Nobody tells you that menopause has a long doorway.
Most of us grow up with one picture: hot flushes, then periods stop, then it is over. What is rarely explained is perimenopause, the years of change before periods end. It can begin in the 40s, sometimes earlier. And it often arrives quietly, looking like something else.
Your periods come closer together, or further apart, or heavier than before. You wake at 3 a.m. and cannot get back to sleep. You snap at people you love, then feel awful about it. You lose a word mid-sentence. Your body feels unfamiliar and nobody around you seems to be going through the same thing, because nobody is talking about it.
If that sounds like you, two things are worth knowing first.
You are not imagining it. The NHS lists changes to periods, hot flushes and night sweats, sleep problems, low mood, poor memory and brain fog, and aches and pains among common symptoms. It also says clearly that perimenopause is different for everyone. Some women have symptoms that affect work, relationships and daily life. Others hardly notice any.
And you do not have to push through it quietly. Many of these symptoms have other possible causes, such as thyroid problems, anaemia or stress. If your periods change, if bleeding is very heavy, or if symptoms are disturbing your life, speak to a doctor. A doctor can tell you what is going on and discuss options, including medical treatment where appropriate. Yoga does not replace that conversation.
WHERE YOGA FITS
Now the honest part, because women going through this deserve honesty more than promises.
Yoga is not a cure for perimenopause. It does not “balance your hormones,” and no one can promise that a practice will end hot flushes.
Research gives a more careful picture. In a randomised trial published in the journal Menopause (the MsFLASH trial), 355 women with hot flushes were randomised to yoga (107 women), aerobic exercise (106) or usual activity (142). The yoga group had 12 weekly 90-minute classes plus home practice. Compared with usual activity, yoga made no difference to how often hot flushes happened or how bothersome they were. It did reduce insomnia symptoms. A 2012 review of randomised trials found the evidence for yoga on menopausal symptoms was limited and mixed. More recent reviews of mind-body exercise suggest possible benefits for sleep, anxiety, depression and fatigue in women around menopause, although study quality varies and results differ between trials.
So what can we say fairly? Yoga may support sleep and how you cope with stress and mood during this time, and some women find it a welcome part of their week. It is not a proven treatment for hot flushes, and it is not a substitute for medical advice. Both things are true.
IF YOU WANT TO TRY IT
There is no single right practice, and what suits one woman may not suit another. These are things to think about, not instructions.
Work with a qualified teacher. Tell them what you are experiencing and any health conditions you have, so the practice can be adapted to you. If you can, choose a teacher who is comfortable working alongside medical care.
Keep it comfortable. Many women find gentler, shorter sessions easier to keep up than something demanding, especially on days with poor sleep or heat waves. Choose what feels manageable for you, and skip heated rooms if heat is hard for you.
Let rest count. Some days, lying still is the practice. That is not failing at yoga.
Notice, don’t force. If breathing practices feel calming, keep them easy. If anything brings on pain, dizziness or distress, stop. Also note that paced breathing was not recommended for hot flushes in the North American Menopause Society’s 2023 position statement, so it is best seen as a way to settle, not as a treatment.
A FEW THINGS TO WATCH
Tell your teacher about any health condition, including heavy bleeding, joint pain, high blood pressure, osteoporosis or a recent diagnosis. Come out of any pose that causes pain or dizziness. And if symptoms like low mood become heavy or hard to shake, please see a doctor or mental health professional rather than waiting for a practice to fix it.
If you have a history of certain cancers or are on medication, your doctor should guide your choices about symptom treatment. Yoga can usually sit alongside that care, but it should never be a reason to delay it.
WHY THIS CONVERSATION MATTERS
Women often learn about perimenopause late, and mostly by living through it. A good teacher can change that. When a class is a place where a woman can say “I have not been sleeping” and be heard, without being told to “just keep busy,” something real has already happened.
At hellomyyoga, we believe learning yoga should respect the whole person and the medical care that goes with it. Our programs bring together yoga with the wider context of health, so that practitioners and teachers understand both what yoga can offer and where its limits are. You can explore the programs on the hellomyyoga website.
If you are in the middle of this transition, be patient with yourself. Your body is not failing. It is changing, and you are allowed to ask for support while it does.
This article is for general education and is not medical advice. Please speak to a qualified doctor about symptoms, diagnosis and treatment.
Sources
- NHS, Symptoms of menopause and perimenopause: https://www.nhs.uk/conditions/menopause/symptoms/
- Newton KM et al., Efficacy of yoga for vasomotor symptoms: a randomized controlled trial. Menopause, 2014 (MsFLASH; 355 women randomised to yoga, exercise or usual activity): https://mymenoplan.org/wp-content/uploads/2020/12/ms13.pdf
- Cramer H et al., Effectiveness of yoga for menopausal symptoms: systematic review and meta-analysis of RCTs, 2012: https://pmc.ncbi.nlm.nih.gov/articles/PMC3524799/
- Mind-body exercise in perimenopausal and postmenopausal women: systematic review and meta-analysis: https://pmc.ncbi.nlm.nih.gov/articles/PMC11465887/
- The North American Menopause Society, 2023 nonhormone therapy position statement: https://pubmed.ncbi.nlm.nih.gov/37252752/
