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Being a woman is great: we have longer lifespans on average, stronger immune systems than men, and let’s not forget that we possess the miraculous ability to create new life! Despite the many obvious differences between men and women, researchers long considered women to be “small men” and neglected to study us as separate beings with unique physiological and psychological needs.
Just as symptoms of a heart attack manifest differently in women, so does our response to stressful events. And considering women are 70% more likely to develop a depressive disorder compared to men, it’s quite evident that there’s room for improvement when it comes to how we manage women’s mental health. So this Women’s Health Month, let’s consider how women process stress and what we can do to achieve mental clarity in the face of a never-ending to-do list.
Why Women Experience Stress Differently Than Men
Stressed-out women were long viewed by clinicians as “hysterical,” and while I loathe that term, there is some truth buried beneath the blatant sexism. Human and animal studies have shown that all else equal, men and women actually experience stress events differently; stressors produce a greater psychological impact on us.1 However, it’s not because our uterus is floating around our abdominal cavity untethered!
The human stress response is mediated through a complex network of communication between the nervous, endocrine, and immune systems: the sympathetic-adreno-medullar (SAM) axis, the hypothalamic-pituitary-adrenal (HPA) axis, and the immune system. At the most basal level, the male stress pathway has less hormone fluctuation than the female’s. Lower hormone concentrations, plus less receptor sensitivity, mean that men often have less dramatic responses to stress.3,4
When men experience a stressful event, a spike in cortisol occurs. Cortisol, a hormone produced by the adrenal glands, is the body’s main stress hormone and exerts its effects within the HPA axis. Once the stressor is resolved, cortisol levels lower back to baseline, and normal homeostatic activity resumes.
Unfortunately, women are hit with a double whammy: we not only excrete more stress hormone when stressed, but our receptors tend to be more sensitive to its presence. And because cortisol floods our system at a higher concentration, it takes longer for the body to metabolize it, allowing effects to persist for a longer period of time. This can result in a more intense psychological response and reduced mental clarity.
Consider this: a man and woman experience the same stressful event, let’s say they both jump from a 15-foot diving board into a pool. From the literal and figurative jump, each of their bodies emit a different amount of cortisol. Because cortisol has a shorter impact on the HPA axis, the man will likely feel the “thrill” of the jump, and then his psyche goes back to normal quite quickly.
The woman in this scenario not only excretes MORE cortisol, but her cortisol receptors produce a heightened response to the hormone, leading to a longer “stressed” period. She’s going to get the same initial “thrill” from the jump, but it will take her body (and mind!) much longer to calm down.
Now let’s factor in socioeconomic differences: it’s well-known that we women typically bear more of the household’s “mental load.” The small task of managing kids’ soccer schedules, maintaining the home, etc., takes a toll over time, and these micro-stressors can accumulate into serious consequences.
With so many checklists and time-management issues floating around in our minds, our thoughts can easily get muddled and feel as chaotic as our outward lives do. Unresolved stress can lead to more ruminative thinking and lower mental clarity. It really shouldn’t be a shock to anyone that women have higher rates of stress-related disorders 5.
What Is Vagal Tone and Why It Matters for Women
Practicing good stress hygiene is a necessary life skill for all individuals. When chronic stress goes unmanaged for long enough, things can go off the rails in a big way. Chronic stress, hormonal fluctuations, poor sleep, and the general chaos of modern life can all reduce what’s called vagal tone, essentially how efficiently your vagus nerve gets you out of “fight or flight mode” and into “rest and digest mode.”
Low vagal tone is associated with increased anxiety, brain fog, poor emotional regulation, and that feeling of being “wired but tired.” However, when the vagus nerve is consistently active and regulated, we can get a really great payoff. Let’s dive into a few ways that women can utilize the vagus nerve to declutter the mind.
How to Use the Vagus Nerve to Improve Mental Clarity
- Box Breathing for Vagus Nerve Stimulation: Slow, controlled breathing is one of the fastest ways to stimulate the vagus nerve. Box breathing is a breathing technique popularized by the Navy SEALS. It can be done anytime, anywhere, and the effects are often noticeable within minutes.
- Practice Positive Thinking: Dwelling on the same problem over and over can cause us to devolve into a mental spiral, a negative thought pattern known as ruminative thinking. When you notice yourself slipping into a ruminative thought loop, shift your attention toward a more constructive or neutral thought.
- Movement and Exercise: What is the best workout? The one you will actually do consistently. Many studies show that it’s not the type of exercise, but the consistency of the exercise you engage in. 30 minutes of walking, yoga, and low-intensity steady-state cardio can have a massive benefit across many quality of life metrics; lowering blood sugar, improving cardiac function, and reducing the incidence of mental health problems.6,7 And these activities have a lower barrier to entry than, say, a marathon or HIIT circuit.
