Taken from the January/February 2015 issue of the Women's Health Activist Newsletter.

There is no agreement in the yoga community about whether women need to avoid inversions (i.e., headstands, handstands etc.) during menstruation. Unfortunately, this idea, which is rooted in the origins of yoga, has permeated into the reinvented Western practice and tainted the idea of practicing yoga during menstruation.

Despite the lack of conclusive medical evidence that it is dangerous to briefly stop menstrual flow, many Western teachers recommend avoiding these postures. This is regrettable as it reinforces the social stigma surrounding menstruation, thus encouraging a detrimental relationship with this physiological cyclle.¹ As a mind-body exercise, yoga improves a woman’s body image through increasing body awareness and body-responsiveness.² So, yoga could be a good way to help build self-confidence, minimize insecurities that might arise during menstruation, and help women become more in tune with their bodies.

Social attitudes about menstruation have a broad effect on women’s health and self-esteem. In a society that shuns any discussion of the normal, biological phenomenon of menstruation, it is not surprising that many women describe their periods as “dirty” and “disruptive.”¹ Menstruation, which causes mental and physical changes, is associated with body anxiety and thus, negative body-related thoughts are highest during this period.³ Women are overall more unsatisfied with how they look during their periods.⁴  These attitudes are important, since women who have a positive relationship with their menstrual cycles are more confident in their ability to communicate their sexual needs, and less likely to engage in risky sexual behavior.⁵ This raises the question: could simply shifting attitudes toward menstruation and by extension towards a woman’s body, improve women’s health?

Yoga is a discipline that creates crossover between mind, body, and spirit through asanas (postures) and pranayama (breathing exercises). Each of the many different types of yoga deals with menstruation slightly differently, but most agree that the body’s energetic force is downward at this time.⁶  This force, known as “apana,” is responsible for elimination of bodily waste.⁶ Geeta S. Iyengar, who is credited with adapting some of ancient yoga’s recommendations to modern women’s needs, recommends complete rest during the first 48-72 hours of menstruation and no asanas.⁷ Afterwards, if tension and aches arise, women may engage in a light yoga practice without any inversions.^7,8  Iyengar states that inversions during menstruation cause one’s flow to stop and may lead to “fibroids, cysts, endometriosis and cancer.”⁷

Western yoga teachers seem more concerned with the risk of retrograde menstruation (in which menstrual blood containing endometrial cells flows back into the pelvic cavity rather than out of the body), which is one explanation for endometriosis.^{4, 6, 9} To date, there is no reliable medical evidence to assess these claims and no information connecting the risk of retrograde menstruation with inversions.

Despite the negative views surrounding yoga and menstruation, the practice has much to offer women during their periods. One study found that women who practiced yoga were more aware of their bodies, better able to respond to them, and more satisfied with their body image, compared to women who did aerobic exercise or got no exercise.² Unlike aerobics classes, most yoga studios do not have mirrors, in order to encourage movement based on internal perceptions rather than external cues.² Practitioners must feel when they have pushed far enough in a posture, and note when they reach their limits. This puts them in tune with basic bodily awareness (broadly defined as posture, interactions, reactions, or attention to change), which is believed to improve one’s body image.¹⁰

For this reason, women should not be discouraged from practicing yoga simply because they are menstruating. This advice simply perpetuates negative views about menstruation and women’s bodies. The medical editor of Yoga Journal recommends that yoga practitioners who are in tune with their bodies should trust their experience and engage in a practice adapted to their physical state.⁶ Pragmatically, women should become aware of what their body is telling them and respond accordingly.^6,11

Since body image and satisfaction are lowest during menstruation, yoga may help women reconnect with their bodies in a positive way, through careful observation and improved self-awareness. By connecting mind and body, yoga may be a safe space where women can gain tools to a healthier relationship with menstruation and their bodies by practicing mindfulness, acceptance, and satisfaction in a place without judgment.^{2, 11} Adjusting yoga to menstruation should not be perceived as a weakness. Unfortunately, even in the 21^st century, it still takes strength to acknowledge the balance and beauty of change over the course of one’s menstrual cycle.

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Maria M. Lawrynowicz is a first year medical student at Georgetown University. As an Environment & Health major at McGill University, she developed a personal interest in understanding health in a broader context. She hopes to maintain a regular yoga practice despite the rigorous schedule in medical school and her monthly internal biological schedule.

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