As a yoga teacher, you will often be asked if it is okay to practice yoga during mensuration. Many students have been taught that practicing inversion during period is unhealthy and unsafe, and that it should be strictly avoided. And likewise there are many teachers who say that inverting during menstruation is no problem at all. Yoga teachers and yoga teacher trainers are quite divided on the topic.
The great division of opinions on the question if it is safe to practice yoga with inversions stems from a cultural stigma in India, the birth land of yoga. The belief that during menstruation a woman is in a cleansing period and should not participate in any spiritual practice is very dominant. In earlier days, and in some rural villages these days still, menstruating women were seen as very impure. They weren’t allowed to engage in prayer or any other religious activity. Entering a temple while menstruating was considered be a sin, and it was even common that women were asked to leave their home and stay in a hut outside their village for the duration of their menstruation.
That woman should not practice yoga during their menstruation is therefore a logical conclusion, were you to be influenced by this stigma.
Remnants of this cultural view on yoga, can be found in most of the yoga traditions: B.K.S. Iyengar’s school of yoga forbids inversions during menstruation. And the Ashtanga Vinyasa School created by Sri K. Pattabhi Jois women are encouraged to take a break from practicing yoga during the “moon days”. Countless other schools of yoga are either strongly against or undecided as to whether practitioners should practice during their periods.
Even thought the stigma on impurity has been watered down somewhat by the Western influence on yoga, it remains quite prominent. In many yoga classes and yoga teacher training’s students are told, that even though it is okay to practice some light and Yin inspired yoga postures, they should definitely avoid heavy practices and inversions. Students are told, that a more vigorous practice, including inversions might slow down the cleansing process and have an adverse effect on their health.
The myth that lies behind this reasoning is, that practicing inversions during menstruation might disturb the expulsion of the menstrual blood and might cause a condition called endometriosis. Endometriosis is a medical condition in which the lining of the uterus, called the endometrium, grows in other places (such as the Fallopian tubes, ovaries or along the pelvis). When that lining breaks down, like the regular lining in the uterus that produces the menstruation, it has nowhere to go. This causes cysts, heavy periods, severe cramps and can even lead to infertility. The cause of endometriosis is unknown so far, but is generally believed to be caused by immune problems or a genetic disposition.
The myth that inversions might trigger the onset of endometriosis is common in the yoga community. The thinking goes, that during inversions, gravity will pull the menstrual flow away from your vagina and towards the Fallopian tubes. This in turn is believed to increase the risk of retrograde menstruation and therefore, endometriosis. So, if you want to keep your period flowing down and out of your body, you don’t want to physically turn your uterus upside down. Right?
The thesis that an inverted uterus during the period causes endometriosis is not correct and has been discarded by the medical community on basis of two reasons:
1. Even if the blood were to flow back toward the uterus (which is called retrograde menstruation), it does not mean a woman will develop endometriosis. In 1984, a group of doctors decided to see just how common retrograde menstruation was. They took samples of the fluid surrounding a women’s pelvic organs while they were on their periods and found that 90 percent of the samples contained menstrual blood. Which means that almost all women who get periods experience retrograde menstruation. But only about 10 percent of the women develop endometriosis. Therefore retrograde menstruation can not be linked to endometriosis.
2. Uterine contractions are, rather than your orientation to the ground, responsible for the flow of menstrual blood. Throughout our entire body, blood is pumped both with and against gravity. The “downward” flow within the body’s tracts, is not disturbed by the body’s orientation to the ground. People who are bedridden can still urinate. And it is possible to swallow even when upside down.
Similarly, the natural downward flow of menstruation will not reverse directions if you stand in a headstand. In fact, even in the zero gravity of space, where there is no “down”, the direction of menstrual flow for astronauts has remained unchanged.
Just as no one alignment cue fits all in yoga practice, not one advise fits everyone in this situation. Most women feel different when they are menstruating, many women experience tenderness in their lower-backs and bellies. Some women experience dizziness and nausea, and most women feel generally less energetic than normal. If you experience these kind of mild symptoms, you might want to adapt your practice and skip inversions and more heavy exercises. Remember that you are supposed to feel better after your yoga practice and not worse!
But also remember that menstruation is a normal physiological process. It is not a disease, and practicing yoga or other physical activities are even recommended during periods. Regular yoga classes may help your body to go through the periods more comfortably; it may also promote health and normalization of periods.
So if you are feeling fine, and you do not have the aforementioned condition of endometriosis, you can practice yoga, including all inversions.
Periods are no reason to avoid physical activities, more so for yoga which helps with both physical and mental health and thus has a positive effect on your hormonal health.
Menstrual cycles are like a barometer of your hormonal health. If this harmony is disturbed, your menstrual cycles will let you know in different ways. That is the reason why frequent changes in periods and severe menstrual symptoms may indicate hormonal problems. In the short run, these changes do not pose any threat, but if you keep on neglecting these signals, you are at higher risk of developing disease conditions.
For example, too heavy bleeding may lead to iron-deficiency anemia. Some women may see a worsening of symptoms of certain diseases like asthma or autoimmune conditions. Other are at higher risk of developing mood disorders like depression. Prolonged cycles may indicate PCOS (poly cystic ovary syndrome), which could lead to infertility. And prolonged cycles might also result in a higher risk of developing diabetes.
In case of any of the following irregularities occur frequently, you should consult a health care professional:
 Innes, K.E. et al. 2005. Risk Indices Associated with the Insulin Resistance Syndrome, Cardiovascular Disease, and Possible Protection with Yoga: A Systematic Review. J Am Board Fam Pract 18(6), pp. 491–519. doi: 10.3122/jabfm.18.6.491.
 Boehm, K. et al. 2012. Effects of Yoga Interventions on Fatigue: A Meta-Analysis. Evidence-Based Complementary and Alternative Medicine . doi: 10.1155/2012/124703.
 da Silva, T.L. et al. 2009. Yoga in the treatment of mood and anxiety disorders: A review. Asian Journal of Psychiatry 2(1), pp. 6–16. doi: 10.1016/j.ajp.2008.12.002.
 Afonso, R.F. et al. 2012. Yoga decreases insomnia in postmenopausal women: a randomized clinical trial. Menopause 19(2), p. 186. doi: 10.1097/gme.0b013e318228225f.
Kalyani Hauswirth-Jain is a senior teacher & the Creative Director at the Arhanta Yoga Ashrams since 2013. She is a lead trainer for the 200 hour Yoga Teacher Training, 300 hour Yoga Teacher Training as well as a variety of 50 hour courses like Yin Yoga and Vinyasa Yoga, for more than eight years now.
She has also co-authored the internationally acclaimed book Hatha Yoga for Teachers & Practitioners: A Comprehensive Guide to Holistic Sequencing.