Yoga | An Essential Component of Every Woman’s Fertility Journey
What is your idea of yoga? Is it the cliched representation of it on tv or social media: flawless teachers and thin, perfect students wearing fun pants and ‘peace and love’ t-shirts? Maybe you have a more realistic perception of yoga, but still think that it requires that you need to be both bendy and strong. The ability to look a certain way in a posture (although some of the poses can be fun) is not what’s important. In fact, the word Yoga, in Sanskrit, means “unity of body and mind” and yoga, to me, is both a conversation with yourself and an invitation to self-discovery.
Although I work hard and am resourceful, I can honestly say that some of the most important aspects of my life, my first NP job, my husband, and yoga, were introduced to me via a convergence of equal parts luck, circumstance and opportunity. When I was in my 20’s, I lived in Manhattan for about a decade, only leaving briefly to go back to school for my Master’s Degree. I returned to NYC as a brand-new Nurse Practitioner (NP). I got a job at an infertility center and felt somewhat lost because I had to both learn about infertility and constantly explain and defend my career path as not many people knew what an NP did back then. I was still struggling with how to eat properly with insulin-resistance, so I wasn’t confident in my appearance, and my grandmother (who was my special person) had just passed away which gutted me. I was living in a city that was amazing, but always felt this undercurrent of inadequacy related to my body image and lack of discretionary income due to a mountain of student loans. Feeling anxious, I went to a therapist for the first time in my life which, at that time, didn’t really help as it just felt like more of a drain on my limited time and finances.
One day, a friend convinced me to go to a Bikram yoga class. As soon as I walked in, I was blasted by the 105-degree heat, yet when I looked around no one seemed to notice. The class was rigorous, yet I saw people smiling through it. I was constantly wiping sweat from, well, everywhere and I noticed that some of the students didn’t even have towels. I noted every body shape and size, and everyone (men and women) wore very little clothes (due to the heat). Toward the end of the class, when it was time for Camel pose (a deep backbend) I was stunned by the feeling that I wanted to cry and, I probably would have, if I had any liquid left in my body after sweating profusely for an hour and a half. It was like something was breaking loose inside me and the resulting sensation was both swift and powerful. I went back to my apartment to clean up and it felt like the best shower of my life. Afterwards, I felt almost buzzed, an odd but potent blend of feeling both rejuvenated and calm. I was shocked that I could feel this way after only one class, but the research has shown this to be true.
I was shocked I could feel this way after only one class, but the research has shown this to be true. I continued to go whenever I could because it allowed me to be the person I wanted to be more often.
I was intrigued. As an NP with access to medical journals, I researched the science of yoga and, at that time (1997), there wasn’t much information available. Like many branches of Eastern medicine, the study of yoga doesn’t lend itself to rigorous scientific data and the brain imaging studies that we have now weren’t yet discovered. Since then, the existing research is compelling in terms of improving countless physical and mental conditions including anxiety and depression. It decreases inflammation, and decreases the hormone cortisol, which is released when stressed. It increases dopamine secretion, a neurotransmitter that boosts your sense of well-being. Continually practicing yoga can be self-rewarding by stimulating dopamine release, which generates a desire more of what you are doing (yoga) in order to get another dopamine ‘hit’. Practicing yoga on a regular basis can actually enhance some parts of your brain. Although at that time, I didn’t know the reason why yoga ‘worked’, I continued to go whenever I could because it allowed me to be the person I wanted to be more often.
Like many people, I had a habit of suppressing uncomfortable emotions, a coping mechanism that was necessary as a child but no longer served me as an adult. Since childhood, it felt like each of these suppressed emotions bonded together and hardened inside me like bricks and the ‘mortar’ was my negative self-talk and thought patterns. Over time, I become a tenser, more rigid version of myself prone to physical injuries and emotional dysregulation. This growing blockage took up so much room in my body that any subsequent thoughts and feelings had nowhere to go and would just spin around in my head like a movie that I couldn’t stop playing. I felt like my nervous system was in a state of high alert and my fight-or-flight response was constantly switched on. I came to realize that camel pose, in that first Bikram class, started to dismantle this rigid scaffolding, resulting in emotional release and the subsequent feeling of calm. After a year of regular yoga classes, my nervous system felt soothed and I felt comfortable in my body for the first time since my diagnosis of polycystic ovarian syndrome (PCOS).
I came to realize that camel pose, in that first Bikram class, started to dismantle this rigid scaffolding, resulting in emotional release and the subsequent feeling of calm.
