The western woman participates in a society that is patriarchal, individualistic, consumerist, competitive and materialistic. Each of these aspects provides her with challenges in her efforts to develop a healthy personality. She attempts to find her place as a woman in a society where the masculine is highly valued and holds central position. She finds that power, wealth and social status are predominantly the domain of men. In this society she strives to make sense of her position of service, provider and nurturer. The communal and cooperative qualities she develops as a woman, mother, teacher, nurse and in other service roles take second place to (even while they support) dominant values.
In the middle years, roughly 45 to 60 years, she attempts to find value for herself from her lifetime of contribution in a society that lives for the moment, consuming and disposing of the old for the new with great appetite. Any status she once derived from youth, beauty or being the mother of children is weakened when she is no longer young, no longer seen as beautiful and the children have left home. She may feel both consumed and disposed of. At this time women also confront a number of other health related issues: ageing, the passage through menopause, possible physiological imbalances from years of poor lifestyle habits, and specific physical symptoms related to frustrations at a deeper level.
Ageing is a natural process usually seen initially as a physical phenomenon. It brings with it a range of possible mental, emotional and spiritual opportunities for growth. The first symptoms of ageing appear on the physical body. There are a number of ways to view the passage of time on the body. If a woman subscribes to society's valuing of her in terms of youthfulness, beauty and her capacity to bear and nurture children, then the ageing process and its physical effects can bring with it a sense of sadness and loss. These emotions can lead to health problems.
There are other more health promoting ways to view ageing. One such framework presents ageing as a cause for celebration. While western society presents few positive images for ageing women, women themselves can refuse to take the negative view promoted, seeing the physical changes as positive. A woman may see herself as a quilter who has threaded her life's experiences upon her body. Each marking reflects her achievements, sorrows, adventures and self-transformations, reflecting the wisdom gathered in a lifetime of experience. Women can value each other and see their increasing years as positive rather than negative, celebrating each other's achievements and together looking forward towards the future with faith and hope.
A second framework for viewing life and the ageing process is presented by Deepak Chopra (1989). His view emphasizes the body, mind and spirit unity within human persons and their connectedness to the cosmos. He proposes that our bodies are composed of energy and information which come from an infinite source. Our mind and bodies are inseparable and we ourselves are not separate nor independent from each other and the rest of creation. We are all connected to patterns of intelligence that govern the universe and our bodies are part of a universal body. Time does not exist as an absolute, but is eternal. An informed woman can make choices about how she views ageing and can walk towards her future with optimism and confidence.
Menopause is a normal biological event which occurs in every woman's life when the ovaries stop producing eggs and begin to secrete significantly less of the hormones, oestrogen and progesterone. Western society has presented this natural milestone in derogatory and misleading ways, causing many women to approach this phase of life with anxiety and dread. The images associated with menopause have been negating rather than life affirming.
However, as Leslie Kenton (1995) points out: The radical and fundamental changes which take place in a woman's life around the time of menopause are not signs of decay. They are signs that the woman is entering a new and liberating phase of her life. ...menopause is a time of celebration that our creativity is no longer bound to our obligation as a member of the human race to propagate the species. Often for the first time in a woman's life her creativity can be set free for use in whatever way the whispers of her soul dictate.
Appreciation and celebration of this passage in life may require some shifts in thinking, considering the social context in which the western woman finds herself. Other times and other cultures have different frameworks in which to understand 'the change' as natural, powerful and having deep spiritual meaning. For example, Leslie Kenton (1995) talks of traditional medicines and eastern philosophies understanding the energy release of the menopausal 'hot flush' as powerful kundalini energy, refining the nervous system so a woman becomes capable of carrying powerful healing energies, energies of wisdom and peacekeeping, all of which throughout history have been viewed as the responsibility of the post-menopausal woman or crone.
