Women's Life stages: yoga as therapeutic

Therapeutic Baseline Facts:

• Exercise & Estrogen
• vigorous exercise reduces estrogen levels and can lead to scanty periods or loss of periods. This has negative repercussions on the bony structure of the body.
• bone loss and calcification can be reversed or managed by the introduction of a slow, isometric practice like yoga in conjunction with a vigorous athletic regimen.
• During OVULATION there is an increased risk of muscle and connective tissue damage (estrogen is high), and lowest when estrogen is down (period through day 14). This is because women with high levels of estrogen can stretch further, but risk injury. 
• Pregnancy
• Shift in practice should be for the health of baby and mother instead of advancing practice
• First Trimester
• women who have a history of miscarriage, cervical insufficiency should not start yoga practice or should abstain from their normal practice during this period
• estrogen and progesterone balance that may effect practice prescriptions
• progesterone prohibits contraction of the uterus and estrogen increases it. High levels of progesterone in the early stages of pregnancy increase as pregnancy progresses
• Muscles, joints, ligaments and tendons in pregnancy
• relaxin opens the joints and softens the ligaments and tendons
• joints are destabilized
• over-stretching is a constant danger (worst in pregnancy)
• affects FEET the most (falling arches due to relaxin) -caution
• abdominal muscles severely stretched. Asana practice should not encourage this late in pregnancy especially if abdominal wall is diaphanous 
• no contraction of the abdominal wall either.
• Inversions
• no indication that if done safely with consideration of added weight, increased instability and potential for higher blood pressure that these are counter-indicated, despite yoga literature
• Balancing
• as weight increases, standing on one leg should be AVOIDED, since it may result in injury based on lack of stability in joints
• well supported standing postures are indicated  to avoid leg cramps due to lack of calcium.
• Respiratory and cardiovascular systems
• in response to the added pressure that the growing fetus places on the ribs and diaphragm, respiration rate increases
• soft tissues of the nose swell due to increased estrogen making breathing through the nose more difficult
• need to use intercostal muscles MORE as pregnancy progresses 
• slower breathing is beneficial
• mouth breathing may be an appropriate accommodation
• Inferior vena cava
• pressure of growing baby tends to trap blood in the legs and lead to swelling and potentially varicose veins
• inversions can be very beneficial here!
• reduces constipation which can be caused by pressure of the fetus on the intestines as well
• can compress when mother lies on her back for a long period of time, so modifications (right anterior side of the spine) especially after month 5
• lightheaded, nauseus, dizziness (so much blood is taken out of circulation)
• avoid this is asana or savasana even if mother feels no ill affects (may be to fetus)
• Nervous and digestive systems
• progesterone levels increasing and higher levels of relaxin lead to constipation and indigestion
• prescribe postures to do this without deep twisting
• Sciatica
• pressure from baby
• Menopause
• decreasing estrogen: hot flashes, mood swings, night sweats, depression, urinary problems, vaginal dryness, aching joints, reduced libido, weight gain
• adrenal and kidneys can make up much of this estrogen production if they are healthy or unstressed
• twists, and backbending!!!!
• oseoporosis
• decreased through premenapausal practice
• muscle loss reduced with yoga
• hot flashes are an activation of the sympathetic nervous system. Anything that can reduce this will reduce hot flashes
• cooling pranayama
• cooling inversions
• lower heart rate and blood pressure and promote vasodilation
• stabilize hormonal imbalance
• relaxation for sleep disturbance
• disturbed sleep & libido

examples of postural prescriptions:

Hot Flashes:

• 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.

Anxiety, Irritability, and Insomnia:

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.

• 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.

• gentle supported backbends, because they encourage the chest and the heart to open and often bring renewed energy, determination, and joy.
• 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:

• specific poses create a mental state that positively affects the mind. 
• “Backbends, especially if supported, allow a sense of lightness into the body,” she says. “They stimulate the adrenals and massage them into action, the heart and lungs open 
• Chest-expanding poses energize the body by improving respiration and circulation, and thus counter feelings of depression. 
• inversions, such as Sarvangasana, can help improve a depressed mood. 

Memory:

• The same postures that counter depression, such as backbends, chest openers, and inversions, can help collect fragmented thoughts
• Adho Mukha Svanasana (Downward-Facing Dog Pose) sends blood to the brain and encourages deep, focused breathing, which can improve mental alertness. 
• Savasana (Corpse Pose) soothes the nerves, calms the mind, and puts the body into a state of repose.

summary of yoga and menopause studies