The Graceful Change

Menopause can be a trying time for women, but with a healthy yoga practice, stress about hormone replacement therapy doesn't have to be part of the picture.

By Trisha Gura

When Alison, 48, began experiencing intense hot flashes, they often arrived at night and interrupted her sleep. But on the whole, her perimenopausal symptoms were more annoying than unbearable. Then her menstrual cycle spun out of control. "Suddenly, my menstrual flow was really heavy and lasted twice as long as before," says Alison, who lives in Chicago and requested that her last name not be used. "My periods went on forever." Her gynecologist suggested that Alsion try hormone replacement therapy (HRT)--prescription drugs used to control menopausal symptoms. "She told me not to rule it out if my symptoms were really bad, but my feeling was that I'd rather try to just get through them," Alison says.

She had good reason for wanting to avoid HRT. The treatment regimen, which artificially elevates a woman's estrogen and progesterone levels, has come under intense scrutiny in recent years. Major studies have linked it to an increased risk of breast cancer, heart disease, strokes, and other life-threatening conditions.

Soon after Alison's menstrual cycles became so irregular, she went to class at Yoga Circle, her regular studio, and learned an Iyengar asana sequence designed to help women cope with the physical discomforts related to their cycles. Many of the poses were restorative; they included Supta Virasana (Reclining Hero Pose), Supta Baddha Konasana (Reclining Bound Angle Pose), and Janu Sirsasana (Head-to-Knee Pose) with the head supported. When Alison's next menstrual period began, she practiced the sequence every day and noticed that her flow returned to normal. Encouraged by the results, she began to think that she could control her symptoms without HRT. Maybe, she thought, yoga could provide the relief she was looking for. And her intuition proved correct. Many women have found that yoga can ameliorate the undesirable side effects of menopause.

The Hormonal Roller Coaster

Though menopause itself is simply the moment that menstruation stops, the transition generally takes several years. This phase is called perimenopause and typically occurs in women between the ages of 45 and 55. During perimenopause, fluctuating estrogen and progesterone levels can trigger a myriad of uncomfortable symptoms. Among the most common are hot flashes, anxiety and irritability, insomnia, fatigue, depression and mood swings, memory lapses, and an erratic menstrual cycle.

Few women experience all of these, but an estimated 55 to 65 percent of them do experience some mild menopause-related problems, says Rowan Chlebowski, M.D., of the Harbor UCLA Research and Education Institute in Torrance, California. About 25 percent report almost no disruption to their daily lives, while approximately 10 to 20 percent suffer severe and often debilitating symptoms.

Hormonal fluctuations generally accompany women's passages into each new biological stage of life; with them often come various discomforts, such as acne and mood swings at puberty, morning sickness during pregnancy, and postpartum depression. "Menopause is no exception," says Nancy Lonsdorf, M.D., author of A Woman's Best Medicine for Menopause (Contemporary Books, 2002).

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