How does yoga alleviate period cramps and PMS?

Period cramps, known medically as dysmenorrhea, are caused by the uterus contracting. This occurs when the hormone-like chemical prostaglandin is released, or can be a result of a uterine condition like endometriosis or fibroids (1Trusted Source2Trusted Source).

There is wide variety in the intensity and length of period cramps, depending on the individual. Many people may even experience periods of heightened and lessened cramps throughout their lifetime, depending on their age and reproductive stage (3Trusted Source).

In addition to the uterus contracting, people with cramps sometimes feel pain in other areas of their body, such as lower back aches or even hip and thigh pain.

Exercise has long been suggested to relieve the back pain and aches associated with PMS (2Trusted Source). The type of exercise may play a role in the pain relief, with higher intensity exercise helping by reduction of inflammation, and lower intensity exercise, like yoga, helping to decrease cortisol and prostaglandin levels.

For example, one study observed the effects of a specific yoga-based program on menstrual cramps and found significant improvement not only on pain, but also quality of life after the yoga session (4Trusted Source).Another study concluded that yoga may be even more effective at alleviating PMS symptoms than general exercise (5Trusted Source).

Sarah Garden has been working as a yoga therapist for over 20 years with a specialty in chronic pain and pelvic health. She has observed that yoga can be particularly helpful with the “broader body response” to the pain associated with dysmenorrhea, like shallow breathing, breath holding, and muscle tension.

Garden explains, “Yoga practice can teach us how to relax our body and breath even in the face of pain. It can gently stretch cramping muscles, and have an overall calming effect on the nervous system.”

The 4 best yoga poses for period cramps

The specific poses that alleviate period pain and PMS symptoms are often subjective. Garden has observed that for some of her clients, a general flow that includes many different types of postures has been helpful, as it moves the body in a variety of ways.

But according to Garden and another longtime yoga teacher, Sara Hess, who adapted both her yoga practice and teaching after being diagnosed with Stage 4 endometriosis, restorative yoga can be a good place start.

Hess has found that this family of poses “can create a nurturing and opening feel for the uterus to relax and heal,” continuing, “the uterus is the strongest muscle in the body, but it commands surrender. Restorative [poses] help us to surrender more deeply within our uterus.”

What classifies a posture as restorative is both the use of multiple props, so the body is fully supported, and longer hold times. As such, the postures below can be held anywhere from 5-20 minutes, as long as you’re feeling supported.

In addition to physical poses, Garden recommends spending time on pranayama, which are the breathing practices of yoga, and deep relaxation meditations.

Supta Baddha Konasanana (Supported Cobblers Pose):

Props required: Bolster, blanket, strap, and two blocks

  1. Place a bolster vertically down the center of your mat. If you do not have a bolster, you can fold blankets into a narrow pile. You may want to place an additional blanket at the top to form a pillow.
  2. Sit in front of the short end of the bolster, facing away from it, with your sit bones on the floor.
  3. Bend your knees and bring the soles of your feet together
  4. Grab your strap. You’re going to weave it around your hips: first around your sacrum and then in-between your legs (along the inner thighs) and around your feet. It helps to have the buckle closer to your pelvis so you can adjust the tightness even after lying down.
  5. Slowly lie back onto the bolster. Rest your head on the blanket if you have one there.
  6. If the groin stretch is too intense, you can place a block beneath each outer thigh.

Setu Bandha Sarvangasana (Supported Bridge Pose):

Props required: Bolster, strap, one block

  1. Place a bolster vertically down the center of your mat. If you do not have a bolster, you can fold blankets into a narrow pile. Set up a block at the end of the bolster. You will be placing your feet on it once you are fully supine.
  2. Loop a strap around your ankles snugly.
  3. Sit on the end of the bolster and lie back.
  4. Slide your body backwards off the bolster, until your upper back is on the floor and shoulders are off the top of the bolster. The sliding movement can be helpful to release the trapezius muscles so they relax down away from your ears.
  5. Release your arms by your sides.
  6. Rest your heels on the block. You might need to slide it away from you to lengthen your legs fully. If you feel any discomfort in your lower back, consider adding more blocks, or even using a chair to rest your feet.

