The author of Yoga and the Wisdom of Menopause answers questions on the subject

Q: What motivated you to write a book on Yoga and menopause?

For the past thirty years my classes have been filled with women who began Yoga during menopause. Many of my early teachers where women who turned to Yoga during menopause. My previous book, The New Yoga for People Over 50, had a chapter on Yoga and menopause that was used as a reprint by teachers for Yoga and menopause workshops and was excerpted on numerous websites. So in addition to my classes with women who were concerned about common menopausal symptoms I received questions and comments about Yoga and menopause from women all over the world. I began to realize that one of the most valuable things a book on Yoga and menopause could do is to let women know they are not alone in how they feel. I learned that even America’s leading Yoga teachers get tired and depressed, suffer from insomnia and need to adjust their practice to cope with common menopausal symptoms like hot flashes. I began writing this book the year that my periods stopped. My Yoga practice became my menopause medicine and I became religious about practicing the Yoga poses described in my book.

Q: Why is Yoga especially beneficial for women going through menopause?

During menopause there is a tremendous shift and release of energy that is both unsettling and liberating. There is a natural, biological movement away from the surface of life, from the dictates and expectations of family and society and an increasing pull inward toward listening to what is really important at the soul level. One of the most common longings during the menopausal transition is for solitude. Consider the deeper implication of the word “men-o-pause.” According to both spiritual teachers and authorities on women’s health, during menopause we are being urged, both biologically (physically) and on a soul level (spiritually), to pause from everyone—to pause from our daily responsibilities –and take some much needed quiet time just to be with ourselves. The practice of Yoga helps us to integrate and cooperate fully with this process. Yoga supports a woman’s physical and spiritual journey through menopause.

Q: Does Yoga help balance the hormonal changes?

A woman’s physical well-being during the menopausal years depends on the healthy functioning of her endocrine (hormone-producing) glands. With all the focus in the media on hormone replacement, it is easy to lose sight of the fact that if all our other glands are functioning well they will, in most cases, continue to produce all the hormones a woman needs for the rest of her life. Yoga helps modulate mood swings and reduce depression and anxiety by helping to balance a woman’s changing hormones. Many of the symptoms commonly associated with menopause, such as irritability, depression, and various aches and pains, are intensified by the inability to cope with stress. The adrenal hormones help us tolerate many of the stresses and burdens of life. However, many women—possibly even the vast majority—enter menopause with their adrenals already exhausted from years of juggling the responsibilities of family and work outside the home. If life has been chronically stressful or if you have been ill, then you have asked your adrenal glands to work overtime and have not given them adequate time to replenish themselves. Practicing Yoga’s relaxing, restorative poses on a regular basis helps ease these symptoms. Equally important, Yoga practice gives you the opportunity to weed out and clear away the mental and emotional debris that is the root cause of many problems associated with menopause.

Q: What else sets Yoga apart from other forms of exercise during menopause?

What sets Yoga apart is the effect Yoga postures and breathing practices have not only on the muscles and bones of your body, but also on your organs and glands. Yoga reduces the effects of menopause’s hormonal changes by balancing the endocrine system. It smoothes out the hormonal and glandular changes that take place during this period. The regular practice of all the categories of poses: standing, sitting, lying down, backbends, forward bends, twists, and inverted (upside down) poses, stimulates and activates all the glands, organs, tissues and cells of the body. Yoga’s inverted poses are particularly important during menopause poses as they have a powerful effect on the neuroendocrine system, allowing fresh, oxygenated blood to flow to the glands in the head and neck. In each Yoga posture (asana) different organs and glands are placed in various anatomical positions and are supplied with fresh blood, gently massaged, relaxed, toned and stimulated. It’s important to bear in mind that all menopausal symptoms are related and using Yoga to ease the unpleasant effect of one symptom generally leads to better health in the rest of the body. Every Yoga pose has a multitude of effects on all the systems of the body.

Q: What are the most important poses for balancing your hormones?

Yoga poses that turn the body halfway or completely upside down such as Standing Forward Bends, Downward-Facing Dog, and various inverted poses stimulate the endocrine system, especially the pituitary gland. This small gland in the center of the brain is involved in the regulation of blood-sugar levels and body temperature, and controls the changes in the hormone levels that occur in menopause. Forward bends also gently compress the abdomen, massaging the uterus and other abdominal organs. When we come out of the pose and release the compression, the organs are bathed in freshly oxygenated blood, and we feel refreshed and rejuvenated. This alternate squeezing and soaking enhances the functioning of the ovaries and the hormones they produce. Forward bends also soothe the nervous system and have a quieting effect on the mind. Yoga’s relaxing, rejuvenating inverted poses and other important restorative poses can break the vicious cycle of adrenal exhaustion, stimulation and fatigue. They smooth out the emotional rough edges common during menopause and give us some much-needed time to be quiet. Yoga poses, such as twists and backbends, improve the functioning of the adrenals, helping them to increase the amount of estrogen in the body. These poses also stimulate the kidneys, promoting healthy elimination of metabolic byproducts.

