In popular press, a great deal of emphasis is placed on the struggles that women encounter during the stages of menopause, which can lead to negative connotations and disparaging remarks. STIGMA arises! Not every woman wants to think about or talk about this stage of life. However, the more we understand the changes we are going through, the more we can be empowered to support ourselves and others effectively.
Menopause, and the stages before and after menopause (pre-menopause / peri-menopause and post-menopause) are natural and inevitable stages in a female’s life; though for some women, menopause may occur earlier than naturally expected due to other health issues and medical treatments. Each individual’s experience of the stages of menopause will be unique to their story. Please bear in mind that 'menopause' is actually a moment in time, and one that we can only know in retrospect. It refers to the moment of cessation of menses. This is why we speak of 'the stages of menopause' which gives a fuller impression of the transition over time.
Why do we need to understand the stages of menopause as yoga teachers?
When practising yoga in my late forties, early fifties, I was not very savvy about the stages of menopause and did not know how I should adjust my yoga practice accordingly. This understanding only came through my training as a Vinyasa Yoga teacher with Zazyoga, which provided me with many tools for supporting healthful ageing, and then further studies on Yoga for the Stages of Menopause (Yinstinct / Niamh Daly). I also completed a course called Yoga for Healthy Bones (more on that in another post - to come) which again helped me commit to my regular practice.
I believe yoga has the potential to play a supportive role for women on their natural journey through the stages of menopause, supporting mind and body; potentially nurturing a spirit of acceptance, though not abandonment. In the process of change we need to learn to appreciate each day, which can at times be challenging (especially when we feel at war with ourselves or betrayed by our body).
Yoga teachers work with body, breath and mind, through asana, breathwork and meditation. Understanding the stages of menopause enables yoga teachers to respond more effectively to student’s individual needs, ensuring ongoing safe practice into a hopefully, healthful old age.
A 2016 study (Yoga Alliance) found that 72% of yoga practitioners are women (in the U.S.), though this trend is reported elsewhere too. 58% of yoga practitioners are age 40 and over, so this means a good two thirds of female practitioners are likely to be journeying through the stages of menopause.
What are the stages?
Mosconi (2021) calls the stages of menopause, ‘menopause transition’. The transition is both a ‘reproductive transition’ and ‘neurological transition’ and is linked to the neuro-endocrine aging process.
Biological markers that helps us to understand the changes in the body include changing levels of hormones: oestrogen, progesterone, melatonin and cortisol. Most of us don’t go about our days measuring our hormone levels, and it’s not something that we may consciously think about. To me, at least, hormones were some abstract idea, and maybe I never took them too seriously. However, their interplay affects us daily, potentially impacting the quality of our day and night.
This is what happens:
As women move into their forties, they start to experience a decline in the level of the fertility hormones, oestrogen and progesterone. This decline may occur across a two-to-fourteen year period (around 40s to 50s), after which the hormones level off and stabalize. While progesterone typically declines first, the decline in oestrogen tends to follow a more spiky path.
During the same period melatonin levels also decline, potentially impacting sleep. Conversely, cortisol levels (stress hormones) increase, potentially creating more anxiety (also contributing to sleep disturbance).
Combined with this, from age 30 there is a decline in bone density, and in the 5 to 7 years following menopause, women are at risk of losing a full 20% of their bone density, potentially leading to osteoporosis.
In combination with all of the above we learn that women's happiness levels are typically lower during midlife (Dolan, 2014). And worryingly, in the UK and Ireland, the highest rate of suicide for women is between the ages of 45 to 54.
How developing a yoga practice can help
Developing a yoga practice potentially helps us to navigate each stage of menopause with more comfort, dignity and equanimity; and in doing so generate acceptance and self-compassion.
Interestingly what we pay attention to in one given moment relates to how happy we feel. The Science of Happiness tells us that ‘women experience greater happiness overall when purpose is added’ (Dolan, 2014). Activities that engender self care are considered ‘purpose’ driven. Yoga can be an effective tool to bring to a ‘self care’ routine, and potentially support overall happiness. Yoga can help us to feel empowered to enjoy a healthful life into old age.
Women who focus on improving their quality of life before, during and after menopause may have reduced symptoms and may be at less risk of health related issues. Through sharing our practice and understanding of menopause we can empower women to engage with positive life style choices (Mosconi, 2019) that potentially make a difference to long term health:
Sleep (asana, breathwork, meditation, Nidra)
Managing stress (breathwork and meditation, thought management)
Nutrition (yogic diet)
Yoga is potentially one way to increase quality of life through movement, through enhancing sleep and through stress reduction.
Note: What we offer as yoga teachers, is offered within the boundaries of our practice as yoga teachers, and students are always be guided to seek appropriate medical, therapeutic and/or nutritional intervention from the appropriate services when needed. Please also see Dr. Mukherjee @the.hormone.doc for insights on the balance between lifestyle choices (nutrition, exercise, sleep and stress management) for wellbeing and HRT.
Jeddah friends, if you are a woman enjoying the stages of menopause in it's full delight... why not come join my Yoga for Wellbeing classes!
References and Links
Daly, N. (2021) Yoga for the Stages of Menopause: Course Handbook. Yinstinct Yoga.
Dolan, P. (2014) Happiness by Design. Penguin
Ipsos Public Affairs (2016) The 2016 Yoga in America Study Conducted by Yoga Journal and Yoga Alliance
Mosconi, L. (2019) Brain Food: How to Eat Smart and Sharpen Your Mind. The neuroscience behind the foods that will improve your mental fitness. Penguin
Mosconi, L. et al (2021) Menopause impacts human brain structure, connectivity, energy metabolism, and amyloid‑beta deposition. Scientific Reports | (2021) 11:10867
Mukherjee, A (2021a) Menopause: Beyond HRT. https://www.facebook.com/watch/live/?ref=watch_permalink&v=1066485297192494
Mukherjee, A. (2021b) Menopause and HRT. https://www.facebook.com/watch/live/?ref=watch_permalink&v=766982113960446