Understanding the vagus nerve at menopause is key for our wellbeing. What is the vagus nerve and whats it got to do with menopause?  The vagus nerve and menopause are both hot topics, but is the vagus nerve at menopause important? You might be wondering what the vagus nerve and menopause are all about. Can you really improve vagal ‘tone’ and what is the impactof the vagus nerve on menopause health.

Vagus comes from the Latin for wandering and is a good name as it travels from the brain to the gut. On its way it connects to the middle ear, vocal cords, heart, lungs, and intestines. The vagus nerve is often referred to as the body’s superhighway, carrying information between the brain and the internal organs and controlling the body’s response in times of rest and relaxation. The vagus nerve is our secret weapon at menopause. When it comes to supporting our physical and emotional health at menopause the vagus neve is key.

Menopause and Stress

At menopause our bodies are going through enormous hormonal shifts which increase physical and mental stress This has had an impact on our mental and physical health. At menopause it is key to make time for ourselves and reduce stress. No hormones function in isolation, they have a knock-on effect. So, stress hormones are closely related to sex hormones, and this causes imbalances especially if sustained for any length of time. The term ‘hormone imbalance’ can be a little misleading as the body’s functions are never static. Our body is always seeking to find equilibrium in an ever-changing internal and external environment.

For example, during our fertile years the sex hormones normally fluctuate at different times of the cycle. The stress hormones are similar ebbing and subsiding when stress is alleviated. This allows our bodies time to recuperate and rest and digest status can return. It is not just the interactions of hormones; the immune system is involved in the stress response. Other factors influence our tendency to stress and anxiety at menopause. The neurotransmitters are affected by low oestrogen and other hormonal changes, making women more susceptible to stress.

The Stress response

Stress triggers the sympathetic nervous system or well known as the  “fight/flight” response which increases our pulse, blood pressure and breathing rate to get blood/oxygen to our muscles to enable us to run away from danger faster and therefore survive. Once the danger has passed ideally, we return to the parasympathetic “rest and digest” mode. This allows our body to replenish itself both mentally and physically.

In modern life not only are we more sedentary, mentally stressed and isolated, stressful events are no longer short-term. We are designed for survival and short phases of acute stress like hunting an animal or even working physically. We experience chronic stress that keeps us in “fight/flight” In this state we cannot easily digest food or produce sex hormones. It causes hormone imbalances that can have drastic effects on women including at menopause. However, Rest and Digest allows our bodies to stop being on alert or in survival mode. read more here 

The Role of the vagus nerve  

The vagus nerve is a key player at menopause in activating the parasympathetic nervous system, the part that is responsible for unconscious processes, like digestion and breathing and heart rate. It helps deactivate our flight and flight response so we can enter the state of “rest and digest.” This restores heart rate and blood pressure, proper digestion, and the gut function because these are all affected by the stress response.

The Social Nervous System

Polyvagal Theory suggests different functions and states. A branch of the nerve activates the ‘social nervous system.’ Social interaction supports the vagal response and helps us build stronger social connections, which in turn support relaxation. During face to face interactions the nervous system interprets the verbal and visual signals and helps with communication. It even guides the tone of your speech, and plays a role in the expression in your face when you respond to others. So, the the vagus nerve supports ‘social engagement’ and allows us to be less guarded. Helping our ability to self-regulate and to connect with others. All of this feeds into our emotional wellbeing.

The Freeze Response

This can happen in extreme circumstances when stress is sustained for long periods and our flight and flight response is overwhelmed. It appears to be a protection mechanism that shuts down the brain, digestive and immune systems. It may contribute to depression, exhaustion, chronic fatigue, chronic pain including irritable bowel syndrome, multiple sclerosis and fibromyalgia.

Hormonal Effect on the Vagus Nerve

Hormones at menopause affect the vagus nerve. Oestrogen tends to increase vagal tone, when measured by its ability to regulate heartbeat. Progesterone is known as brain calming has the opposite effect on the vagal nerve. During the fluctuations in oestrogen and progesterone at perimenopause the vagal tone is likely affected. This might explain our mood changes. Post-menopause when oestrogen is low it may be more difficult to activate the vagus nerve due to hormonal changes.


In addition to increased feelings of stress and anxiety at menopause we lose the anti-inflammatory effect of oestrogen and the risk for heart disease, weight gain and osteoporosis increases. Supporting the vagus nerve helps manage inflammation that chronic stress can cause. This is ultimately what causes the negative effects of stress on our physical and mental health.