The crone in mythology represents the destroyer. Through western eyes the crone can be quite frightening. She is the aged hag, withered, ugly and socially very unacceptable, something to be feared and rejected. Yet in mythology the crone represents the destruction of one in order to renew. We could consider the symptoms of sadness, loneliness, rage, withdrawal, depression and irrationality often surfacing at times during menopause as the crone screaming out to us to clean out of our lives whatever is no longer essential to our inner being, whether this be possessions, relationships or jobs, anything that doesn't help us to grow and fulfil our deepest needs (Kenton, 1995). A woman can, therefore, choose to see menopause as a powerful force for positive life change and self-transformation.
Many western lifestyles and food habits do little to promote health. Because there is truth in the saying We are what we eat, by the time we reach our middle years we are often beginning to feel the effects of diet and lifestyle choices. Although the body is a marvellous organism in its ability to manage these unfavourable assaults, in the middle years, a woman's body may be showing signs of distress. These signs can be misconstrued as part of the ageing process and menopause, or they can be seen, more correctly, as signals to make lifestyle changes.
If a woman chooses to change unfavourable lifestyle habits, symptoms such as obesity, body aches and pains, unhealthy cholesterol levels, headaches, bone loss, menstrual tension, digestive disorders and depression can be lessened, managed or resolved. The woman in her middle years can then begin to see her body as vital, active, full of energy and in tune with the biorhythms of nature.
The community in which she lives is very mobile. Very few women in this generation construct a lifelong community based on extended family relationships or friendships made in childhood and sustained to adulthood. The population moves for various reasons including work opportunities, climatic and financial reasons. This mobility, for women in their middle years especially, should be balanced by a clear understanding of the need for community and belonging. Women who make the life changes involved in relocation often no longer have access to the sense of belonging that accompanied responsibilities of raising children and a job.
For these women there is also the increasing likelihood of embarking on this phase of life alone. Divorce, relationship changes and death of a spouse may increase the perceptions of dislocation and disconnection. Therefore, lifestyle choices should consider particular needs relating to diet, exercise, living in harmony with the natural biorhythms and community and human relationships.
The human body is an amazing biological system. It takes in and assimilates raw material, produces energy and excretes waste in order to grow and sustain life. It is even more amazing if we appreciate its relationship with the mind. The body has the intelligence to mirror back to us many aspects of ourselves: our needs, unconscious reactions, repressed emotions, aspirations and fears. This reflection is not in words but in the body's language of health and ill health.
Appreciating this mind/body link, we can move in a direction away from the view that accepts specific symptoms of ill health in mid-life as part of the natural process of ageing or menopause. Backache, headache, joint pain or obesity, for example, could be considered as an illness telling us that we need to stop doing something. That is, the repressed memories and experiences insist on expression, if not through the conscious mind, then through the body. Knowing the body's capacity to signal to the mind that unconscious material needs to be dealt with is a powerful and necessary understanding. The woman in her middle years who gains this knowledge, who accepts the body's messages and who learns methods of resolving inner conflicts can deal effectively with many of the specific symptoms which manifest at this phase of her life.
A balanced yoga program will include weight bearing practices (relevant to ageing), practices for the endocrine and nervous systems (related to menopause), dynamic practices (to deal with issues of sedentary lifestyle), and relaxation/meditation techniques (for emotional release). The shatkarmas neti, kunjal and laghoo shankhaprakshalana can both prevent and relieve disorders of the respiratory and digestive systems which may arise in mid life.
Weight bearing practices address the issue of muscle loss and bone density changes accruing as part of the ageing process. Recent research (Deepak Chopra, 1993) funded by the USA government (motivated by the spiralling costs of an ageing population) has found that weight bearing practices improve muscle mass and can reverse problems of bone density loss. This research found that other physical indicators associated with ageing, such as declining base metabolic rate, lowered aerobic capacity, increase in blood pressure, changed ratio of healthy to unhealthy cholesterol in the body and altered proportion of fat to muscle, also responded positively as weight was brought to bear on the body.
Osteoporosis, which is progressive bone loss, is seen as part of the ageing scenario, but it can be strikingly more severe in the menopausal body because of hormonal changes. Osteoporosis often goes unnoticed and unchecked until bone fracture occurs. For this reason preventive practice is very important. Asanas which bring weight to bear on the body can provide one such practice.
