Menopause-related symptoms such as hot flashes, night
sweats, and fatigue negatively affect the quality of life of millions of women.
Can yoga offer relief? Yes and no. According to two
recent studies, regular yoga practice may relieve some symptoms of menopause,
but not others.
To get a deeper understanding of the effects of yoga on
menopausal symptoms, a multidisciplinary group of researchers conducted a large
clinical trial to examine the unique benefits of yoga when compared to exercise
or no activity, in addition to taking an omega-3 supplement or a placebo.
Study participants included 355 peri- and postmenopausal
women aged 40-62 years, who were randomized to one of three groups: yoga (107
participants), exercise (106), or usual activity (177). These women were also
randomized to receive either 1.8g/day of an omega-3 supplement (177) or an
olive oil placebo capsule (178).
Those in the yoga group attended weekly, 90-minute yoga
classes and were asked to complete a home practice daily for 20 minutes. Yoga
practices entailed “cooling” pranayama, 11-13 asanas,
and yoga nidra (guided meditation).
The exercise group engaged in 40-60 minute personal
aerobic training sessions, three times per week. Their aerobic output was
monitored to ensure that their energy expenditure was consistent.
Women in the usual activity group were asked to engage in
their typical behavior, and to refrain from beginning a new exercise regimen or
taking yoga classes.
Yoga Boosts Quality of Life and Sexual Function
In the first study, published in Menopause,
authors examined changes in the frequency and perceived bother of vasomotor
symptoms (hot flashes and night sweats) by group (yoga, exercise, or usual
activity controls). No differences were found for vasomotor symptoms, however,
women in the yoga group reported modest improvements in sleep quality and a
reduction in insomnia and depressive symptoms.
In the second study, recently published in American
Journal of Obstetrics and Gynecology, authors focused on women’s
self-reported quality of life (QOL)
Study participants were asked to complete the Menopause
Quality of Life (MENQOL) measure, and questionnaires regarding sleep quality,
stress, pain, enjoyment of life, activity, sexual function, depressive, and
anxiety symptoms, and hot flash interference with daily activities at the
beginning of the study and after the 12-week intervention.
Compared to the usual activity group, those in the yoga
group reported improved quality of life (QOL) and better sexual function and
less hot flash interference compared to controls after the 12-week program.
These changes were not observed for the exercise or omega-3 groups compared to
controls. Members of the exercise group reported improvements in their physical
quality of life.
It is important to note that the first study published in Menopause reported
no effects on vasomotor symptoms, while the second study indicated modest
improvement. The initial study examined the frequency of hot flashes and night
sweats (average number of occurrences). The second study examined women’s
subjective experience of whether hot flashes affected their activities.
When evaluating any study it is important to note what
was measured and how, as well as the types of yoga practices that were
employed. At present, findings from yoga research are hampered by the
inconsistency of the types of practices used, and the ways in which researchers
measure their outcomes of interest. As such, most studies should be interpreted
with a certain degree of caution.
Relative to the study published in American
Journal of Obstetrics and Gynecology, the authors concluded that,
“relative to usual activity, a 12-week program of yoga somewhat improved
menopause related QOL and reduced the extent to which hot flashes interfered
with a woman’s daily function among women with VMS, but that exercise and
omega-3 supplements had no effect on these measures. Among the individual
MENQOL domains, we found modest benefit for VMS and sexual function domains
from the yoga intervention and benefit for the physical domain for the exercise
intervention.”
The Complexities of Menopause
Their findings draw attention to the fact that menopause
and its symptoms are complex. Hormonal changes lead to a cascade of physical
and emotional adjustments that are often experienced as destabilizing and
distressing. They can profoundly affect a woman’s physical, psychological, and
psychosocial landscape.
While conventional therapies address specific correlates
of these symptoms, they fail to address a woman as a holistic system in which
factors including diet, relationship quality, employment, and social support
influence her ability to successfully navigate this change.
Symptoms of
Menopause and Related Yoga Prescriptions
Here are descriptions of the most common symptoms and
specific recommendations for taming them.
Hot Flashes
One of the most common (and mysterious) symptoms; nearly
80 percent of all women experience them during perimenopause. Characterized by
a rise in core body temperature coupled with a rapid pulse rate, these “power
surges” produce a blushing that begins in the face and spreads down the neck
and arms. Hot flashes can disappear as quickly as they appear, often leaving a
woman feeling chilly and clammy as her body tries to correct the temperature
fluctuation.
No one really knows what causes hot flashes, although
theories abound. Some say the hypothalamus plays an important role; another
possibility is that the hormonal fluctuations in the body irritate the blood
vessels and nerve endings, causing the vessels to overdilate and producing a
hot, flushed feeling. Most researchers (as well as many menopausal women) agree
that stress, fatigue, and intense periods of activity tend to intensify these
episodes.
Experts suggest incorporating more cooling and
restorative poses. Any gripping or tension in the body can make hot flashes
worse, so using props such as bolsters, blankets, and blocks to help support
the whole body is a good idea. Placing the head on a bolster or chair during
forward bends, for example, helps calm the brain and relax the nerves.
Supported reclining poses can also help promote complete relaxation. Supta
Baddha Konasana and Supta Virasana, for instance, allow the abdomen to soften
and any tightness in the chest and belly to release; Ardha Halasana (Half Plow
Pose) with the legs resting on a chair calms jittery nerves.
