A Woman's Balance: Inversions and MenstruationMary P. Schatz, M.D. 6/25/2002
Yoga teaches us balance: balance of the body in relation to gravity; balance of the mind between action andobservation; and balance of the neuroendocrine system between stress and relaxation. Through a regular yoga practice we learn which poses are effective in re-establishing balance in some aspect of our existence. In this ancient discipline as taught by B.K.S. Iyengar, there are poses that are particularly useful during the menstrual period. These poses ease menstrual cramps, heavy bleeding, pelvic discomfort and the low back pain associated with menses They are also effective in smoothing out the emotional rough edges some women encounter at this time of their cycle.
Geeta S. Iyengar, Mr. Iyengar's daughter and a yoga teacher at his Ramamani Iyengar Memorial Yoga Institute in Poona, India, has a particularly strong interest and great experience in yoga for women. Recommendations on the poses in this article are from Geeta's basic principles.
Just as some poses are helpful at period-time, other poses should be avoided. Many women ask if these recommendations stem from a cultural tradition that is sexist, and yoga teachers are often reluctant to tell menstruating students not to participate in parts of the class, lest they feel singled out and ostracized. These guidelines are not sexist, however, they are based on sound physiologic knowledge and time-tested applications of yogic principles to women's special needs. We are cyclic beings. Denying that we are does violence to the basic principles of self-understanding we seek through yoga.
The menstrual period should no longer be dreaded as "the curse." Instead, in combination with a special menstrual yoga practice, it can be welcomed as a time for going within, for allowing ourselves to be in low energy. Use this time to experience different aspects of your nature and your yoga practice. So often we are drawn to the exhilaration of the standing poses, arm balances and backbends. These are great fun and immediately rewarding, as they suffuse us with energy. But a practice that is always high-energy needs to be balanced by the quiet and peace low-energy yoga can offer. The menstrual period is a perfect time to vary one's practice and turn inward.
Poses to Avoid During The Menstrual Period
Inversions: Inversions are not recommended during the menstrual period for philosophic as well as physiologic reasons.
During the menses, the pelvic vascular bed contains more blood than at other times of the cycle. The uterine blood supply enters the uterus from the right and left sides of the pelvis. These blood vessels are located in the broad ligaments that suspend the uterus from the pelvis. The uterine arteries are thick-walled and muscular. The uterine veins are thin-walled and easily collapsed.
During inversions, the uterus is pulled toward the head by gravity, causing the broad ligaments to be stretched. This can cause stretch and partial collapse or occlusion of the thin-walled veins, while allowing the uncollapsed arteries to continue to pump in blood. Thus, more blood enters the uterus via the arteries than can be carried away by the veins. The vascular congestion that results can lead to increased menstrual bleeding.
Hindu philosophy teaches that during menses the direction of energy is down and out of the body. This flow should not be obstructed or reversed as it is in inversions.
There have been numerous misconceptions about why to avoid inversions. I would like to dispel two of them:
Endometriosis : Endometriosis is a condition in which small areas of endometrial tissue (uterine lining) develop on the surface of the pelvic and abdominal organs. This tissue responds to the hormones of the fertility cycle. When menstruation occurs, these foci of endometriosis break down and bleed just as the uterine lining does. But since there is no exit for this flow, scarring and adhesions result. This can cause pain and infertility.
It was once thought that endometriosis resulted from the escape of small bits of menstrual endometrium through the fallopian tubes into the pelvic cavity. It was postulated that these fragments of tissue implanted themselves on the surfaces of the pelvic organs and proceeded to grow. If this theory were true, it would certainly be reason enough to avoid inversions during the menstrual period. However, this is no longer thought to he the origin of tendomeriosis. It is now known that endometriosis arises from the presence of cells in the pelvic lining that are capable of developing into endonietrial-type cells.
Infection: It has been suggested that inversions during menses increase the incidence of pelvic infection. This is not the case. Conditions for the ascent of bacteria up to the uterus are not more favorable during menstruation- or inversion. Bacteria move in the layers of fluid on the surface of the vagina and uterine lining, essentially free of gravitational effect. If inversions did cause pelvic infections, then they would be contraindicated in women regardless of the time of the cycle.
Free-Standing Poses and Non-supported Backbends
In general, poses requiring the use of exertion and great energy are not recommended during menstruation. Physical strength may be somewhat diminished at this time, causing one to be shaky or off balance; therefore, standing poses in the center of the room and strenuous backbends may be difficult and exhausting. Attempting such a practice when energy is low can lead to injury or further depletion of energy supplies. This is a time to allow yourself to rest.
Poses Recommended During The Menstrual Period
The following guidelines are provided for your exploration. They are not presented as restrictions on your practice, but suggested as a way to more deeply experience and enjoy your natural cyclic rhythms.
1. Forward Bend Series
- Paschimottanasana (Full Forward Bend Pose)
- Janu Sirsasana (Head to Knee Pose)
- Triang Mukhaikapada
- Paschimottanasana (Three Parts Forward Bend Pose)
- Modified forward bends in chair with fists pressed into lower abdomen
2. Supported Standing Poses
- Parivrtta Trikonasana (Revolved Triangle Pose)
- Parivrtta Ardha Chandrasana (Revolved Half Moon Pose) Done with the support of a wall or chair.
- Lying Knee to Chest Twist
- Seated Chair Twist
- Pose of Child Twist
4. Supported Setu Bandha (Supported Bridge Pose)
This pose is calming, It also relieves pelvic discomfort.
5. Supported Viparita Dandasana (Upward Turned Staff Pose).
This pose is helpful for pelvic discomfort