Inversions During Menstruation?

19 May

Inversions During Menstruation?

Whipstitch Chronicles just published a nice blog reviewing information currently on the internet about the hazards of doing inverted postures while menstruating.

Overall, the blog was great, but I have an objection to one line.

The medical perspective has basically verified that there is no reason to fear that inverted poses during menses will increase a woman’s risk factor for developing endometriosis, a painful pelvic condition that can lead to infertility.

This is so not true.

I understand where she gets it. In the Yoga journals a medical doctor once quoted some (at the time – a decade or so ago) cutting edge research about the cause of endometriosis that pointed to factors other than retrograde flow as causative. The studies referred to determined that migrated stem cells within the pelvic cavity developed into endometrial tissue. Now we know those stem cells likely come from the endometrial layer of the uterus   from retrograde flow. Others docs have said that most women have some backwards flow but that not all women develop endometriosis. Thats true. There are other factors working in concert, but retrograde flow is a risk factor and the more backward flow, the more likely one is to develop disease.

Although we still don’t really know for sure what makes some women have the disease and not others, Samspons 1927 theory of retrograde menstruation remains the prevailing scientific hypothesis for what causes endometriosis. Its complicated, and other factors play a part- things like genetics, epigenetics, immune function, environmental toxins like dioxins, etc.

For sure, women who have more frequent periods, those who bleed heavier, and those with a blockage to normal flow through the vagina are the most likely to develop endometriosis. That indicates the amount of backward flow is important in development. Quantity matters. Baboon studies back this up the more endometrial tissue in the pelvic cavity, the more likely you are to develop disease.

“While there are no studies looking specifically at whether or not women who practice inversions during their periods are more likely to develop endometriosis (arguably a very difficult study to really do well), prudence is wise. Anyone with a personal or family history of endometriosis should never do inversions while on their period. Other women need to be careful too, especially during the days of heaviest flow. If they choose to invert during menses, then time in the posture should be limited to one minute.”

The longer time spent inverted and the heavier the flow, the more likely there is to be retrograde drainage of endometrium into the pelvic cavity. The presence of endometrial cells in the pelvic cavity in sufficient quantity increases the risk for endometriosis.

These consequences, of course, arent observable right away. You may feel fine right after spending 20 minutes in sirsasana during the time of heaviest menstrual flow, but youve possibly just begun a cascade of changes that ultimately lead to a debilitating and painful disease, one that often leads to infertility.

7 May

Top Yoga Food: Barley

When I think of barley, two things come to mind…

beer and MOMOS!

Almost all beer includes the malted form of this grain as its starch. And momos? They’re dumplings made from tsampa, a flour that is the main carbohydrate source for most Tibetans.

  1. and I ate plenty of momos when we were traveling in Tibet in 2006. We were far in the west, making a pilgrimage around Mount Kailash. It was high and cold, beyond the point of growth for most veggies and beyond much of civilization. Barley flour, cabbage, potatoes, and rice were our main foods – anything to avoid yak, yak grease, and heavy yak buttermilk.

Even though barley reminds me of my time in Tibet and south Asia, I was surprised to see it on the list of recommended food for yogis in the Gheranda Samhita. But, of course, there were great Tibetan Buddhist yogis like Milarepa and Padmasambhava. I bet they ate their fill of tsampa. Others, too.

And with good reason. Barley is a health food, particularly the hulled type, which is a whole grain, unlike the pearled variety. Epidemiological studies have shown that populations eating whole grains are less likely to develop type-2 diabetes and heart disease.

This month a meta-analysis of randomized, controlled trials of the effects of barley consumption on cholesterol levels was published in the European Journal of Clinical Nutrition. The authors found a highly statistically significant lowering of LDL cholesterol levels in people who regularly eat barley, and they recommend adding barley to the diet to help to control cholesterol levels. I think that’s a great idea – anything to lower the amount of drugs taken or maybe to get off cholesterol-lowering medications entirely.

Consumption of barley may also help to stave off the development of type 2 diabetes, and it can help diabetics to control their blood sugar levels. Barley, and other whole grain cereal products rich in indigestible carbs, improves blood sugar levels by raising levels of short chain fatty acids (SCFA) like butyrate. The carbs that can’t be digested in the small intestine are fermented in the colon by bacteria, producing SCFA. SCFA act on cells in the pancreas to help control insulin release, and they work in the liver to control glycogen breakdown. SCFA can also stimulate the expression of genes that code for glucose transporters in the intestine, helping to decrease the amount of sugar absorbed.

Barley suppresses appetite, an effect of increasing health importance as the world population grows more and more obese. Obesity is a major preventable risk factor for serious health problems, second only to smoking cigarettes in the damage it concurs on our population. A study published last year concluded that consumption of whole grain high-fiber barley foods significantly decreased hunger whereas whole wheat and refined rice foods did not.

One cup of cooked barley added to your favorite vegetable soup adds 6 grams of fiber to the diet, providing one quarter of the body’s daily need. That fiber not only provides the health benefits outlined above, it also improves colon function and decreases constipation to keep you regular.

One cup of barley also has 4 grams of protein, 12 % of the body’s daily need for iron, and 20% of the body’s need for selenium. It’s packaged naturally with high levels of B vitamins.

Here’s a hearty, healthy winter soup to try:

  • ½ cup dry, hulled barley
  • 1 cup lentils
  • 1 medium chopped onion
  • 2 minced garlic cloves
  • 2 chopped celery sticks
  • 2 chopped carrots
  • 4 cups fresh spinach
  • 1 tsp salt
  • ½ tsp black pepper
  • 1 tsp oregano
  • 1 tbsp cumin
  • ¼ tsp dry red pepper
  • 6 to 8 cups of water

Bring all ingredients except spinach to a boil and then simmer covered for about an hour. Add spinach and simmer until wilted. Adapted from


Gheranda Samhita. Kaivalyadhama Institute edition. Lonavla, India. 1978.

Abumweis SS, Jew S, Ames NP. ?-glucan from barley and its lipid-lowering capacity: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr. 2010 Dec;64(12):1472-80. Epub 2010 Oct 6.

Nilsson AC, Östman EM, Knudsen KE, Holst JJ, Björck IM. A cereal-based evening meal rich in indigestible carbohydrates increases plasma butyrate the next morning. J Nutr. 2010 Nov;140(11):1932-6. Epub 2010 Sep 1.

Schroeder N, Gallaher DD, Arndt EA, Marquart L. Influence of whole grain barley, whole grain wheat, and refined rice-based foods on short-term satiety and energy intake. Appetite. 2009 Dec;53(3):363-9. Epub 2009 Jul 28.