Even if you make over your environment and do your best to avoid triggers, you may still experience hot flashes with the menopause transition. But what can you do?
When you feel a hot flash coming on, try paced breathing. This type of breathing is slow, deep diaphragmatic breathing. With normal breathing, you take about 12 to 14 shallower breaths a minute. With paced breathing, you take only five to seven breaths a minute. And the paced breaths are intentionally slow, smooth and deep enough to move your diaphragm — the muscular wall located beneath your lungs. The goal of paced breathing is to reduce the stress chemicals that your brain processes and bring about a relaxation response within your body.
A Mayo Clinic study shows that practicing paced breathing twice a day for 15 minutes seems to be most helpful, rather than just reverting to this technique only when you’re having a hot flash. This breathing exercise is a nice, relaxing way to start and end your day. If you get in the habit of practicing paced breathing before you brush your teeth every morning and night, it will become part of your routine.
It may take some practice to get the hang of the technique. To practice diaphragmatic breathing:
- Sit or stand comfortably with your hand on your belly and pay attention to your breathing.
- Imagine filling a cup with water when you inhale.
- As if filling a cup from the bottom up, fill your lower lungs and then your upper lungs by expanding your belly and moving your diaphragm.
- Pay attention to the movement of your belly under your hand as you inhale.
- During exhalation, reverse the process and empty the cup from the top down.
- Empty your upper lungs first and then the lower lungs.
Once you’re comfortable with diaphragmatic breathing, focus on establishing a slow rhythm or pace. To start, you might try to make each inhalation and exhalation last for four or five seconds. You may need to count as you breathe in and out. (Breathe in, 2, 3, 4. And breathe out, 2, 3, 4. In, 2, 3, 4. Out, 2, 3, 4.) Over time, slow your breathing into a comfortable pace that equals out to five to seven breaths a minute.
Follow the instructions in this video to try slow, relaxed breathing.
Dr. Suneela Vegunta talks about other ways to manage hot flashes in this short Mayo Clinic Minute video.

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The New Rules of Menopause
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