Yoga guide
Yoga is a good way to stay strong, steady and calm through perimenopause and after your periods stop, and both the NHS and Women's Health Concern suggest it. In small trials it eased overall menopause symptom scores a little and helped sleep a little.
It isn't a treatment for hot flushes: in the largest trial, where women counted their flushes every day, flushes fell by about the same amount with or without yoga. It doesn't build bone on its own either, so it works best alongside strength training.
This guide covers what yoga does and doesn't do, how much to do, the poses to change with osteoporosis, glaucoma or high blood pressure, when to see a GP, and a free 35-minute class to follow.
The NHS suggests you "try relaxing things such as yoga, tai chi or meditation" and exercise regularly. Women's Health Concern, the British Menopause Society's patient arm, says restorative exercise such as yoga and Pilates helps the body recover "and can also help to increase strength and flexibility".
In the largest yoga trial, 249 women counted their flushes every day, and 12 weeks of yoga made no clear difference. The newest review of 24 trials agrees. If flushes are hard to live with, NICE (the National Institute for Health and Care Excellence) says to offer hormone replacement therapy (HRT), with menopause-specific cognitive behavioural therapy (CBT) as an option.
Insomnia scores improved a little with yoga in the largest trial. For insomnia that has lasted 3 months or more, CBT for insomnia is the most effective treatment, Women's Health Concern says.
In 11 studies, yoga or Pilates changed bone density no more than control groups. NICE asks doctors to explain "the importance of maintaining muscle mass and strength through physical activity", and the UK osteoporosis consensus puts strength training and impact first for bones.
With osteoporosis, bend forward from your hips rather than rounding your back deeply, twist gently, and leave out plough and shoulder stand. Fractures have been reported with yoga poses that bend the spine far forward.
In two trials, slow paced breathing didn't reduce hot flushes. It is still a good way to wind down before bed.
Perimenopause comes first, and one of its first signs "is usually a change to your periods". The NHS says "Menopause is when you have not had a period for 12 months. After this it's called postmenopause". Symptoms "usually last for 7 to 9 years, sometimes longer", and they can change over that time.
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"Hot flushes are when your face, neck and chest suddenly feel very hot or cold. It can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy." Other common symptoms include problems sleeping, low mood or anxiety, muscle aches and joint pains, palpitations, and needing to pee more or leaking. NICE warns that symptoms of thyroid problems may be mistaken for the menopause.
In the largest trial, run by a US research network called MsFLASH, women had 12 weekly 90-minute classes: breathing, 11 to 13 poses (restorative poses, gentle inversions, side bends, twists and forward bends) and deep relaxation, plus 20 minutes at home on other days. They came to 8.5 of the 12 classes on average. Across 13 trials, programmes usually ran for about 12 weeks, twice a week, for about an hour.
Most yoga is light activity, like a slow walk, though brisk flows reach moderate effort for part of a class (our yoga benefits guide). The NHS counts yoga as muscle-strengthening, but these activities "are not always an aerobic activity, so you'll need to do them as well as your 150 minutes" of moderate activity a week.
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In the MsFLASH yoga trial, 249 women aged 40 to 62 with at least 14 flushes a week kept daily diaries. After 12 weeks of classes and home practice, flushes had fallen by 35% with yoga and by 27% with usual activity, a difference of 0.3 flushes a day that could easily have been chance. How much they bothered women didn't differ either.
Pooled with the other MsFLASH trials (899 women), yoga, aerobic exercise and omega-3 capsules didn't reduce flushes, while three medicines did. The newest meta-analysis, of 24 trials and 2,028 women, found no difference for hot flushes, and the North American Menopause Society doesn't recommend yoga for them. A Cochrane review found exercise and yoga no different from each other, from low-quality evidence.
Reviews that pool symptom questionnaires against doing nothing find benefits, including on flush scores, but the women knew they were doing yoga and the results weren't robust to that kind of bias. Flushes also fall in every group over time: in a pilot trial with daily diaries, they fell by 66% with yoga, 63% with health education classes and 36% on a waiting list. A restorative yoga study in 14 women found flushes fell by about 31%, but it had no comparison group. Women's Health Concern puts the placebo effect of "almost every menopause intervention" as high as 50 to 60 percent.
A UK overview of 17 reviews rated the evidence on flushes inconclusive. The US National Center for Complementary and Integrative Health (NCCIH) says yoga reduced "physical symptoms such as hot flashes", citing one of these questionnaire reviews.
In MsFLASH, insomnia scores fell by 4.4 points with yoga and 3.1 with usual activity, on a 28-point scale, but sleep measured with a wrist monitor didn't change. Pooled with the other MsFLASH trials, CBT for insomnia cut insomnia scores by more (5.2 points) than any other treatment tested.
Across 6 trials, yoga improved sleep quality in menopausal women. A network of 44 trials found yoga improved sleep quality, as did relaxation, CBT, mindfulness, acupuncture, massage and exercise, with mindfulness ranked first, and a 2026 review named CBT for insomnia and calming techniques such as acupuncture, yoga and massage as the most robust non-drug options. A review of 19 trials found smaller benefits around the menopause than in other women. In single trials, yoga eased insomnia more than stretching in 44 women with insomnia, and in 208 women it improved sleep in perimenopausal and postmenopausal women but not in younger women.