We are probably familiar with ways to retrain our brain which can help us be more resilient. But understanding the function of the vagus nerve and how to manipulate it for our good can make this easier to do.

Do you ever have a gut feeling? 

The vagus nerve is the biggest nerve connecting your gut and brain. It sends signals in both directions often referred to as bidirectional. There are approximately 100 billion neurons in the human brain and surprisingly your gut contains 500 million neurons. These are connected to your brain through nerves in your nervous system, they use both brain chemicals, hormones, and immune messengers to communicate with each other.

This large nerve helps to control digestive functions like stomach acid, digestive enzyme production and stimulates gut motility (the muscular contraction that moves our food down the gut it is key in supporting digestion. working on our vagus response can support the negative hormonal effects on digestion at menopause

Blood Glucose

At menopause our sensitivity to glucose can be jeopordised due to hormonal shifts making it harder to control our eating, affecting weight and long term health. Oestrogen and progesterone have an effect on the way insulin works. Insulin is a hormone produced in the pancreas, which helps your body use glucose for the energy and stores surplus for later use. Oestrogen helps to optimize insulin.

So blood sugar control can be problematic during and post menopause. Raised blood glucose is part of the stress response, providing us with energy to run away from danger. But the vagus nerve helps us return to rest and digest, preventing long term blood glucose dysregulation. T

Because the vagus nerve is involved in many body systems affected by our hormones understanding and strengthening this can help us support ourselves better during this transition.

Can you improve the vagus Nerve 

Although the tone of the vagus nerve can be measured it is not an indicator of how well someone manages stress. This is because it responds to the stress response. While relaxing, our vagal tone will naturally be higher than when under mental or physical pressure, then it naturally “shuts down.”

Importantly how we handle stress is rooted in our brain and emotions. Vagal tone is just a reflection of our response at that point in time. So, we need to manage our stress and control our minds This is important but also difficult.

The good news is the vagus nerve is your superpower! It can assist with reducing our fight or flight response. It works by counterbalancing the fight or flight and triggering rest and digest in our body. Learning how it is activated and putting simple practices in place can help us switch off the stress response.

How to Tone the Vagus Nerve


Deep, slow breathing stimulates the vagus nerve and lowers the heart rate. Deep belly breathing is the most effective. Be aware of the rhythmic rising and falling of your belly, this helps the activation. Try making your exhalations longer than your inhalations. Aim to slow it down to 6 breaths a minute. Many activities that cause deep breathing are therefor beneficial like laughing or singing.

Social Interaction Smile and be kind.

It’s a two-way street as emotions can affect vagal tone, but there is also communication coming back. So being friendly, kind  and grateful can strengthen the vagal tone.


All the vagal pathways in the face relate to our connection with others from our eyes, smile, to our voice. Massage around the eyes, ears, jaw, and neck to stimulate the vagus nerve. Massage in general stimulates the vagus and the release of oxytocin from the brain which in turn inhibits the release of stress chemicals.


Gargling with water and splashing your face with cold water. No doubt cold water swimming would also work if you’re brave enough!


The vagus nerve is associated with sleep quality because of its role in promoting a slower heart rate that induces relaxation, and ultimately sleep. We know if we are stressed we just can’t sleep and menopause can cause us to wake up too. Practise good sleep hygiene, try lying on your right side, as this promotes vagal activity as opposed to lying on your back.

Positive social connection and affirmation 

Other activities 

Mindfulness, moderate sun exposure, mindfulness, mediation and movement incorporate relaxing, breathing, gratitude, social interaction and nature. This may be why mindfulness and yoga, and even walking are known to support mental health.

Check out The Basic Vagal Nerve Exercise (from the book Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg) it’s simple exercises to trigger relaxation.https://youtu.be/rbowIy6kONY 

As a holistic nutritionist I inspire women to find their menopause mojo with tailored nutrition and lifestyle advice. I empower them to nourish themselves inside and out, so they feel like themselves again.

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Wilkie L, Fisher Z, Kemp AH. The Complex Construct of Wellbeing and the Role of Vagal Function. Front Integr Neurosci. 2022 Jul 7;16:925664. doi: 10.3389/fnint.2022.925664. PMID: 35875509; PMCID: PMC9301262.