This is why I strongly recommend (i.e. force) my health and fertility clients to ‘get to their mats’. An infertility diagnosis and treatment is often fraught with obstacles and stressors, and it’s obvious that these can have a profound effect on the mental health of all who are on a fertility journey. Many women who are used to having some control over their work or life outcome, now suddenly find themselves grappling with feelings of helplessness, powerlessness and futility for maybe the first time in their lives. Yoga is not the cure for this but can be a potent tool to help cope. Here’s why:
Yoga connects us to our bodies and the sensations that they hold. Many of us store tension or stress in our bodies and we try to solve or fix it with our minds. Bessel van der Kolk, MD writes that we store unresolved trauma in our bodies in his landmark book The Body Keeps the Score. If we define trauma as anything that overwhelms our body’s capacity to respond, then the experience of infertility would certainly meet this criterion. In other words, we often suppress feelings, particularly if we think they are ‘bad’ or not acceptable, but they don’t really go away. Our bodies bear the residue of these repressed emotions. Over time this can lead to various ailments and issues (like my repetitive injuries and stomach aches) so using the body to release these emotions can provide substantial relief. Yoga is a moving meditation and allows you to get out of your head and into your body. Once there, you can self-diagnose and treat. Does your shoulder feel tight? Do your hips need a little love? Are you clenching your jaw? Acknowledging what comes up for you then guiding the body gently to let it go can have a major healing effect on your mental and physical health. I think, in retrospect, the reason that talk therapy alone didn’t work for me is that I didn’t acknowledge that my body was part of the equation.
Yoga helps us practice tolerating uncomfortable situations which can enhance psychological flexibility or the perceived ability to handle any situation. One of my favorite yoga teachers used to tell us that the pose didn’t start until we got to the point where we wanted to release it (i.e. thighs shaking in quiet rebellion during warrior pose). The ability to not only stay in the pose but to double down and trust that your body can handle it is one of the most important lessons ‘on the mat’ that someone on a fertility journey can take ‘off the mat’. This can translate to not reacting to a careless comment like “When are you going to have a baby” or maybe proceeding with a treatment cycle even though the outcome is unknown. Yoga teaches you self-containment or, as Glennon Doyle writes, that you can do hard things.
Yoga allows us to explore one of the best and quickest strategies to reduce anxiety or fear: breathing. Arguably this pandemic has emphasized the importance of breathing deeply, a process that we often take for granted but shouldn’t, as it’s a powerful tool that is readily available. Learning to move with your breath and breathing long and slow, using the belly to generate the inhale, then taking your time with the exhale innervates the parasympathetic nervous system which can quickly and efficiently calm the body down.
Yoga allows us to feel grounded and in the present moment. For many of my clients they are always multi-tasking (as am I). The act of sitting on a yoga mat and being alone with your thoughts (without distractions) can feel almost unbearable to some. But, like any practice, the more you do it the easier it becomes. You begin to crave the time that you can get to your mat and let go of all that just happened or could possibly happen in the future. For me, being on my yoga mat was one of the first times that I didn’t feel like I needed to apologize for not accomplishing something and instead was invited to honor what my body needed at that moment . For a codependent, like me, it was a foreign, but incredibly freeing, feeling. Also, by feeling your feet or hands on the floor, you get the explore the sense of touch as a way to ground you in the here and now, a strategy that many experts recommend when you feel overwhelmed or anxious.
Yoga builds and cultivates a compassionate, generous community. For many, fertility treatments can generate feelings of being isolated and alone and some struggle to find empathetic relationships during this time. Yoga fosters authentic connection by providing a group of people who have a shared experience. In fact, although I have played many sports and been part of many clubs, I have yet to experience a group of people that are so incredibly welcoming to all as those I’ve met through yoga. Yoga students are incredibly inclusive and celebrate all bodies and people, no matter your shape, size, income or athletic ability.
Yoga improves self-confidence. A fertility journey can present you with circumstances that feel beyond your control, which can take greatly affect your sense of self-esteem. Although difficult to measure in a double-blind clinical trial, yoga enhances innate qualities that contribute to self-esteem such as an emphasis on acceptance, self-compassion, and flexibility over perfectionism and control and an acknowledgment that you and your needs are important. The people with whom you spend the most time affect your well-being and sense of self. Surrounding yourself with a group of women who genuinely like and accept themselves can embolden you and improve the quality of your friendships and relationships.
Researchers are still not sure which of yoga’s common elements: breathing, meditation or exercise/movement are responsible for its incredible benefits. Many think it’s a combination of all of the above, but what is important is that you don’t need to go to a studio for an hour or be able to stretch into a split in order to practice yoga. I love going to yoga studios for the energy, instruction, and sense of community, but you can explore the benefits of yoga on your mat at home. Every time you get on your mat, you keep a promise to yourself, which trains your brain to trust yourself again. The time spent on the mat each session isn’t fixed but, like any new habit, it’s more important to practice for a short time, but practice often, than to have sessions that are long but infrequent.
So far, we’ve discussed what yoga is and does, so let’s end with what yoga doesn’t do. Yoga doesn’t fix you because you aren’t flawed. Yoga doesn’t provide a solution for problems; it illuminates the fact that you can rely on your own capabilities. Yoga doesn’t teach you to be positive, but it opens up a little bit of space and in that space, you can find room for all emotions without side-stepping them nor letting them rule your life. Yoga recalibrates our nervous system and teaches us that we can survive the discomfort and navigate the unpredictability inherent in a fertility journey.
I hope that you will consider joining an in-person or virtual class to take steps to restore your confidence, feel empowered and find out what is unique and special about you.