Paschimottanasana (Western Stretch/Forward Fold)

Props required: Bolster, blanket(s), block

  1. Sit onto a folded blanket and stretch your legs out in front of you. If your lower back is rounded, try piling more blankets beneath you or bend your knees.
  2. Place the bolster perpendicularly across your thighs. Pile a block on top.
  3. Attempt to drape yourself over the props with your forehead on the block. If the props are too low, build them higher with more blankets and more blocks.
  4. Your back will round, but we want to avoid any straining in the neck to do so.
  5. Let your arms relax by your sides.

Viparita Karanai (Legs-Up-The-Wall)

Props required: One blanket or a thin bolster

  1. Bring the short end of your mat to a wall.
  2. Sit sideways next to the wall. Lie down and turn your body, taking your legs up the wall.
  3. You will want your sacrum on the floor, so slide back as much as you need to, to achieve that.
  4. Take a narrowly folded blanket or thin bolster underneath your sacrum. Ensure your sit bones are on the floor.
  5. Place your arms anywhere that feels comfortable.
Are yoga inversions OK to do on your period?

To begin, let’s clarify what a yoga inversion is. They are generally classified as shapes where your pelvis is above your heart.

Common inversions that people may question doing on their period are poses like as Handstand, Headstand, Shoulderstand, and Forearm balance, but many postures can actually be classified as inversions, even without your feet leaving the floor. For example, Adho Mukha Svanasana (Downward Facing Dog) can be considered an inversion.

As such, many evidence-based yoga teachers and yoga therapists, like Garden, have been digging into the studies trying to find supporting evidence that going upside-down on your period is dangerous, only to come up empty-handed.

There is not a full consensus among yoga practitioners whether people on their periods should not invert. For example, in the Ashtanga tradition, some shalas (studios devoted solely to this style) will ask you to leave if it’s the first three days of your period (6).

In yogic philosophy and Ayurveda, menstruation is a process requiring apana, or “downward flowing energy,” and inverted positions disrupt the natural flow of apana. However, there is much controversy over this concept among contemporary yoga teachers (7).

Many modern teachers, like Garden and Hess, are working hard to debunk what they feel are outdated beliefs and hand the power back to the students as to whether they feel right about going upside down that day.

And frankly, as anyone who menstruates knows, your body tells you what you need. Some days at the beginning of your cycle it is hard enough to lie flat on your yoga mat, let alone jump into a handstand, but then later that week, you could feel ready to fly.

Yoga is ultimately about listening to your body and doing what is best for you.

Tips and considerations

Just because some poses may reduce pain or relieve symptoms does not mean that you should ever force yourself to do physical movement when you are feeling low on energy.

One of the symptoms of PMS is fatigue, and if you are extremely tired, there is a risk that you may be less mindful when moving. In that case, it might be better to rest and try again a different day.

Please also note that some people have medical conditions such as polycystic ovarian syndrome (PCOS) and endometriosis, which can worsen PMS and period cramps to the point that physical movement can actually exacerbate certain symptoms.

Please always speak with your medical provider before trying anything new or if you are experiencing more pain after exercising.

Garden reminds us that, “while yoga can be very helpful, it often needs to be a part of an integrated approach with consideration given to other treatment modalities and supports.”

The bottom line

Our periods may be something we have to deal with every few weeks for the majority of our lives, but thankfully there are some great alternative approaches and therapies that can help us find some relief.

Something to consider, which many of the philosophical teachings of yoga reinforce, is that nature is filled with ebbs and flows. The cycles of the moon wax and wane, the waves of the ocean crest and fall. Just as in nature, our body cycles too.

Those weeks during a person’s menstruation cycle can be a nice opportunity to slow down and connect with your body in a more restorative way.