for my cardiovascular fitness. Hubbie thought it was time to work on his ‘bucket-list’ and follow the Tour de France for a couple of weeks. Every day we were hiking or biking up to the finish line of the race – many of which were on the top of high mountain passes.

I was pleased that I had been working on my post-menopause fitness, especially my cardio-pulmonary (heart-lung) fitness, before leaving home. 

There was a time when I wouldn’t have undertaken a holiday that involved biking up some mountain passes. My heart rate would be racing and I would be struggling to catch my breath. 

Nobody had ever mentioned menopause and the connection to changing lung health to me. 

Hot flashes, sore joints and muscles, mood swings,  night sweats, changes in blood pressure and energy levels as well as weight gain are menopause symptoms commonly discussed. 

But there are many other menopausal symptoms such as changing cardiac health and cardio-respiratory health, which includes our lung function.  Numerous women find that their health is changing in their menopause to post-menopause transition – with or without menopause HRT. Many women who join me on the MyMTℱ programs, become concerned about their health as they get older. Which is why it’s so important that mid- life women are informed about the lifestyle changes they need to make to set themselves up for their healthy ageing.   If this sounds like you, and your breathing difficulties have arrived now that you are in menopause, then read on.

What causes shortness of breath during menopause?

Declining oestrogen levels as women move through menopause may contribute to the loss of elasticity in lung tissue. Essentially, as women move towards post-menopause, the lungs become a bit ‘stiffer’ and this affects lung capacity with increasing age. This is of some concern, because measurement of lung volumes and capacities is considered a key indicator of physical health in older women.

In fact, up to 200mls of precious lung capacity may be lost as we move towards post-menopause. If you find that you are more breathless when you climb the stairs or do your usual exercise, then this could be why.

These lung changes in peri-menopause and again in post-menopause can also contribute to your feelings of anxiety. 

So, as a timely reminder, I want you to stop what you are doing, and take a few slow deep breaths through your nose. When you do this, you will be helping your lungs to expand and fill more deeply. If you’re in menopause then rest assured, deep breathing is an essential part of your self-care for your health – as oestrogen production declines, menopause is associated with accelerated lung function decline [Triebner, Matulonga, Jahannessen et al., 2016].

A number of studies report that lung function declines more rapidly among women who are transitioning through menopause and into post-menopause – in particular, the most important changes occur to our Forced Vital Capacity [FVC].

This refers to the total amount of air exhaled in one breath. I think many of us have felt this change as we’ve moved through our menopause transition. I know that I used to feel that I couldn’t quite catch my breath when I was swimming or jogging. And it’s not only when we are exercising, but also when we are resting. As Diane mentioned,

“I didn’t sleep well last night. It seemed as if I struggled to breathe and I could feel my heart racing as well. The Doctor can’t find anything wrong and I feel exhausted. I know it’s something to do with menopause.” [Diane, United Kingdom].

The email from Diane felt like deja vu. I used to lie in bed and feel that my breathing was more shallow too. Whilst increased stress levels and anxiety can cause our breathing to change when we arrive in menopause, I personally felt that I wasn’t able to breathe in deeply enough to fill my lungs. I also felt I had more phlegm building up overnight. Don’t even mention the snoring!

Who knew that our lungs are affected by lowering oestrogen too? I certainly didn’t.

Many of us never give our lung function a thought as we move through menopause, but for those of you who sit at a desk all day, then it’s important for you to be aware of your changing lung capacity. 

For decades I’ve been a regular exerciser and one of the known benefits of regular exercise is that it stimulates our breathing. But when I began to experience more breathlessness in my early 50’s, especially doing all the high intensity exercise that is promoted to us, I began to get more curious about my lung function and the connection to menopause. 

One of the very first studies to investigate the effect of menopause on lung function in a large population-based survey was undertaken by researchers with support from the Norwegian Research Council.

It’s known as the European Community Respiratory Health Survey and has been going on for a number of years and has only recently followed up with women transitioning through menopause. I’d like to thank them for including nearly 2000 menopausal women and testing them. Because as you can see from the graph above, our lung function declines as we age. 

Part of this decline in lung function is also the reason for women feeling that their anxiety levels are changing as they move into peri-menopause too. If we can’t get enough oxygen around our body to deliver to cells and tissues, then there is going to be consequences of this – including an elevated heart rate and feelings that we aren’t coping. 

As such, there are numerous changes that we have to adjust to and one of these is to improve our lung function. One of the strategies that I teach women on my 12 week programs to do, is to (re) learn how to breathe better.

Researchers have discovered that the lungs play a far more complex role in mammalian bodies than previously thought, especially in middle-age females.

It seems that our lovely lungs don’t just facilitate respiration – they also play a key role in red blood cell production and platelet function, and the health of your bone marrow . All of these areas contain oestrogen receptors and therefore, are affected by menopause hormonal changes.

As such, we have to purposefully focus on regulating our breathing every day and engaging in activities that stimulate our lung function to try to reduce the rate of decline.

Lung function and capacity reduces as we move into menopause.

