Nature Therapy and Forest Bathing for Perimenopause: What the Research Shows

Why Nature Has More to Offer Than Fresh Air

Spending time in nature has been understood intuitively as restorative for as long as humans have been stepping away from crowded spaces to find relief. What has changed in recent decades is the scientific investigation of why this is true, and the findings are more specific and more interesting than fresh air alone can explain. Nature therapy, and its Japanese variant shinrin-yoku or forest bathing, has generated a body of research that measures physiological rather than simply psychological outcomes.

For women in perimenopause, this research is particularly relevant because the physiological mechanisms that nature exposure appears to affect, cortisol regulation, autonomic nervous system tone, immune function, and mood, are exactly the systems that perimenopause disrupts. Understanding what the research actually shows, rather than simply accepting the general wellness claim that nature is good for you, gives you a clearer picture of how to use time in nature intentionally as part of your perimenopause management.

The Research on Cortisol Reduction from Time in Nature

Cortisol, the primary stress hormone, is measured in saliva, blood, and urine as a marker of HPA axis activation. Multiple studies have compared cortisol levels before and after time spent in forest environments versus urban environments, with consistent findings: forest environments produce significantly greater cortisol reduction.

A frequently cited series of studies from Japanese researchers, including work by Qing Li and colleagues at Nippon Medical School, found that two-hour walks in forested areas reduced salivary cortisol by measurably more than equivalent walks in urban areas. The effects were not trivial; cortisol reductions in the range of 12 to 16 percent compared to urban baseline have been found across multiple studies. What is particularly interesting is that these effects appear even when controlling for physical activity, meaning the environment itself, not just the exercise, contributes to the cortisol reduction.

In perimenopause, where cortisol dysregulation is implicated in hot flash severity, sleep disruption, and the heightened anxiety many women experience, a reliable and accessible method of cortisol reduction has real practical value. Nature time is not a replacement for other management strategies, but its low cost, availability, and the additional benefits it carries make it worth building into your regular routine.

Phytoncides: The Tree Chemicals You Are Breathing

One of the more surprising findings in forest therapy research is the role of phytoncides, volatile organic compounds released by trees and other plants as part of their own immune system. Phytoncides include compounds like alpha-pinene and limonene, which are responsible for the characteristic smell of forests, particularly coniferous ones.

Research by Qing Li and others has found that inhaling these compounds affects human immune function measurably. Studies on forest bathing found increases in natural killer (NK) cell activity following forest visits, with some studies showing effects that persisted for up to a week after a multi-day forest stay. NK cells are part of the innate immune system and play a role in surveillance against infection and cancer.

In perimenopause, immune function changes are a real though less-discussed aspect of the transition. The autoimmune diseases that are more common in women tend to either first appear or change in activity during the perimenopause-menopause transition. While forest bathing is not an immune treatment, supporting immune function through accessible, enjoyable activity is a reasonable complementary strategy. The phytoncide research is one of the more compelling explanations for why forested environments seem to offer something beyond what parks without trees or urban green spaces can fully replicate.

How Nature Affects Mood Differently Than Indoor Relaxation

The mood benefits of time in nature are distinguishable from those of indoor relaxation in ways that have been documented in controlled research. Attention restoration theory, developed by researchers Rachel and Stephen Kaplan, proposes that natural environments restore directed attention capacity in ways that urban environments do not. The claim is that natural environments engage involuntary attention, the kind of diffuse, effortless noticing you do when watching leaves move or listening to water, which allows directed attention circuits to recover from fatigue.

For perimenopausal women who often report cognitive fatigue, brain fog, and difficulty concentrating, the restoration of directed attention is not a trivial benefit. Research on attention restoration theory has found that even brief exposures to natural environments, as short as twenty minutes, improve performance on attention tasks and reduce self-reported mental fatigue.

The mood effects of nature exposure also include reductions in rumination, the repetitive negative thinking pattern that is strongly associated with depression and anxiety. A study from Stanford found that participants who walked in natural environments showed less neural activity in the subgenual prefrontal cortex, the brain region associated with rumination, compared to those who walked in urban environments. For perimenopausal women who find that anxiety and rumination are features of their transition, this is a practically significant finding.

How Little Time Is Needed to See Measurable Effects

One of the most practically useful findings in nature therapy research is that meaningful physiological effects can be observed with relatively modest exposure. You do not need to live near wilderness or carve out entire days to benefit.