Q: How does Yoga help create pelvic health? Can you discuss Yoga’s effect on your uterus and ovaries?

Yoga helps create pelvic health by increasing the flow of blood and oxygen to your reproductive organs and restoring your energy reserves while relaxing the nervous system and balancing the endocrine system. Lying Down Bound-Angle Pose, one of the key poses described in Yoga and the Wisdom of Menopause, is considered by many to be one of the most effective poses for both regulating and balancing a woman’s menstrual cycle and relieving symptoms associated with menopause. Blood flow is directed to the pelvis, bathing the reproductive organs and glands and helping to balance hormone function. The pose relieves tension and constriction in the abdomen, uterus and vagina. The centering, balancing effect of Lying Down Bound-Angle Pose helps reduce mood swings, anxiety and depression. This pose is additionally beneficial for those with high blood pressure, headaches and breathing problems.

There are three poses, known in Yoga as restorative poses, that I consider essential to practice daily while crossing the menopausal bridge. They are usually referred to as Supported Lying Down Bound-Angle Pose, Supported Legs-Up-the-Wall Pose and Supported Bridge Pose. It seems fitting to call these three essential poses for the menopausal transition the Goddess Pose, the Great Rejuvenator and the Menopausal Bridge Pose. Supported Legs-Up-the-Wall Pose (known in Sanskrit as Viparita Karani, which means “Inverted Lake”) is practiced with the legs up the wall, pelvis elevated on a bolster or folded blankets. If the legs tire in the straight position, bend the knees and cross the legs, with knees near the wall. This pose stimulates baroreceptors (blood pressure sensors) in the neck and upper chest, triggering reflexes that reduce nerve input to the adrenal glands; slow heart rate; slow brain waves; relax blood vessels; and reduce the amount of norepinephrine circulating in the bloodstream. No aspect of Yoga is more important for women crossing the menopausal bridge than to take time every day to practice at least one of Yoga’s relaxing, restorative poses. Like many women, I have spent my adult life juggling the myriad responsibilities of working outside the home, raising children, caring for animals and doing volunteer work. I was never so grateful to Yoga, especially Restorative Yoga, as during these past perimenopausal years. My Yoga bolsters, blankets and sticky mat were always in view. I became religious about practicing on a daily basis, no matter how busy I was. No matter how tired or cranky I feel, even a short Yoga session works wonders, especially when practiced with the help of props. I tell my students that Yoga bolsters are my “menopause medicine”. “And,” I add, “you will not hear about a study ten years from now saying bolsters are bad for you!”

Q: Can Yoga help with hot flashes?

Yes – Yoga and the Wisdom of Menopause explains how Yoga postures may relieve hot flashes, night sweats and other common symptoms. Yoga’s classic Shoulder stand and various safe variations have long been valued for their cooling and calming effects. My students tell me these postures are an effective antidote to hot flashes and other common symptoms. Supported inverted poses and supported backbends are especially nourishing and rejuvenating during this time. All upside-down poses, according to your ability to practice safely, are recommended before, during and after the menopausal years. For centuries, classic inverted postures, especially the Shoulder stand, Plow Pose and Downward-Facing Dog Pose, as well as various relaxing forward bends and restorative poses, have been valued for their cooling, calming effect on the mind and nervous system. On a more subtle level, inverted poses affect the flow of prana—or life-force energy—in a way that can help counteract hot flashes. Inverted poses draw prana inward, toward our vital organs and the body’s core, and away from the surface (the skin). According to some theories, during hot flashes, prana is flowing outward from the body’s center, heating the skin. Supported Legs-Up-the-Wall Pose, Supported Shoulder stand, the Shoulder stand variation known as Niralamba Sarvangasana, Supported Half-Plow Pose (Ardha Halasana) and Downward-Facing Dog Pose are all inverted postures recommended by Yoga practitioners as helpful in mitigating the effects of hot flashes. Lying Back Over a Chair or Backbender (Viparita Dandasana) and Supported Bridge Pose are some of the other poses associated with cooling hot flashes.

Q: Can Yoga help prevent osteoporosis?

Yoga is one of the few exercise systems in which weight is borne through the entire body. In weight-bearing standing poses, inverted poses, active backbends and various arm balances, weight is systematically applied to the bones in the hands, arms, upper body, neck and head, as well as the feet and legs. Inverted weight-bearing Yoga poses such as Handstand, Right-Angle Handstand, Elbow Balance, Headstand and Downward-Facing Dog—where the bones in the arms, wrists and hands are strengthened by supporting the weight of one’s body—all work to prevent osteoporosis and other problems related to a weak skeletal structure. These poses help strengthen the arms, upper body and upper spine. Yoga’s upper-body weight-bearing poses help preventing hairline fractures in the vertebrae, which cause the upper-back curvature common to older people in our culture. Because Yoga postures are learned gradually, the weight applied to the bones increases safely and incrementally, as the student becomes stronger and can hold postures for longer periods.