But there are other causes for poor lung function in mid-life too – poor posture from sitting or standing, as well as belly-fat that sits under the diaphragm.

Many women work in sedentary jobs, hence lung function may also change when we sit hunched over computers or we are sitting at desks throughout our day. If we also have the dreaded fat-roll under the diaphragm as I used to, then this impacts on our breathing too.

Sitting all day prevents your lungs from performing to their best. When we sit, our back is rounded, and the anterior, or front thoracic cage shortens and becomes a bit squashed. This means that the tiny intercostal muscles in between each rib cage are not able to do their job properly.

These smaller rib-cage muscles lose oestrogen too, so as we transition through menopause, they don’t function as well as they used to in expanding our rib cage and lungs with each breath. Over time, this can contribute to loss of lung capacity and cardio-respiratory fitness.  

If this is you, then can you focus on standing up every hour, pulling your tummy muscles in tight and lifting your arms above your head and really getting some function in those ageing lungs of yours?  

Lung Function and Weight Loss

The role of the lungs and how they contribute to our circulation, tissue oxygenation, energy levels and our weight management is more powerful than previously thought. 

When I was trying to lose my menopause belly fat, I began to focus on the physiology that I had taught students for years, and that is that when it comes to tissue oxygenation and fat-loss, our breathing matters.

Fat is ‘burned’ in our lovely mitochondrial cells. Having an efficient respiratory system is fundamental to moving oxygen in and out of your mitochondrial cells. Your breathing, stretching and cardio-respiratory fitness is as important as it ever was as you move through menopause.

Improved breathing helps oxygen to move into your mitochondrial cells. These cells store oxygen. Located deep inside your muscles, lungs and heart, mitochondrial cells are the ‘power-house’ of your cell because not only is oxygen stored in these cells, but this is the location of energy production from fats and glucose.

 

That’s why focusing on your breathing improves fat loss. For women with increased belly fat and diaphragmatic fat, lung expansion can be reduced up to 40%, because of the location of abdominal and diaphragmatic fat accumulation.

When you improve your breathing, then you assist oxygen to move into mitochondrial cells and this means that fat-burning mechanisms are improved too.

Then there are the muscles between your rib cages – these are changing during your menopause transition as well.

We all know that our rib cage protects our lungs, but did you know that between every rib are small muscles, called intercostal muscles? These muscles are also affected by our loss of oestrogen as we age and like other muscles, they lose their elasticity. This makes them less effective, so they need to be stimulated and exercised.

Some of you might even like to do the stretches below. The one over a swiss ball if you attend a gym or have an exercise ball like this at home, is powerful. You can even just do this stretch over a rolled-up towel lying across your upper-back whilst you are on the floor or if you can’t get on the floor, lie on your bed over your pillow. 

If you are hunched over a desk all day or you are in a job that requires you to hunch over a lot, (e.g. housekeeping or nursing) then your intercostal muscle fibres become lengthened at the back of your rib cage and shortened at the front. Over the course of the day, your lung capacity and function might be impaired.

If you are mainly sedentary in your working week, then it would be great if you made a plan to do some aerobic, steady-state physical activity in the weekends and focus on your breathing.

Breathing better is something that we all need to do more of. Menopause is time to focus on your respiratory health.

If exercise and your cardio-respiratory fitness is a struggle and you want to get your fitness back now that you are in your 50s, but don’t know where to start, then when you have time, have a listen to the video below.

It’s about the Rebuild My Fitness 12 week online programme, which is also available for you, either alongside the Transform Me or Circuit Breaker programmes if you have symptoms and/or you are overweight, or purchase the exercise programme on it’s own.

I would love to share with you my 30 years of knowledge and experience as a REPS NZ Exercise Specialist, as you improve your fitness, strength, balance and flexibility during or after menopause.

You can do it online in the comfort of your home, so no gym visits if you don’t want to [although there are programmes you can download to take to the gym as well].

Part-payments for 3 months are available too and don’t forget that the Circuit Breaker and Transform Me programmes are on sale during July with savings of NZ$75 packaged up with my free Masterclass on Menopause.

Please use the promo code STARTMYMT if you purchase to get your NZ$75 discount. And yes, you learn all those important breathing exercises too. I invite you to listen to the video about my exercise programme below. 

Dr Wendy Sweet [PhD]/ NZ Registered Exercise Specialist/ Women’s Healthy Ageing Researcher/ MyMTℱ Founder  Member: Australasian Society of Lifestyle Medicine

References: 

Memoalia J, Anjum B, Singh N, Gupta M. Decline in Pulmonary Function Tests after Menopause. J Menopausal Med. 2018 Apr;24(1):34-40. doi: 10.6118/jmm.2018.24.1.34. Epub 2018 Apr 30.

Sharma, G. & Goodwin, J. (2006). Effect of aging on respiratory system physiology and immunology. Clinical Interventions in Aging, 1(3) 253–260

Triebner, K., Matulonga, B. Johannessen, A. et al., (2016). Menopause is associated with accelerated lung function decline. American J. of Respiratory and Critical Care Medicine, Vol 195(8), pp. 1058-1065. 

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