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I love hot yoga. I’ve been loving it for more than 20 years now. I recently took it up again, traveling to a little studio outside of Abu Dhabi and leaving the 40 degree Celsius outdoor heat for the same thing but hotter inside.
This has seemed to me and everyone else who knows me to be lunacy. Except, as I explain, it makes me feel so damn good. Not to mention, lean. Energetic. A great sleeper. Stronger. Not that hungry. Pretty happy, too.
I’ve done hot yoga for almost 25 years now, off and on, ever since being convinced while researching a story for the Ottawa Sun on Bikram (the practice, not the person). One of the subjects was a busted-up retired Canadian military guy named Tippy, who used it to overcome a range of injuries he suffered on the job. All kinds of yoga have served me through the years, but hot is my favorite. And when I look back on the summers through my perimenopausal 40s when I was mostly grounded in the Abu Dhabi heat – like this one – I was the happiest and healthiest when I was doing regular hot yoga. One summer in peri I quit drinking for a month, did almost 30 straight days of Bikram in a row, and dropped 15 pounds just like that. I swear to you. Looking back, perimenopause symptoms were not a factor that August. I felt like Superwoman.
But I couldn’t ever explain why. New research published in recent weeks is helping me work that out, and leading me to suspect this combination may be of particular relevance for peri:menopause. Here is how it breaks down.
You may be thinking, heat is counter-intuitive in peri:menopause, no?
I get it! However when you look at the research and the way the body works, it is not.
A study presented earlier this month at the American Society for Nutrition meeting in Chicago, for example, found that spending regular time in a sauna may help mitigate menopause-related metabolic issues – at least in female mice.
Those who received a daily 30-minute whole-body heat treatment at 40 degrees Celsius demonstrated better insulin sensitivity, reduced fat accumulation in certain tissues, including the liver, and overall gained less weight than a control group. The investigators found that the heat triggered several molecular processes that help the body use energy more efficiently and burn fat, without tissue damage.
Here is how it breaks down, according to the researchers, Soonkyu Chung, team leader and associate professor in the Department of Nutrition at the University of Massachusetts Amherst, and Rong Fan, the doctoral candidate under her tutelage:
> Heat activates TRPV1, a protein that serves as a channel for calcium ions to pass through our cell membranes, and launches a process called futile calcium cycling
> During this process, the body uses more energy – in the form of adenosine triphosphate, or ATP – to help fire those calcium ions across cell membranes
> As this happens, it increases the overall amount of energy the body burns
> This TRPV1 activation-calcium cycling process also stimulates our body to bread down and burn fat in our tissues
> Because this fat reduction helps heal fatty livers and improve insulin sensitivity, it helps heal our overall metabolism
Speaking to Nutrition.org, Fan explains the power of sauna on two fronts: “This series of events suggests that regular application of heat can mimic the effects of calorie burning and fat loss. It could be particularly advantageous for individuals who find physical activities challenging, providing a relaxing way to improve metabolic health.”
Heat in midlife health was just one topic in the wide-ranging and important appearance this week by environmental exercise physiologist and nutritional scientist Dr Stacey Sims on Andrew Huberman’s Huberman Lab Podcast.
When Huberman asked Dr Sims about cold exposure for women, the author of several books and founder of the course Menopause 2.0 replied: “I prefer heat for women. Everyone is a better responder to the heat. Better adaptations.”
She talked about seeing all the same metabolic changes in women, tied to the same improved expression of so-called “heat-shock proteins”, which is what our cells produce in elevated temperatures. These proteins help other proteins do their job by maintaining homeostatis: keeping their shape by preventing folding, boosting transport ability and preventing degradation.
She told Huberman: “For women as we get older and have the offshoot of hot flashes, night sweats, that kind of stuff, if you're doing heat exposure you're sending a stronger stimulus to the hypothalamus and you're also getting a better serotonin production from the gut, because we have 95 percent of our serotonin produced from the gut, which thins to better temperature control and shuts down hot flashes.”
Huberman, a neurologist, jumped in to helpfully mansplain that our brains have a set of neurons in the medial pre-optic area that serves as a sort of thermostat.
“If you heat the surface of your body,” he said, “the medial preoptic neurons say “oh let's cool down the core of the body now."
“I prefer heat for women. Everyone is a better responder to the heat. Better adaptations.”
Dr Stacey Sims, environmental exercise physiologist and nutritional scientist, on the Huberman Lab Podcast
Now, for the yoga part.