Many practices can be adapted for women with bone weakness. Three points can be considered. Firstly, bed rest contributes to bone and muscle loss (so this is no solution for women with osteoporosis). Secondly, when the body is in a standing position, the weight of muscle attached to bone provides enough stress for bones to regenerate (Tortora, G.T. and Grabowski, S., 1996), (so just standing is a useful practice). Third, bone made strong in one section of the body communicates its density to bone mass throughout the body (so even working on one part will help other parts of the body) (Deepak Chopra, 1993).
The following asanas are helpful for osteoporosis: marjariasana, tadasana, vyaghrasana, naukasana, dwikonasana, shashank bhujangasana, utthanasana, ushtrasana, vipareeta karani asana, sarvangasana, bhujangasana and surya namaskara, when performed dynamically. Other general weight bearing asanas include: pranamasana, base position, hasta utthanasana, sphinx asana, makarasana, eka pada pranamasana, simhasana and eka padasana.
In the middle years women experience changes in their bodies as a result of menopause, when the ovaries stop producing eggs and oestrogen and progesterone changes occur in the body. This change takes place over a number of years and physical, mental and emotional symptoms may be experienced as a result of hormonal fluctuations. It is important that women understand the workings of their bodies in order to avoid unnecessary fear, anxiety and stress at this time.
The endocrine system is central to the body's smooth functioning and has a great influence in this transitional time. The pituitary gland (and hypothalamus) coordinate the menstrual cycle. During menopause the ovaries produce less oestrogen and progesterone is no longer secreted. In an attempt to stimulate the ovaries into producing eggs the pituitary produces greater amounts of FSH and LH. These pituitary hormones temporarily (over some years) increase their production until the body finds a substitute for oestrogen produced by the ovaries. The fatty tissue and the adrenal glands become this substitute. Increased amounts of FSH and LH is thought to produce hot flushes, a symptom of menopause (Linda Ojeda, 1990).
The thyroid and parathyroid glands, are involved in the homeostasis of bone remodelling. Calcitonin secreted by the thyroid and parathyroid hormone secreted by the parathyroid keep the ionic calcium and phosphate balance healthy within the body so that the breaking down of old bone is replaced with new. A sluggish thyroid also causes fatigue, another symptom of menopause.
The adrenal glands control the balance of sodium and potassium in the body, the metabolism of carbohydrates, proteins and fats, balance the sex hormones, produce muscle tone and produce the fight/flight stress reaction. They are a major source of post-menopausal oestrogen, essential for maintaining healthy bones, by helping to convert androstenoodrone into oestrogen.
The thymus gland is located close to the heart and is important for the immune system. It produces two hormones which promote the proliferation and maturation of T cells which destroy microbes and foreign substances. Recently, evidence is suggesting that thymic hormone may retard the ageing process (Tortora & Grabowski, 1996).
The pancreas secretes glucagon, somatostalin and pancreatic hormone, which raise or lower blood glucose levels in the body. Women who experience fatigue may have a blood sugar imbalance, which may be due to prolonged stress, chronic infection, cancer or tumour, but for the most part is self-induced by eating sugars and refined foods. As a result the pancreas (pituitary, adrenals and liver) may become ineffective, failing to react appropriately in times of major or minor stress, resulting in fatigue.
During and after menopause the ovaries produce significantly lower levels of oestrogen. While the body finds alternatives for this loss it is important to keep the ovaries toned and balanced in order to maintain what level of oestrogen the ovaries continue to produce. Yoga practices that tone and maintain the endocrine glands, and the nervous system that communicates with these glands, include forward and backward bending, twisting and sideways bending and inverted postures. Pranayama, mudras and bandhas are also beneficial. The following practices are recommended: tadasana, marjariasana, bhujangasana, shashank bhujangasana, kandharasana, paschimottanasana, yogamudrasana, shalabhasana, dhanurasana, trikonasana, vipareeta karani mudra, ardha matsyendrasana, supta vajrasana, halasana, ushtrasana, surya namaskara, kapalbhati, nadi shodhana, bhramari, jalandhara, moola, uddiyana and maha bandha, shambhavi, nasikagra and sahajoli mudras, neti and trataka.
