Yin Yoga for the Menopause
Menopause is a natural transitional phase in a woman’s life, not a disease. It marks the end of her fertile life and the beginning of a new phase. For 85% of women, Menopause is a discombobulating phase of their lives, feeling often misunderstood, tired and depleted. For this reason, it is important to normalize and understand what happens within a women’s body from a physiological, emotional and energetic point of view. Traditional Chinese Medicine (TCM) offers timeless wisdom to help cope with its symptoms and imbalance and find renewed balance and equilibrium.
This article is for informative purposes, it is not meant to be interpreted as a replacement of Health Care Provider (HCP) advice and work. If you are experiencing any of the symptoms described below, you are highly encouraged to visit your HCP and if you wish to learn more about ways you can manage your symptoms from a TCM perspective, I highly encourage you to visit a Chinese Medicine doctor.
This information and practices have been collected to deliver a Yin Yoga workshop, teaching physical postures, breathing techniques and acupressure points to raise awareness about menopause under a Wester and TCM perspective and offer participants techniques to potentially help minimize the negative symptoms of the hormonal imbalances. Scientific research is needed to prove the validity of these methods to manage symptoms and provide non-pharmacological treatments to women experiencing peri-menopausal symptoms.
Sequence
Viparita Karani - you may want to add a bolster or pillow under your sacrum; use a wall or furniture for support
Wall Straddle - continue supporting the sacrum with a prop. If you want you can wear an eye pillow to cover the eyes
Sheetali Cooling Breath - exhaling via the alternate nostril
Use acupressure points below, starting from the left side of the body and repeating on the right
Ham dangle - use a strap
Reclined half frog - use a strap
Sphinx - repeat twice pausing on your belly between each round
Butterfly - with spine flexion
Pigeon - with spine flexion
Supported bridge or pontoon - use a block or bolster just above your glutes
Supine Twist
Savasana - final relaxation, you may want to bring a bolster under your knees or cover your eyes
Acupressure points
The following acupressure points have been recommended by Giovanni Maciocia (2011), renowned author, lecturer and Chinese Medicine practitioner. These points have been cross-referenced and validated with Angela and John Hicks‘ work (2010). Press each point for around 1 minute, I normally use my thumb.
What is menopause?
Menopause occurs between 45 and 55 years, with a median age of 51. These numbers coincide in studies across different countries and the median age has remained unvaried across centuries. From a Western Medicine perspective, menopause is the progressive recession of the ovarian functions, including the gradual decline of the ovary reserves resulting in hormonal level fluctuation. Menstruations become irregular, fecundity decreases, follicles progressively decline and ovaries reduce their estrogen secretion. Women witness a progressive decline of follicles from their conception: “at the time the ovaries are formed in the foetus, there are approximately 6,000,000 primordial follicles, which decrease to about 600,000 at birth, to 300,000 at menarche and to about 10,000 at the time of the menopause.” (Maciocia, 2014) The period from the onset of menopausal symptoms until the complete menstruation cessation is called the Peri-menopause.
Symptoms
85% of women aged between 40 and 60 will experience some menopausal symptoms, such as:
Palpitations
Formication
Weight gain
Vaginal dryness
Loss of libido
Muskoscheletal pain
Cardiovascular problems
Osteoporosis
Hot flushes and sweats
Emotional imbalances
Poor concentration
Insomnia
Fatigue/lethargy
Headaches
Dizziness
Nervousness
Maciocia categorizes, in his 2014 “Menopausal Problems and Treatment with Chinese Medicine - Presentation”, menopausal symptoms according to the organ or tissue involved:
Bone: osteoporosis
Skin: thinning, slow healing, itching
Vagina: vaginal dryness and atrophy
Brain: hot flushes, depression, anxiety, insomnia, poor memory and concentration
Heart: coronary heart disease
Blood vessels: arteriosclerosis
Aggravator symptoms
Menopausal symptoms can be aggravated due to lifestyle choices and in Chinese Medicine, women from their 30s are recommended to avoid the following (Maciocia, 2014):
Alcool, tea and coffee
Stress
Emotional stress
Worry and fear
Smoking
Poor diet
Overwork
Dairy products
Menopause in Traditional Chinese Medicine
To grasp how menopause is understood in TCM, it is essential to explain the concepts of Kidney Jing, Tian Gui and Ming-men.
Jing translates as vital essence or energy, it is the energy reserve we are born with. According to how we manage our energies, we can either maintain the energy reserves levels healthy throughout our lives or we can deplete them faster due to lifestyle choices. Imagine that you are born with an energy bank account with 100 credits, by the time you will die, the account will be empty, but you can choose to burn your cash/energy currency fast, or use the energy currency slowly and proportionally throughout life. If you use your reserves fast, you will incur illness and imbalances earlier in life, if you wisely use your reserves and give yourself plenty of rest and self-care, these reserves will last longer and may even replenish.
In TCM, the Kidneys are considered the Power House of the body. That’s where our energy reserves are stored. They regulate our ageing process, fertility and liquids in the body and are the source of our internal wisdom. Jing is stored in the Kidneys to regulate birth, growth development and reproduction. When the Jing is healthy, we have willpower, determination and we allow life to flow its course.
