Tuesday, June 26, 2012

Are we being too impatient?

One of the greatest lessons that yoga has taught me is patience.                                         

I wasn't born with higher flexibility than the rest of mortals. I started practicing yoga as an adult when i could hardly touch my feet. On top of that, i have some congenital muscolo-skeletal problems that make it impossible for me to ever attain 'perfect alignment' in some poses: my legs and my arms are not straight. I had to learn how to accept my body and its deviation from the norm. 
For this reason in my yoga practice i look for function rather than form and whatever progress i make is the product of perseverance, patience and understanding. 

Yoga taught me that there are no shortcuts in life. 
If we avoid certain stages of self-development that lead to our growth and awareness, sooner or later we will pay for it.

I approach the menopausal transition in the same way. I welcome it as an opportunity to learn more about myself and life. I don't look for a magic bullet that would mask menopausal symptoms and give me the illusion that it's not happening.

HRT and antidepressants that are routinely prescribed to treat menopausal symptoms, remind me of the Freisch├╝tz legend: a marksman, by a contract with the devil, has obtained a certain number of bullets destined to hit without fail whatever object he wishes. As the legend is usually told, six of the magic bullets are thus subservient to the marksman's will, but the seventh is at the absolute disposal of the devil himself.

Modern medicine has devised a 'magic bullet' for menopause - a natural phase, by the way: drugs that modify thoughts, emotions, and behaviors that were earlier seen as normal variations in human experience and personality.

Where is the raw authenticity of the human life fully lived through joy and grief, pain, and pleasure, if these states can be chemically short-circuited? What happens to our free will if we can medicate our deepest emotions and intentions as easily as we can treat our athlete’s foot?

The brain is a complex ecosystem, and, as in the case of its counterpart on the earth, inducing changes in one part of the system can produce often-unforeseen changes in another.

Is it desirable, to chemically dampen the experience of menopause for instance, when that experience is an essential part of the readjustments we need to make in order to prepare ourselves, both emotionally and physically, for the latter part of our lives?

Why are we eschewing wisdom for the false promise of eternal youth and ever-lasting happiness?
Do we really believe that happiness comes in a pill or are we fooling ourselves and sweeping uncomfortable truths under the carpet?

It's undeniable that life in our society makes impossible demands on people. There is no time for Introspection, reflection, critical thinking. Self-awareness, doubt are actively discouraged as potentially disruptive. We are expected to conform to a dominant 
idea of success, i.e. economic success, one that serves the logic of capitalism.

The widespread use and marketing of newer antidepressants serves specific social interests, some of which may not be in line with the needs of the people they are said to serve. They have become part of the technologies employed to produce more efficient and productive workers. In doing so, they may contribute to external life conditions that are becoming increasingly damaging to individuals’ well being, such as longer working hours, and increased stress in the workplace (antidepressants become, from an employer’s perspective, the ideal worker’s drug: one that increases motivation, energy, attention, and concentration while decreasing the need for sleep and decreasing anxiety.)

During menopause women need time for themselves, crave introspection and reflection, want to slow down and 'smell the roses'. They have enough wisdom to see through the bullshit of consumerism, careerism and productivism. Some may feel the need to lead a more spiritual life, get to the root of their existence, others experience an increased sex drive that makes them seek younger partners, some develop psychic abilities and trust their intuitive knowledge, many desire a closer contact with nature.  They are inherently subversive because they start to question the kind of lives they have led until then. Hence they are prescribed drugs to keep them in line. 

In medieval times they burnt 'witches' on a stake (women accused of witchcraft were predominantly menopausal women!), today there is no need for this extreme measure, a daily pill would suffice to ensure they conform to the unwritten rules of our society.

Monday, June 25, 2012

Why i practice yoga at home

A friend asked me where i practice yoga and was rather surprised when i told her i usually practice in my living room. She reformulated her question  "i mean, which studio?". At that point i had to explain to her why i prefer the comfort of my home. It is a pretty good question, that deserves a longer explanation than the one i gave her while waiting for a tram.

