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Yoga and Perimenopause, Introduction

The meaning of menopause, as experienced by American women, is diverse; it is a different experience for each woman. George (2000) showed that some women experienced menopause as unremarkable and, for the most part, a normal part of the life cycle. And still these women were relieved to become post-menopausal. For other women, it can be  tumultuous. Many women expressed anxiety over the sense of not having control over their bodies during hot flashes, according to George (2000).

Locus-of-control is the mechanism behind a woman’s reaction to hot flashes, that is, a woman’s experience depends on where and how she locates control of her symptoms. Does she perceive an internal sense of control or are forces outside of herself exercising control? Variables that affect the locus-of-control include her perception of stress and her belief in the likelihood of controlling symptoms, according to Kennedy (1998). It comes down to how a woman appraises hot flashes followed by the strategies she uses to cope with them. Her psychological state depends on the perception she has of her ability to control her symptoms, according to Reynolds (1999). Will she experience anxiety? Depression? Women who experienced more of these symptoms perceived less internal control, according to Kroll (1989). On the other hand, the women who used alternative therapies often said the desire for personal control was important to them, according to Seidl & Stewart (1998) and, as a result, they engaged in preventive strategies which provided them the perception of greater control over symptoms.

Women who locate control of their symptoms externally to a physician are usually prescribed hormone replacement therapy (HRT). What I offer is an alternative to HRT for women who want to develop their internal locus-of-control. This is through the use of balancing poses and stretches which also increase flexibility. The postures and deep rhythmical breathing, along with the restraint of senses, concentration, and meditation, leads to a significant improvement for anxiety and depression (Vahia, Doongaji, Jeste, Ravindranath, Kapoor & Ardhapurkar, 1972).


Climacteric: As a woman enters the climacteric during her life cycle she may experience hot flashes, anxiety or depression associated with a change in sleep patterns, typically associated with irritability or difficulty in daytime functioning. The climacteric is the transitional phase during which a woman gradually moves from being reproductive to non-reproductive. It includes perimenopause, menopause and post menopause.

Perimenopause: A woman is in perimenopause when ovarian activity becomes erratic due to estrogen levels dropping off; this is usually between 40 or 50 years of age, even as early as 35 years of age. It is the last six months of perimenopause that marks the major reduction in ovarian function.

Post menopause is official after her periods cease and reproductive capability ends. The post menopause is said to begin approximately one year after the last menstrual event. Menopausal changes result from lowered estrogen levels which are linked to osteoporosis (estrogen preserves bone mass) and heart disease (estrogen protects the heart) and for this reason, medical doctors have historically treated menopause as a disease process, suggesting that an endocrine organ atrophies. Atrophied ovaries, they said, results in a decrease in hormone secretion, resulting in life-threatening disorders. This disregarded the fact that estrogen is produced by other glands besides ovaries, and especially the fact that ovaries continue to produce additional hormones, such as testosterone, which alone argues against the idea of atrophy.

End of Introduction

The practice of yoga has the effect of detachment from endless fluctuations of pleasure and pain, thereby reducing physiologic reactivity to any given stimuli.  Additionally, the overall intent of yoga, according to Patanjali (circa 200 C.E.), is to eliminate the erroneous belief in an individual body mind that is separate from all others, in other words, unity. For our purposes, the physical postures increase control over voluntary muscles and work off stress hormones accumulated in the body. Breathing exercises, called pranayama, improve control over the autonomic nervous system. Sense withdrawal, called pratyahara, reduces sensory stimuli. Meditation increases self-awareness and insight into thought patterns and habits (Muskin, 2000).

My thesis reviewed the literature for hot flashes, anxiety and depression and it offers a detailed explanation of yoga as a therapeutic intervention according to Ayurvedic principles. Ayurveda views menopause as simply an imbalance of body humors during a seasonal, or life cycle, transition. Hatha yoga is a part of a larger system called Ayurveda. The literal translation of the Sanskrit word “Ayurveda” is derived from two roots: ayur, meaning life; and veda, meaning knowledge, according to Vasant Lad.


I completed a master’s degree in psychology, and while I was publishing my literature review  the Women’s Health Initiative released their findings on the dangers of hormone replacement therapy (HRT). My review of the literature had revealed the studies that are largely ignored by the medical establishment as well as pharmaceutical companies. I admit that I was furious reading the existing research, some of which appeared literally suppressed; I argued with  my advisor over what I could or could not say (she won) and then the WHI study was released at the same time that I completed my work which, by the way, vindicated me.

Feel free to download a copy of Yoga Therapy for the Management of Hot Flushes, Depression and Anxiety during the PerimenopauseHere is the password: paws4fish.

Hint: You will benefit from receiving a one hour Raindrop Massage. The power of the 10 essential oils along your spine will relax your diaphragm for the full experience of the breath that research suggests will regulate your internal “thermostat.”  The use of essential oils, in this particular way, makes it easier for the average woman to experience the type of breath that really works.

The breath works! Please use this information as a doorway for your own exploration!