As our Kidney Jing gets worn throughout life when a woman reaches 49-51 years of age, this reserve has been used and reduced, hence why menopause onsets. This is a natural process that can be entered gracefully, if reserves have been used wisely, or gravely if reserves have been depleted prematurely. Declining Kidney Jing (as the powerhouse of the body - energy reserves) leads to both yin and yang deficiencies.
In TCM, it is believed that the woman’s life goes through 7 years cycles, which mark her growth and fertility. These cycles are called Tian Gui, Heavenly tenth. Around the second cycle, at circa 14 years of age, menarche occurs, which marks the start of a women’s fertility. While at around 49 years of age, due to exhaustion of mental and physical energy, menopause onsets.
At menarche, the Kidney Water starts the menstruations which are believed to not be blood but water. They maintain the liquids necessary for conception and fertility. Menstrual blood is Tian Gui derived from Kidney water. Tian Gui also includes hormones estrogen and progesterone. The kidney energy starts declining as a system responsible for: temperature regulation, fertility, fluids regulation.
The Ming-men, also known as Gate of Life, refers to an energy centre located in between the kidneys associated with the origins of the Governing Vessel (Du Mai) and Conception Vessel (Ren Mai). Here our Primordial Qi, innate Qi is stores as Yuan Qi. The fire of Ming-men keeps the uterus warm and balances yin (dryness); kidney yang is also the fire that starts fertility. For this reason, menopause issues are both Kidney Yin and Yang deficiencies.
During peri-menopause gradual reduction of Kidney Qi (essence & blood) leads to imbalances and organs dysfunctions:
Recession Kidney Qi, exhaustion Tian Gui
Deficiency in the conception vessel (regular menstruation)
Deficiency thoroughfare vessel (fertility)
These exhaustions and deficiencies lead to amenorrhea and menopause. As a consequence of these imbalances, the kidneys also impact the functions of the liver, heart and spleen (Qi Yu, 2018), which lead to the development of the different symptoms according to which organ is the most impacted. In most cases, a kidney deficiency and liver depression are developed. The liver is the centre of emotional regulation, hence, imbalances in this organ and Qi may lead to emotional lesions/imbalances. This explains the mood swings and emotional imbalances experienced during peri-menopause. The heart dominates blood circulation and mental activities, whose imbalances can lead to a murky mind and difficulty thinking. This may explain why some women become more prone to circulatory issues and emotionally may struggle to find focus and concentration. The spleen is an acquired constitution responsible for nutrient synthesis, yang deficiency in the Kidney lead to spleen deficiencies. Overall, Kidney deficiency can lead to heart dysregulation, spleen deficiency and liver depression.
Hot Flashes
In Western medicine, “some gynaecologists consider only hot flushes and vaginal dryness as oestrogen-related menopausal symptoms. Hot flushes (flashes) are the most common menopausal symptom: up to 85 per cent of menopausal women suffer from them and 45 per cent of them do so for up to ten years after menopause.
Associated with an increase in temperature, increased pulse rate, and increased blood flow in the head, each hot flush lasts on average 2.7 minutes. Hot flushes are a mechanism for dissipating heat through vasodilatation and perspiration in response to the thermoregulatory centres in the anterior hypothalamus. The vasomotor symptoms (hot flushes) occurring during the climaterium are probably due to fluctuating pulses of pituitary follicle-stimulating hormone (FSH) which rises to abnormal blood levels at this time in an effort to provoke ovulation from increasing unresponsive follicles. Oestrogen in the form of HRT (ERT) “deceives” the pituitary that normal ovulation and oestrogen production is continuing so that the overproduction of FSH ceases and so do the hot flushes.” (Maciocia, 2014)
In Chinese Medicine, hot flashes are seen as an excessive Kidney fire and yin deficiency in the liver and kidney hyperactivity in liver yang. It is important to nourish the yin and clear heat to regulate neuroendocrinal functions. Kidney deficiency and empty heat rising from kidney deficiency.
Want to learn more?
REFERENCES
Hicks, Angela & John, Five Element Constitutional Acupuncture (Churchill Livingstone; 2nd edition, 2010)
Maciocia, Giovanni Obstetrics and Gynecology in Chinese Medicine (Elsevier Health Sciences, 2011)
Maciocia, Giovanni Menopausal Problems and Treatment with Chinese Medicine (2014 Presentation)
Qi Yu (ASSOCIATE EDITOR) (2018) Traditional Chinese medicine: perspectives on and treatment of menopausal symptoms, Climacteric, 21:2, 93-95, DOI: 10.1080/13697137.2018.1434983
https://www.maciociaonline.com/product/menopausal-problems/
https://giovanni-maciocia.com/the-treatment-of-menopausal-problems/
https://giovanni-maciocia.com/giovanni-maciocia/
https://www.tandfonline.com/doi/pdf/10.1080/13697137.2018.1434983?needAccess=true
https://www.acupuncturetoday.com/mpacms/at/article.php?id=27965
https://www.macphersontcm.com/single-post/2019/09/20/breeze-through-menopause-with-tcm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122509/
https://kripalu.org/resources/yoga-menopause
https://core.ac.uk/download/pdf/268633193.pdf
https://www.yogajournal.com/lifestyle/health/womens-health/the-graceful-change/
https://triyoga.co.uk/blog/yoga/menopause-yoga/
https://www.menopause-yoga.com/blog