These days my energy and mood are hugely affected by my changing hormonal levels. During perimenopause estrogen and progesterone levels no longer follow a predictable curve, if someone were to measure them, the weekly chart would look like a roller coaster designed by a madman!

By practicing alone i can select poses that are either calming or energizing, challenging when i feel strong enough for a challenge, restorative when i feel that my energy is depleted, soothing when i suffer from ovulation pain, menstrual cramps, low back pain. I can play classical music one day and Tibetan bells the next, or just listen to the sound of the rain outside. I can lie in Savasana for 30 minutes, or chant 108 OM's.

There are hundreds of poses to choose from, and learning yoga (a lifelong pursuit!) entails using them as a map that leads you to the discovery of your body and its connection to the mind.

Studying a pose and its effect requires time, it's not something i can do by holding it for 30 seconds in a group class. I want to hold it until i learn to breathe effortlessly in that pose, until the fluctuations of my mind are stilled. I come out of a pose when i am ready, not when everybody else does at the prompting of their teacher.

In a one-to-one session the teacher can provide useful instructions and adjustments, prepare a sequence of poses that meet your current needs and are suitable for your level, take into account your general fitness level, muscolo-skeletal imbalances or injuries, help remove psychological obstacles that hinder your practice, etc.

A group class may provide the motivation to practice yoga, but unless it leads you to exploring poses in depth at your own pace at home, it may not provide the benefits that you are seeking.

If the higher cost of a personalized yoga session is an issue, you may want to attend a drop-in group class on a day when you feel well, learn some new poses, and then spend the rest of the week working on certain poses at home, selecting those that are recommended for your particular needs.

You can pick up a 'Yoga for Women' or 'Yoga for Menopause' book and learn more about the benefits of each pose.

I use 'The Woman's Yoga Book" by Bobby Clennell, "Yoga, a Gem for Women" by Geeta Iyengar, "Yoga and the Wisdom of Menopause" by Suza Francina, "Yoga Therapy" by A.G. Mohan & Indra Mohan.

If you suffer from low back pain, one of the best videos you can get is "Viniyoga Therapy for the Low Back, Sacrum and Hips" by Gary Kratsow (no yoga experience necessary, the focus is on correct breathing and all exercises are very gentle and slow-paced)

Tuesday, June 19, 2012

HRT, very profitable for Big Pharma, very dangerous for women

Some women asked me what i think of HRT, Hormone Replacement Therapy to treat menopausal symptoms.

Here is my opinion, and though i am not a doctor, it is shared by many enlightened doctors and those who believe that we shouldn't regard the menopause as an illness.
HRT is one of the darkest chapters in medical history.

HRT had a long prescription history before the discovery that it doubled the risk of breast and cervical cancer, and other serious diseases. Premarin was introduced in 1942, long before synthetic alternatives existed. It became the most prescribed drug in the USA, and perhaps the most prescribed drug ever. It is a highly profitable drug, and is now being peddled in Asian and African countries where for centuries women treated menopausal symptoms with natural remedies and diet.

Yet whilst HRT became the drug of choice for the menopause, what sort of 'disease' is this? Is puberty regarded as a disease? If not, then why is its reverse, menopause, treated as one?

Germaine Greer once stated that women had passed through the menopause for thousands of years without any significant help from doctors - but that this all changed when the drug companies wanted to sell its HRT drugs!

The risks and side effects of HRT were known many years before 'scientific' research highlighted its dangers.

Martin Walker's book 'HRT. Licenced to Kill and Maim' (2006) questions a health care system that first creates illnesses (menopause), and then creates profitable drugs to 'cure' them.

Are we really that wise to argue with Nature's wisdom and defy it?

Yes it's true that some women are at an increased risk of osteoporosis when their estrogen level drops, but bone density can be increased naturally, without relying on HRT. Moreover bone mineral density varies widely in a population and decreases with age, how can we decide where to draw the line and call it abnormal? When does it become a disease requiring treatment?