- Social Connection: Humans are wired for connection, especially women. Positive social interactions like laughing with friends, meaningful conversations, and even eye contact can improve vagal tone and allow for the release of oxytocin, the body’s love and bonding hormone.
- Intentional rest: This one may be the hardest to practice, but it’s the most important. Many women operate on a “I’ll rest when everything is done” mindset, but the issue is everything is never Make intentional time throughout your day to rest your mind and your body. Truvaga can be a useful tool for this. It’s a two-minute reset that quickly gets your mind into “rest and digest” mode.
- Vagus Nerve Stimulation Devices: Sometimes, natural vagal stimulation methods aren’t enough. Non-invasive vagus nerve stimulation is almost like “box breathing on steroids.” Truvaga has been shown to reduce symptoms of stress and improve mental functioning with just a one two-minute session
Taking Stress Reduction Seriously
It’s important to remember that women aren’t “overreacting” when it comes to stress. We truly experience it more intensely than men! At the end of the day, the goal isn’t to eliminate stress entirely (that’s neither realistic nor necessary), but to incorporate practices into our day that allow us to keep our minds organized and prevent normal stress from becoming chronic.
When we understand the system we’re working with and stop defaulting to one-size-fits-all strategies that weren’t designed with women in mind, we’re far better equipped to manage our mental health effectively.
So this Women’s Health Month, consider this your permission slip to take stress reduction seriously. Personally, I’ll be celebrating with a massage.
Frequently Asked Questions About the Vagus Nerve and Women's Stress
Why do women experience stress more intensely than men?
Women tend to produce more cortisol — the body’s primary stress hormone — in response to stressors, and their cortisol receptors are more sensitive to it. This means stress hormones remain elevated for longer, resulting in a more prolonged psychological response. Societal factors like carrying a greater share of household mental load can compound this biological difference.
What is vagal tone and how does it affect mental clarity?
Vagal tone refers to how efficiently the vagus nerve shifts the body out of “fight or flight” mode and into “rest and digest” mode. Higher vagal tone is associated with better emotional regulation, reduced anxiousness, and clearer thinking. Low vagal tone — often caused by chronic stress, poor sleep, or hormonal fluctuations — can lead to brain fog and a “wired but tired” feeling.
What are the best ways for women to stimulate the vagus nerve naturally?
Several evidence-informed methods can improve vagal tone: slow, controlled breathing techniques like box breathing; consistent moderate exercise such as walking or yoga; positive social interaction; and intentional rest periods throughout the day. For faster results, non-invasive vagus nerve stimulation (VNS) devices, like Truvaga, can complement these lifestyle practices. Everybody is different, so we recommend trying a few methods out and seeing what works best for your body.
Can vagus nerve stimulation help with brain fog and anxiousness in women?
Yes. Non-invasive vagus nerve stimulation activates the parasympathetic nervous system, which counteracts the stress response. Research on devices like Truvaga suggests that even short sessions can reduce symptoms of stress and improve cognitive functioning. When used alongside healthy lifestyle habits, VNS can help significantly reduce brain fog and anxiousness.
References:
- Austad, Steven N., and Kathleen E. Fischer. “Sex differences in lifespan.” Cell metabolism 23.6 (2016): 1022-1033.
- American Heart Association. “Heart Attack Symptoms in Women.” Www.heart.org, 13 Dec. 2024, www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women.
- Chu, Brianna, et al. “Physiology, stress reaction.” StatPearls [Internet]. StatPearls Publishing, 2024.
- Verma, Rohit, Yatan Pal Singh Balhara, and Chandra Shekhar Gupta. “Gender differences in stress response: Role of developmental and biological determinants.” Industrial psychiatry journal 20.1 (2011): 4-10.
- Albert, Paul R. “Why is depression more prevalent in women?.” Journal of psychiatry & neuroscience : JPN vol. 40,4 (2015): 219-21. doi:10.1503/jpn.150205
- Zheng H, Orsini N, Amin J, Wolk A, Nguyen VT, Ehrlich F. Quantifying the dose-response of walking in reducing coronary heart disease risk: meta-analysis. Eur J Epidemiol. 2009;24(4):181-92. doi: 10.1007/s10654-009-9328-9. Epub 2009 Mar 22. PMID: 19306107.
- Mayor, Susan. “Walking groups improve cardiovascular and general health, study shows.” BMJ 350 (2015).
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