What advice would you give to any students who are menstruating regarding doing inversions?
I found a passage I really liked in one of the articles I read about the topic, and I thought it would make a great opening for this article.
“The bottom line is that hatha yoga is full of contradictions and varied opinions, leaving each of us ultimately responsible for our own choices. Pay attention to your body and discover what works and what doesn’t—not just during your period but every day.”
Barbara Benagh, Inversions and Menstruation
I like it because this is what most of the topic of yoga and menstruation (or yoga and many other concerns) boils down to: common sense, body awareness, experimenting, and listening to your body. This passage anticipates my answer to the question, which is: there is no medical reason that suggests you should not be doing inversions while menstruating, so – if you feel like it – you can go ahead and do as many inversions as you like.
The two main reasons adduced by detractors of inversions during your period are very different in nature. One is philosophical: apana. The other is physical: endometriosis.
Apana is associated with the concept of Nāḍi, the channels through which, in traditional Indian medicine and spiritual science, the energies of the subtle body are said to flow. They are connected to special points of intensity called Chakras. They are first mentioned in the Katha Upanishad:
“A hundred and one are the arteries of the heart, one of them leads up to the crown of the head. Going upward through that, one becomes immortal.” (CU 8.6.6)
There are three nāḍis, through which different types of energy flow. To the sides are Ida and Pingala, which carry Apana and Prāṇa respectively. In the middle is Sushumna. Prāṇa is a positive element, the cosmic energy which is believed to come from the sun and connect the elements of the universe – prāṇa is life. Apana is the opposite – it is responsible for elimination of waste products from the body and resides in the lower part of the body.
The practice of Pranayama is aimed at directing the flow of prana downwards, toward the pelvic plexus, where it mixes with apana. When prana and apana flow together through Sushumna to the top of the head, the experience of Samadhi takes place, which is the goal of all yogic practice.
You can now see why, according to traditional Yoga, being upside down during your period is not a good thing: the menstrual blood is considered as apana, and having it flow towards the head is not a good thing – apana is supposed to go down and out of the body.
Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside the uterus. The cause for endometriosis is not entirely clear. The main and most widely accepted theory for its formation is that of retrograde menstruation, also called the implantation theory or transplantation theory, which suggests that during a woman’s menstrual flow, some of the endometrial debris exits the uterus through the fallopian tubes and attaches itself to the peritoneal surface (the lining of the abdominal cavity) where it can proceed to invade the tissue as endometriosis.
Some people think that inversions during a woman’s period can increase the chances of retrograde menstruation. This is a theory that has not been proved scientifically. Avoiding inversions is of course a way of eliminating this risk, but is it really necessary?
First of all, while most women may have some retrograde menstrual flow, typically their immune system is able to clear the debris and prevent implantation and growth of cells from this occurrence. In fact, endometriosis is not just the result of retrograde menstruation, but it appears that several risk factors concur to its development, such as genetics, compromised immune system, environmental toxins ageing, and frequent and/or abundant periods.
Secondly, thirty breaths in Sirsasana are probably not enough to stimulate retrograde menstruation unless this condition is already present. The risk may increase if you hold the position for many minutes or hours, but that is not something that should scare beginners or women who do not have endometriosis.
Thirdly, in extreme cases endometriosis can affect parts of the body that are not even close to the uterus, such as the skin, the brain, and even the eyes. How could retrograde menstruation affect these areas of the body? This seems to suggest that the disease is more related to immune deficiency or genetic alterations than to menstrual blood contamination.
Finally, according to Robert Taylor, a reproductive biologist at the Wake Forest School of Medicine Menstrual, blood doesn’t “fall out of the uterus” due to gravity. It’s pushed out by uterine contractions. Because turning upside-down has no effect on those contractions, inversions won’t change the direction of a woman’s flow or increase the amount of retrograde menstruation she experiences.