My mother was diagnosed as suffering from 'severe osteoporosis' after being tested at 43, when she entered menopause. And yet the so-called 'abnormal' result of the test may have a simple explanation: she has always been very thin, and her bones are small and light.

She was prescribed Fosamax, a drug manufactured by Merck, which incidentally, set up a nonprofit organization called the Bone Measurement Institute, to spread the use of cheaper scanning machines that brought down the price of bone exams. So, here we have Big Pharma 'generously' promoting the development of small, less expensive scanners that could be used on a heel or wrist in a doctor’s office. Unsurprisingly the majority of post-menopausal women tested were found to suffer from "dangerously low bone density", and prescribed Fosamax!

The problem with the smaller peripheral machines is that taking a measurement of someone’s heel or forearm isn’t going to tell you what you need to know about the bones in the parts of the body that, if fractured, increase a woman’s risk of death — the hip and spine.

My mother stopped taking Fosamax due to serious side-effects, and guess what? She has never had a fracture!

Aging is natural, and so is a decrease in our bone density. If we want to lead a healthy and active life well past the menopause, we can do so without relying on drugs. Yoga, weight-bearing exercise, prevention of falls, quitting cigarettes, curtailing alcohol and caffeine, and ensuring adequate intake of calcium and vitamin D are all beneficial.

For symptoms such as hot flashes and night sweats, Black Cohosh, a phytoestrogen, helps many women manage menopause symptoms. Other herbs recommended as beneficial include Dong Quai, Evening Primrose Oil and Vitex Agnus Castus.

For a treatment plan, one can consult a naturopath, or a Chinese medicine doctor (Chinese medicine has been very effective in treating my friends' symptoms)

It's not natural to eat processed food, nor to forego the important foods that can help balance our hormones. It's not natural to go without physical exercise, live in a polluted environment....and then take HRT and antidepressants to feel 'normal'.

Almost all this "unnaturalness" is imposed from without - from the polluted environment, the stress of maintaining two-income households, eating processed food for convenience, or getting less exercise due to labour-saving devices. But these factors have a negative impact on a woman's hormonal balance and overall health, and may ultimately be linked to her seemingly 'sudden' menopausal symptoms and 'sudden' ill health.

We need to take our lives back.

The menopausal transition is like a big wave: we can learn how to surf it and have a life-changing experience that will empower us and give us the confidence to ride all the waves that bring us closer to the core of our being, or we can resist it, build a big seawall against the wave and live in fear that it may crack or be destroyed..

I think of HRT as that seawall. It gives you a false sense of security as it cannot protect you from life unforeseeable and extreme events.

Overall, a holistic approach to managing menopausal symptoms is preferable. It is important to remember that a seawall is a static feature, it conflicts with the dynamic forces of nature and impedes the exchange between land and sea (that is, between you and the transforming force of menopause).

This is a time of Change and Renewal. It may feel like a storm at times, but we can all become riders on the storm, to paraphrase The Doors!

Sunday, June 17, 2012

Chinese medicine perspective on menopause

I live in Hong Kong, and have recently started to compare notes on the menopause with Chinese friends and acquaintances. It seems that for Chinese women, hot flashes and night sweats are uncommon experiences, and very few of them choose hormone replacement therapy. It is an interesting fact that fewer Chinese women experience noticeable menopausal symptoms, compared with the majority of Caucasian women.

What explains the difference between the typical Chinese woman's experience of menopause and the typical Western woman's experience?

Based on my observations, I would say that it is a combination of diet, acupuncture, and Chinese herbal medicine that is the determining factor in maintaining their health through menopause.

In Chinese medicine the physiological stages are defined in seven-year segments.

A woman’s first seven-year cycle is when “kidney” energy gets stronger. In the second seven-year set, a pituitary gland and sexual hormone called Tian Gui arrives, the Ren meridian opens up, and the Chong meridian is full of energy. This brings on menstruation and other changes.