Headaches and
Migraines
Migraines and headaches are probably the most disruptive
of all menopause symptoms. You know the feeling. You have to take care of the
family, go to work, or scratch ten things off your “to-do” list. But the pain
is unbearable.
Menopause migraines are all too common as the hormonal
changes take over. What triggers your headaches? Maybe stress, anxiety, certain
foods, or lack of sleep? There are a variety of products and treatments to help
ease the pain, but yoga can be the right natural solution for you.
Headaches during menopause can often result from tight and contracted muscles in your head, neck, and back. Or from high levels of stress. There are numerous health benefits of yoga, as a simple yoga routine can produce a calming effect on the nervous system and reduce stress. Yoga can provide relief from sensory overload. Relax your mind so that your body can effectively combat the pain of menopause migraines and headaches.
The Child’s Pose is ideal to calm your emotions and nerves. Blood gently flows to your head and helps relieve the tension that can cause menopause headaches and migraines. Supported with a good bolster or blankets, the Child’s Pose is a basic yoga position and provides an escape from your everyday demands.
Anxiety, Irritability, and Insomnia
During perimenopause, estrogen spikes (or progesterone
plummets), causing anxiety, nervousness, and irritability. Adrenal glands that
are exhausted and overtaxed can also produce bouts of anxiety and intense
irritability. (Many alternative healers believe that the adrenals can wear
themselves out by constantly responding to stress, a poor diet, and lack of
sleep.)
When a person is under stress, the sympathetic nervous
system responds by accelerating the heart rate, slowing down the muscles of the
digestive tract, and increasing blood circulation to the brain to fight the
stressor.
Once the stress dissipates, the parasympathetic nervous
system responds by doing just the opposite-slowing the heart rate back to
normal, stimulating the smooth muscles of the digestive tract, and bringing the
body’s systems back into balance.
When the body is under continual stress, the sympathetic
nervous system and the adrenals-which manufacture stress—fighting hormones
along with the male hormones that get converted into estrogen—can get stuck in
overdrive.
Forward bends, such as Uttanasana (Standing
Forward Bend) and Prasarita Padottanasana (Wide-Legged Standing
Forward Bend)—in both cases with the head resting on a bolster or blankets—can
help reduce irritability and mental tension, because bending forward and
shutting out external distractions and stimuli can soothe the mind and reduce
the effects of stress. The nervous system then receives the signal that all is
well, and the adrenals and sympathetic nervous system stop working so hard.
If insomnia is a problem, inversions can sometimes help,
because they ground the body’s energy and burn off excess anxiety. When
followed by restorative postures, they encourage a deep state of rest.
Fatigue
Of all the symptoms women complain about during
perimenopause, fatigue is second only to hot flashes. Plunging progesterone
could be the culprit, especially if the fatigue is coupled with depression and
lethargy; if a woman feels inexplicably weary for days or weeks on end,
depleted adrenal glands could be part of the problem.
Either way, gentle supported backbends are recommended,
because they encourage the chest and the heart to open and often bring renewed
energy, determination, and joy. One of the proper examples for this is Supta
Baddha Konasana. A deeply restorative posture, it can instill feelings of
safety and nourishment. It also opens the chest, improves respiration and
circulation, and helps lift the spirits while completely supporting the body.
Depression and Mood Swings
Menopause signals the end of the childbearing years; for
many women, it is a time to mourn the end of their youth. Long periods of fatigue,
coupled with a melancholy attitude or a sense that the life they once knew is
now over, can trigger bouts of depression. Too much progesterone (or a drastic
drop in estrogen) can also contribute to everything from a bad case of the
blues to severe clinical depression.
But yoga practitioners have long known that everything
you do with your body can affect your thoughts and attitude. Sometimes
something as subtle as a shift in posture can lighten a dark mood. If a woman
stands tall, with dignity—opening and broadening her chest—and walks with
confidence, she announces to the world (and, most important, to herself) that
she is grounded, happy, and in tune with her surroundings.
Specific poses were confirmed to create a mental state
that positively affects the mind. Backbends, especially if supported, allow a
sense of lightness into the body. They stimulate the adrenals and massage them
into action. Also, the heart and lungs open and take in more oxygen. Chest-expanding
poses energize the body by improving respiration and circulation, and thus
counter feelings of depression. And many yogis have discovered that inversions,
such as Sarvangasana, can help improve a depressed mood. By turning everything
upside down, inversions influence your emotional being in a positive way.
Memory
At times during menopause, some women suddenly lose their
train of thought or find themselves unable to organize their thoughts. This
“fuzzy” thinking often happens at moments of great hormonal fluctuation. Girls
going through puberty, pregnant women, and those who have just given birth
often suffer similar levels of fogginess. Many women find that yoga helps clear
the cobwebs, especially if their condition is exacerbated by lack of sleep or
increased agitation. The same postures that counter depression, such as
backbends, chest openers, and inversions, can help collect fragmented thoughts.
Chair Yoga
While there are many yoginis are able to improve their lifestyle
and ease difficulties of navigating through numerous menopause symptoms, for
some, it is still not acceptable for some menopausal woman. It might be physically
challenging for the beginners mid-life women, who has never been physically
active and not used to the intensive exercises. If that is a case for you, do
not jump into the water, as that might be difficult and discouraging at the
beginning. Start from small steps on your way to the better health. Start with
Chair Yoga. While having numerous health benefits, it is suitable for any
physical conditions, and is a good starter do break through the psychological
barrier.
Please review the video presentation (the session is just
3 minutes):
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