A new randomized controlled trial involving 31 women between 40 and 60 looking at the effect of yoga on menopause symptoms, published in the May-June edition of the journal Holistic Nurse Practitioner, concluded: “Sixty minutes of yoga two days a week for 10 weeks may reduce the psychological, somatic and urogenital symptoms experienced in menopause”.
And in May, a review of 11 randomized controlled trials involving more than 1,000 participants found that mind-body exercises including yoga, pilates, tai chi and qi gong “positively influences bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women”, according to data published in Menopause, the journal of The Menopause Society in North America. Despite the growing body of research on the benefits of yoga for menopause symptoms, The Menopause Society did not endorse yoga or any other mindfulness-based interve that has led to guiding bodies like The Menopause Society to endorse yoga as one of the few non-hormonal methods they recommend for symptoms in a 2023 statement.
If sitting in a sauna isn’t your thing – and it certainly isn’t mine – then it’s not a leap to think that adding heat to movement might be a magic combo. I haven’t been able to find any studies specifically investigating hot yoga in relation to menopause symptoms. It’s not that surprising, considering how women’s health research lags behind men’s, and how peri:menopause research lags behind that. If anyone else has, please share in the comments or reply to me directly). And that’s why here at Hotflash inc, we rely on scientific evidence, human experience, and expert opinion.
.My motivation for doing hot yoga has been two-fold: I love yoga, and there is a compelling amount of research associating regular use of infrared sauna and reductions in all-cause mortality. Since it’s expensive to pay to sit in an infrared sauna and most people can’t afford to build one in their home, isn’t combining the two, kind of… winning?
Hotflash hot tip: Frozen shoulder
When she appeared on The Hotflash inc Podcast last December in the second most popular episode ever, Dr Vonda Wright said the number one thing women ask her about is frozen shoulder. By all accounts this perimenopause-related condition is just as horrid as it sounds – a painful, immobilized shoulder – that can take up to two years to heal. The American double board-certified American orthopedic sports medicine surgeon, who is aiming to popularize the term Musculoskeletal Syndrome of Menopause, aka MSM for the range of joint and muscle issues women experience, explains what you can do about it ahead of seeing a doctor or a physiotherapist.
“Number one: You just got to keep it moving. Gently pendulum, which means bend over in the shower and sway your hips like a hula dancer and your shoulder will move in its socket. Or taking your other arm and gently moving it as much as you can stand it. Keep it moving. Number two: anti inflame. Get the sugar out of your diet… green, leafy, lean protein.”
She’s got other great tips throughout the episode, as well as cautions about some of the potential treatments. And for more on frozen shoulder, check out my two-part series here and here while you can: it’s going back behind a paywall next week.
Quote of the week:
“We need to divorce ourselves of this: it has to be bad enough for us to warrant or deserve relief.”
Noor Al-Humaidi, a New Hampshire-based family physician posting on Instagram as @lifestylesbyNoor, talking about hormone therapy
Medicine is soooo different in various parts of the world. Tune in to The Hotflash Inc Podcast this week as Dr Bibi Lockhat, of Zulal Wellness Center by Chiva Som in Qatar tells us all about Traditional Arabic and Islamic Medicine, aka TAIM – and how it approaches the perimenopause transition.
ICYMI: Menopause at the RNC
Kari Lake, the only woman and mother the Republicans have nominated to run on a competitive Senate race, might just be the first person to ever talk about menopause at the Republican National Convention, last weekend:
“I can think of one thing more dangerous than a grizzly bear, and that’s a middle-aged, fed-up mother in Washington, D.C.,” Lake said to applause. “And I haven’t even started my hot flashes yet, guys. Just wait.”
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Click, watch, read, listen + learn
“Raw banana and a glass of chass with lunch”: Some of the most interesting perspectives from come from outside the West. The Hindustan Times covered this perimenopause breakdown from Indian nutritionist Rujuta Diwekar, who has more than 1 million subscribers on YouTube (but stresses she does no paid campaigns, brand endorsements, collaborations, and has no products to sell).
Sometimes you just need a dude to tell it to you straight, and this week, fellow Substacker, The Love Drive’s Shaun Galanos was that dude for me: How women can speak the fuck up to men (And, just a question: how much do we suffer by not doing this?)
BBC reports on a new research study out of the University of Aberdeen will examine how menopause impacts women at work and how to help them.
Over in India, She The People TV is getting celebrities talking about menopause
Dr Karen Magraith, GP and past president of the Australian Menopause Society, writing in The Medical Republic: Caution required over MHT miracle claims