It is in the seventh cycle of seven years when this cycle begins to reverse. A woman’s Ren meridian energy drops, energy in the Chong meridian weakens and the Tian Gui hormone slows or stops production. Timing of all these changes varies because woman with stronger “kidney” energy will menstruate longer.

When a woman arrives at menopause the ovaries stop producing eggs and they stop manufacturing estrogen. During menopause these ‘retired’ ovaries transfer their function to the adrenal glands.
If we accept the 'seven-year stages' theory, we know that nothing happens suddenly. When a woman's kidney qi starts to decline, the yang rises to the surface, causing hot flushes, night sweats, headaches, irritability, dry eyes, vertigo and insomnia. 

The yin-yang balance can be restored with natural remedies, yoga, acupuncture, diet and lifestyle changes. If a woman is already suffering from kidney yin’s deficiency due to stress, constant activity, long hours, irregular eating habits, excess mental activity, etc. with not enough time allowed for the body to rejuvenate, inevitably menopausal symptoms will be magnified. 

Using adrenal gland cultivators such as Dong Quai (Chinese Angelica root), Di Huang (Rehmenia root) and others will let the adrenal glands gain more strength and work smarter over a three or four month period.

 On the other hand if her qi is balanced, a woman may hardly notice the transition.

what's your dosha?

As each human being possesses a unique combination of doshas (Vata, Pitta, Kapha), women may suffer from different menopausal symptoms according to the dosha that is predominant in their constitution.

For this reason, the ideal approach to yoga during menopause is one that takes into account your current imbalances, be they physical or emotional, encourages development of the continual self-care concept and connects with a woman’s innate wisdom. Yoga for menopause is best taught individually, as poses and breathing exercises should be adapted to each individual's needs.

Since menopause is the transition from the Pitta phase of life to the Vata phase, if a woman already has a significant Pitta or Vata imbalance in the years before menopause, things are likely to get worse during menopause, which is a period when hormonal and other natural changes take place in the body.

So, what's your dosha?
I have found an excellent diagnostic tool online. Take the Ayurveda test and learn more about ways to rebalance your doshas.


Ayurveda teaches us that diet can be a crucial tool in menopause management.

If you are prone to Pitta-based problems, such as hot flashes, mood swings and anger, follow a Pitta-pacifying diet: avoid foods that are spicy, such as chilies, cayenne and black mustard seed, salty foods and foods that are sour, such as yogurt (unless it is diluted and sweetened in a lassi) and sour condiments such as mustard and vinegar.

Favour foods that are bitter, astringent and sweet, as these are cooling to Pitta dosha. Sweet, juicy fruits such as pears and plums also pacify Pitta dosha. Cook with Pitta-reducing spices, such as cinnamon, coriander, cardamom, fennel and small amounts of cumin seed.

If you experience Vata-related symptoms of menopause such as restlessness, anxiety, depression, brain fog, memory loss or vaginal dryness, you'll want to bring Vata dosha back into balance. For this, you'd better stick to foods that are cooked, warm, and unctuous (meaning that they have a small amount of good fats such as ghee and olive oil). Eat foods that are sweet, sour and salty, as this balances Vata dosha.

For both Pitta and Vata imbalances, a breakfast of cooked apples and prunes and figs is a good way to start the day, as it balances the doshas and cleanses the digestion.
Try to eat your main meal at noon, when digestion is the strongest, and eat at the same time every day. Sleep is just as important to balance Vata and Pitta: go to bed and wake up at the same time (so difficult and yet so important for Vatas who are natural night-owls like myself)

Kaphas tend to be rounder and have large frames. Their menopausal symptoms are therefore characterized by weight gain, feeling tired and bloated. Kaphas should watch their diets, eat small portions, avoid cold, oily, sweet and heavy foods. Eat three meals a day, with the lunch being the main meal. Weekly fasting is helpful. Most or all of the daily food should be consumed between the hours of 10 a.m. and 6 p.m. They should also get plenty of physical exercise.