A frequently cited threshold in the research is two hours per week in natural environments. A 2019 study published in Scientific Reports found that people who reported spending at least two hours per week in nature had significantly better health and wellbeing than those who reported no nature contact, with the association holding across age, gender, socioeconomic status, and physical health. The two hours did not need to be in a single block; multiple shorter visits across the week appeared to provide similar benefits.

For the specific physiological effects of forest bathing, some research suggests that twenty to thirty minutes in a tree-dense environment is sufficient to produce measurable cortisol reduction and parasympathetic nervous system activation. This is an accessible time commitment for most people, particularly when it can be built into an existing walk or commute rather than requiring a separate dedicated trip. The research does suggest that forested environments outperform parks with few trees, and parks outperform street-level urban environments, so if you have options in terms of where to spend your outdoor time, forested areas appear to provide a stronger dose.

What Forest Bathing Actually Means as a Practice

Shinrin-yoku, translated literally as forest bathing or taking in the forest atmosphere, is a practice that originated in Japan in the 1980s as a public health initiative. It is distinct from hiking or outdoor exercise in that the primary intention is sensory presence rather than physical destination or achievement. You are not trying to cover distance or reach a summit. You are moving slowly through a natural environment while engaging all your senses.

A simple forest bathing practice involves finding a forested area, leaving your phone in your pocket or bag, and walking at a slow, aimless pace while deliberately attending to what you can see, hear, smell, and feel. The instruction to leave your phone away is not arbitrary; research shows that even having a phone visible, even without looking at it, reduces cognitive restoration. The practice works through immersive sensory attention, not through physical effort or information consumption.

Certified forest therapy guides are trained to lead groups through forest bathing practices, using invitations and activities that support sensory engagement. The Association of Nature and Forest Therapy offers a guide directory if you want to try the practice in a guided format first. But the practice is also entirely accessible on your own with nothing more than access to a forested area and the intention to move slowly and attend to your surroundings.

Making Nature Therapy a Regular Part of Perimenopause Management

The challenge with nature time as a health practice is the same as with many other beneficial activities: it requires prioritization in a life that likely already has competing demands. The research on habit formation suggests that attaching new behaviors to existing anchors, existing routines that reliably happen, makes them significantly more likely to persist.

If you already walk for exercise, shifting some of those walks to a more natural setting, a park with mature trees, a trail near your home, or even a tree-lined path rather than a street route, costs you no additional time while increasing the nature exposure benefit. If you commute and have options along your route, spending twenty minutes in a nearby park before or after commuting provides the minimum effective dose without requiring a separate trip.

Seasonal variation matters for this practice. If you live in a climate with cold winters, having an indoor plant-rich environment and planning lower-barrier nature activities like short nature walks when outdoor conditions are difficult helps maintain the habit year-round. Research on indoor plants shows modest but real effects on mood and stress reduction, suggesting that even bringing natural elements into indoor environments has some benefit when outdoor access is limited.

Tracking how you feel on days when you spend time in nature versus days when you do not is the most direct way to build personal evidence for whether this practice is serving you. Like other perimenopause management strategies, the goal is building a pattern of practices that cumulatively support your wellbeing, and nature time is one of the most accessible and lowest-cost options in that toolkit.

Combining Nature Therapy with Other Evidence-Based Practices

Nature therapy combines particularly well with other perimenopause-relevant practices. Walking in nature simultaneously provides gentle exercise, which has independent evidence for symptom management, and the nature exposure benefits described above. Outdoor meditation, bringing a mindfulness practice into a natural setting rather than indoors, appears to amplify the benefits of both based on the available, if limited, research on this combination.

Walking with a friend in nature combines social connection with nature exposure, both of which have independent evidence for mood and wellbeing. This pairing may be particularly useful for women who find that both isolation and sedentary indoor time worsen their perimenopause mood symptoms.

Acupuncture, meditation, creative practice, and nature therapy all represent low-risk, relatively accessible practices with growing evidence bases for stress and mood in the perimenopause context. None of them require abandoning conventional medical care, and none of them are likely to interfere with hormone therapy or other medical treatment. Building a perimenopause lifestyle that incorporates several of these practices alongside appropriate medical support creates a more stable foundation than any single approach alone.

Medical Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Nature therapy and forest bathing are complementary practices and are not replacements for medical care for perimenopause symptoms. If you have health conditions that affect your ability to exercise or spend time outdoors, please discuss this with your healthcare provider. Do not delay seeking medical care based on information in this article.