Yoga for Menopause: Fatigue

by Nina

Rose Light by Melina Meza

When I was going through perimenopause, the worst symptom I had was fatigue attacks. Although fatigue or exhaustion is a classic symptom of perimenopause, I'm pretty sure I made up the term "fatigue attack" because I needed a special term for how it felt to me. I'm a pretty energetic person who gets a lot of things done in a given day, and my yoga practice during that time was quite athletic. But during that period, once in a while, I'd suddenly feel so drained of all energy that all I wanted to do was collapse into a puddle on the floor. There was something essentially different about these hormonally based episodes of fatigue than normal tiredness, and I remembered that same feeling of utter exhaustion from my pregnancies (although those were combined with nausea). So I knew it wasn't something I could fight with energizing poses, such as backbends or sun salutations. Fortunately, I got some guidance from two different senior teachers, Rodney Yee and Patricia Walden, who both helped me figure out a good way to practice when I was feeling that way.

When I first talked with Rodney about a fatigue practice, he came up with a sequence of supported inverted poses (see Just In Time for the Holidays: Inverted Poses). However, the first pose in the sequence was Downward-Facing Dog with head support (traditionally the beginning pose in a supported inverted pose practice), and I complained to him (whined?) that when I was feeling exhausted, that pose felt like to much. So he changed the sequence to start with a long Legs Up pose (Viparita Karani) so I could have a nice rest to start and then move on to more active inversions. That was a revelation to me who had only done that pose at the end of a practice. Learning I could rest at the beginning of my practice instead of the end—that I could break a rule that wasn't even a really rule— was a revelation. I started to realize I had a lot more freedom to adapt my practice to my particular needs that I had known. And practicing was a good way to get through a fatigue attack and did leave me feeling refreshed.

Later I took a workshop from Patricia Walden on Yoga for Menopause. She, too, recommended a combination of restorative poses and supported inversions. Eventually, when the book she wrote with Linda Sparrow, The Woman's Book of Yoga and Health, was published, I started to practice her menopause fatigue practice on a regular basis. This sequence is quite long and some of the poses may not appropriate for many of you, but I'll list all the poses here just in case.

1. Supported Reclined Cobbler's pose (Supta Baddha Konasana)
2. Supported Seated Forward Bend (Paschimottanasana)
3. Supported One-Legged Forward Bend (Janu Sirsasana)
4. Simple Seated Twist (Bharadvajasana)
5. Downward-Facing Dog with head support (Adho Mukha Svanasana)
6. Standing Forward Bend with head support (Uttanasana)
7. Headstand (Sirsasana)
8. Inverted Staff pose (backbend in a chair) (Viparita Dandasana)
9. Chair Shoulderstand (Sarvangasana)
10. Half Plow pose (Plow pose with chair) (Arda Halasana)
11. Supported Straight Leg Bridge pose (Setu Bandha Sarvagasana)
12. Legs Up the Wall pose (with variations) (Viparita Karani)
13. Relaxation pose (Savasana)

Regardless of whether you try this sequence or not, it's worthwhile to look at the strategy behind it. It begins with Supported Reclined Cobber's pose (Supta Baddha Konasana), which is a very restful and relaxing pose. Next are a couple of supported seated forward bends, which are also quieting and restful but a bit more active than the first pose. The simple seated twist is even more active, and definitely stimulating. So now, after having a rest and being a bit energized, you're ready for the more strenuous poses: Downward-Facing Dog with head support, Standing Forward Bend with head support, Headstand, and Inverted Staff pose (backbend in a chair). From there, with the Chair Shoulderstand, Half Plow pose, Supported Straight Leg Bridge pose, and Legs Up the Wall pose, you are moving into the quieting, soothing supported inversions, ending with the most restful of the group. You are also getting a balanced asana practice, with a combination of forward bends, backbends, twists, and inverted poses. (I should say this my analysis of the sequence, not Patricia's.)

As with any sequence, you could shorten this sequence by leaving out certain poses (especially if there are ones you don't normally practice) but still keep the remaining poses in the same order. Or, you could come up with a sequence of your own that combines restorative and supported inverted poses in a way that allows you to rest in the beginning, move toward more active poses, and then rest again at the end. The important thing is to acknowledge your fatigue, and adapt your practice to your current condition, thinking outside the box as needed. And, remember, doing even just one pose (such as Reclined Cobbler's pose or Legs Up the Wall pose) will very likely make you feel better than doing nothing.

Naturally, if you aren't going through periomenopause or menopause (or aren't a woman!), you can still do a practice like this whenever you feel exhausted.

Featured Pose: Hunting Dog

by Baxter and Nina

This week’s featured pose is one of Baxter’s favorite poses for lower back pain. Hunting Dog pose, which is a great precursor to strong poses like Warrior 3, is a wonderful way to tone and strengthen your upper body, especially the serratus anterior muscles, as well your pelvic stabilizers and core belly muscles. It’s also a good pose for anyone trying to improve core strength as well as strengthening the lower back.

Baxter prescribes this pose for:

• lower back pain
• balance issues
• fatigue (when standing poses are too tiring)
• improving right/left coordination
• building arm strength

General Instructions: Start by placing a folded blanket on the floor. Then come into a hands-and-knees position, with your knees on the blanket and your hands on the floor or yoga mat. Keep a neutral curve in your lower back and strong arms.

Next, slowly take your right leg back behind you into a lunge position, with your toes turned under and the ball of your foot on floor. Try to keep your pelvis area and lower back in the starting neutral position at all times—no tip, tuck or turn. 

If you are feeling stable, lift your right leg up until it is about parallel with the floor, but no higher. Again, no change to pelvic alignment!

Finally, consider reaching your arm forward parallel to the floor.

Hold the position for at least 6 breaths, and up to 16 breaths. When you release, shake out your left hand and wrist.  Repeat on the second side.

Cautions: If you are having lower back pain, keep the toes of your straight leg on the ground rather than lifting your leg. If you have wrist pain, bend your elbows and rest your forearms on blocks, rather than putting weight on your hands.

CHRONIC STRESS: AN INTRODUCTION

by Nina

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Wounded Bird by Brad Gibson

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by:

• raising your blood pressure
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut)
• dilating your pupils and bronchioles, providing improved vision and oxygenation
• generating needed energy by breaking down sugar and fat stores for immediate use

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and your bronchioles for reduced oxygenation
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease
• hypertension (high blood pressure)
• insomnia and/or fatigue
• digestive disorders
• headaches
• chronic anxiety or depression
• weakened immune system

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.