Dynamic practices are a means of addressing problems arising from a sedentary lifestyle. They stimulate and tone all the systems of the body cardiovascular, nervous, respiratory, digestive, circulatory and hormonal and often involve energetic movements of the body, stretching and strengthening the muscles and joints. Furthermore, because many women tend to be shallow breathers, the forced deep breathing which dynamic asanas produces can contribute to bringing new and positive habits of deeper breathing. Useful dynamic practices are pawanmuktasana 2 and 3, surya namaskara, dynamic paschimottanasana, dynamic halasana, jhulana lurhakanasana, trikonasana variation 4, shashank bhujangasana and spinal twists.
The middle years are a time to deal with any unresolved issues from the past in order to move towards the future. Because of the mind/body/spirit link, asanas can help to release pranic blocks and free mental and emotional tensions as they relax stiffness in muscles and joints. Other helpful yogic tools are shavasana with breath awareness, yoga nidra, pranayama, mudras and meditation. All influence the physical, mental and spiritual planes, helping to release unresolved issues at the unconscious level.
Yoga nidra is a relaxation technique as well as a tool for reconstructing and reforming the personality. The stages of sankalpa and visualization can act as a support for women in mid-life by constructing positive images of the future. For example, sankalpa can set the scene for changing negative attitudes to positive. Visualization can provide for a woman a vision of herself and the future as positive, healthy and strong.
Pranayama involves influencing the breath and altering the flow of prana in the body. Because pranamaya kosha is the link between the annamaya kosha (physical body) and the manomaya kosha (mind), the practices of pranayama can reach all the levels of the mind and influence the unconscious. These practices therefore help to resolve unconscious issues by clearing energy blocks and harmonizing prana. Useful pranayama practices include full yogic breath, kapalbhati, nadi shodhana, bhramari (and mudras). Mudras create a link between the physical and pranic bodies which together influence the mental body. With the nadis clear and prana flowing freely, deep seated conflicts find channels to surface and be resolved.
Meditation, in particular antar mouna, can help to maintain physical, mental and spiritual health. Allowing the unconscious thoughts, feelings and images to rise to the conscious level while witnessing these as a neutral observer facilitates the resolution of many unconscious conflicts and the release of repressed memories and experiences. Other useful meditation practices include trataka, chidakasha dharana, hridayakasha dharana and ajapa japa.
Vanaprastha ashrama, the third stage of life, or life after retirement, provides a useful and positive inspiration for women who have fulfilled all the dharmas and obligations of family and social life. Each person has their own destiny and it is futile to interfere with the destiny of family members who, for so long, have been the woman's full-time responsibility. She is freed to fulfil other aspects of her dharma. In this stage she begins the quest for moksha (liberation). She may legitimately begin to withdraw and focus inwards.
Karma yoga is service in the interests of others. Most women are no strangers to working in the service of others, whether as spouse, mother, or in the service industry section of the workforce. In the middle years, some will find there is a gap in their previously active lives, as children leave home, the workforce shrinks leaving many with little or no paid work and some are left without partners. The concept of karma yoga can provide new meaning to a woman's activity at this time. Personal sadhana can extend from morning asana, pranayama and meditation routine to include karma yoga and dealings with other people throughout the day.
Yoga has a major contribution to make to women in their middle years. The physical benefits may be felt as relief from specific ailments, an improvement in other physical problems and a whole sense of physical well-being. This can be a very powerful experience for some women who have lost touch with their body and who are alienated from the physical dimension. The mental and emotional benefits include an overall sense of relaxation and calmness, which act as a means to control stress and tension in their lives. At the spiritual level yoga can provide an enriching experience through kirtan and meditation. For those women who have lost contact with their spiritual nature it can awaken this aspect and provide a means to realize a deeper centre within themselves.