When the back becomes rounded, it compresses the chest and causes shallow breathing, which limits the amount of oxygen the body’s cells receive. This collapsed posture contributes to cardiovascular and other health problems. Yoga counteracts and reverses all these changes, and prevents or corrects the most visible sign of osteoporosis — the shortening and rounding of the spine. Poor posture and the degeneration of the spinal column affect the health of every system of the body. Not only do a rounded spine and collapsed chest restrict breathing, but they also interfere with the vital flow of blood and nerve impulses to internal organs. In this way, poor posture interferes with digestion and elimination. According to Dr. Christiane Northrup decreased height is not always the result of bone loss. Years of poor posture, lack of stretching or feeling weighed down by life’s burdens can also make a woman shorter than she once was. Some height loss results from the shrinking of spaces between vertebral discs, even when bone density is good. Dr. Northrup observed the least height loss in her patients who regularly practiced Yoga. I believe this is because Yoga helps keep the space between the vertebrae open, plump and supple. Many of my older students report that after practicing Yoga for a while, they regain their youthful height. Similarly, when students who have experienced some height loss stand very tall and strong, the height loss is not noticeable.

When we are under stress, our blood becomes slightly more acidic, which, over time, removes calcium from the bones. When we are more relaxed, our blood becomes more alkaline and doesn’t loose as much calcium. The stress-reducing benefits of Yoga can also help prevent osteoporosis.

Q: Your book has a chapter on women and heart disease. How does Yoga benefit the health of the heart?

The most important task of the cardiovascular system is to supply blood to the brain. Inverted poses help strengthen the heart, increase blood flow to the brain and may prevent the death of brain cells. According to Yoga experts, passive, supported backbends gently stretch the heart muscle and the cardiac vessels that supply the heart. This increases blood flow to the heart and helps prevent arterial blockages. Backbends also help maintain the elasticity of blood vessels, and force the heart to contract—lengthening cardiac muscle and enhancing blood flow.

Stress is now considered a significant contributor to poor health and an important factor in the development of heart disease, cancer and many chronic and acute diseases. Most modern-day stress reduction techniques have their roots in Yoga and its emphasis on the breath and deep relaxation.

Our everyday posture—the way we sit, stand and walk—affects our respiration, circulation and the health of the heart. Chronic slouching decreases circulation to all the vital organs. One of Yoga’s most immediate effects is improvement in our posture. The body almost sighs with relief as the chest opens and the breath flows freely. Standing poses, backbends and inverted poses open the chest and expand the breathing process. Upward and Downward Dog, both from the floor and with the aid of wall ropes, stretch the muscles of the front of the body, expand the chest, increase breathing capacity, and strengthen the back, chest and shoulder muscles.

Q: What are the most important poses to practice for heart health?

The most important poses for heart health are:

Supported Lying Down Hero Pose (Supta Virasana) The chest opening in this restful, supported variation of the classic pose is particularly beneficial for the heart. Supported Lying Down Hero Pose helps prevent arterial blockages by gently massaging and strengthening the heart and increasing coronary blood flow. It stretches the abdomen, aids digestion, relieves acidity and flatulence and is one of the few poses that can be done after a heavy meal. This pose also helps relieve discomfort and swelling in the legs and feet and helps prevent varicose veins. All standing poses are useful for increasing circulation in the heart and throughout the body. Lying Down Hero Pose, Supported Bridge Pose and backbends such as Lying Back Over a Chair and Upward Facing Bow (Urdhva Dhanurasana) are among the postures most noted for their effect on the health of the heart.

The Yoga and Menopause Practice Guide in my book is based on a style of Yoga known as Iyengar Yoga. I think it helps if the teacher herself is a woman who is going through or has gone through menopause. Women who begin Yoga during menopause are advised to seek out a class appropriate to their level —one that emphasizes good body alignment and has available props to help ensure the integrity of the spine. Props are invaluable for teaching students how to lengthen the spine and create space between the discs—which is important if women have concerns about osteoporosis. I highly recommend finding a teacher who is trained in Restorative Yoga and who can help you modify poses so that they are safe and nourishing for you.

Menopause is indeed a wake-up call to take care of ourselves. Or, as a doctor friend of mine used to say, “Either take time to be healthy or take time to be sick.”

About Suza Francina

Suza began teaching Yoga in 1972. She is a pioneer in the field of teaching Yoga to people at midlife and older. Her first book Yoga for People Over 50, was published in 1977. She is the author of The New Yoga for People Over 50 (Health Communications, Inc., 1997); Yoga and the Wisdom of Menopause (HCI, 2003); and The New Yoga for Healthy Aging (HCI 2007). She is currently completing a spiritual memoir: Autobiography of a Yogini.