In a 2025 review, yoga's effects on depression and anxiety around the menopause were not statistically clear (3 and 2 trials), and MsFLASH found no change in either. In 120 Indian women aged 40 to 55, 8 weeks of integrated yoga, an hour a day on 5 days a week, reduced menopause symptoms and stress more than simple exercises. Exercise in general reduced depressive symptoms across 16 trials in menopausal women. Women's Health Concern calls mindfulness and meditation "a very useful addition" alongside restorative exercise such as yoga.
Against no treatment, yoga lowered total menopause symptom scores in reviews of 13 and 24 trials. The UK overview found improvements in physical symptoms (including sleep, joint pain and tiredness), bladder and vaginal symptoms and total symptoms with yoga 2 to 3 times a week. In MsFLASH, menopause quality of life improved by 0.3 points on an 8-point scale, which the authors called modest.
In 240 women aged 45 to 90 who leaked every day, 12 weeks of pelvic floor yoga reduced leaking by 2.3 episodes a day, against 1.9 with a general stretching and strengthening programme: no clear difference. Sleep didn't differ between the groups. A Cochrane review found too few yoga trials to judge.
Bone is lost fastest from about a year before the last period to 2 years after: in 862 women, 7.4% of a 10.6% loss of spine bone over 10 years happened in that window. In 11 studies of women aged 45 to 78, yoga or Pilates changed bone density no more than control groups, and 2 yoga trials pooled showed no effect. The popular study saying a 12-minute routine reverses bone loss had no comparison group and analysed 227 of 741 volunteers.
In a 2024 review, the bone benefit of mind-body exercise came from tai chi and Pilates trials, not yoga, and a 2026 network of 74 trials found mind-body exercise combined with resistance training the most effective for bone density at the spine and hip. The UK osteoporosis consensus puts progressive strength training and impact first.
Across 18 trials in healthy adults, yoga improved standing balance compared with no exercise, from low-certainty evidence; its effect on falls was unclear.
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In 218 women, 16 weeks of slow paced breathing reduced flushes no more than fast shallow breathing or usual care. In 123 women, slow breathing guided by a device cut flushes by 21%, against 35% for listening to music. The North American Menopause Society does not recommend paced breathing for flushes. We found no study that tested cooling breath (sitali) for hot flushes.
Gentle classes are: MsFLASH reported no serious side effects, and new aches were about as common as with usual activity. The risk is in some poses when bones are fragile. Of 89 people injured by yoga at a US clinic, most were hurt in poses that bend the spine far forward or back, and 13 had compression fractures; in 3 people with low bone density, forward-bending poses led to fractures or pain. The UK osteoporosis consensus links vertebral fractures with "some yoga positions involving extreme spinal flexion".
The trials usually used 2 sessions a week of about an hour for about 12 weeks; MsFLASH used one 90-minute class a week and 20 minutes at home on other days. Our editorial starting point: 2 or 3 sessions of 30 to 60 minutes a week. Judge it after about 12 weeks by how you feel and sleep, not by counting flushes.
As our exercise for menopause guide sets out: strength training on 2 to 3 days a week (2 sets of 8 to 12 of each move, stopping with 2 to 3 reps to spare), about 150 minutes of brisk walking or cycling a week, impact such as heel drops (building towards about 50 on most days, as the UK osteoporosis consensus advises), and pelvic floor exercises every day. Yoga can fill one or two of those days.
Heat can set off a flush (our exercise for menopause guide). The NHS suggests lightweight clothing, a cool bedroom, a cool shower, a fan or a cold drink, and avoiding triggers such as hot drinks. We found no study that tested hot yoga in the menopause. In hot yoga studies, core temperature reached 38.2 to 40.1°C during 90-minute Bikram classes, so if heat sets off your flushes, choose a normal room.
The UK consensus encourages yoga or Pilates "at least twice a week" for strength and balance, advises avoiding "loaded flexion or end of range movements" in them, and recommends exercise to strengthen the back muscles to improve posture. In practice: bend from your hips instead of deep forward folds (our osteoporosis guide), twist smoothly, keep your back long in child's pose, leave out plough and shoulder stand, and include back-strengthening poses such as locust.
Eye pressure rose within a minute in downward dog, a standing forward bend, plough and legs up the wall, in eyes with and without glaucoma. Our glaucoma and blood pressure guides say to skip headstands and shoulder stands, and to keep other head-down poses brief or supported, with your hands on a chair. NCCIH advises beginners to avoid headstands and shoulder stands.
A flush can make you feel dizzy, so come out of the pose, sit down, sip something cold and carry on when it passes (our suggestion). Get up slowly from lying down.
Both have small trials showing modest gains in symptom scores, and neither has been shown to reduce flushes or build bone on its own (our Pilates for menopause guide says the same). Choose the one you'll keep doing, and add strength training.
Doses from the moves' pages: slow breathing for at least 5 minutes, crocodile breathing for 5 minutes at about 4 seconds in and 6 out, alternate nostril breathing for 3 to 5 minutes with no breath holds, and corpse pose for at least 5 minutes, up to 10. Use them to wind down, not to stop a flush.
Mountain pose for 5 to 10 slow breaths, 2 or 3 times, breath reach for 5 breaths and the hip hinge fold for 5 slow folds with 3 breaths at the bottom (the moves' pages). Chair pose for 3 holds of 5 breaths, warrior II for 5 breaths each side, twice, and tree pose for 3 to 5 breaths each side with a hand near a wall (our editorial starting points).
3D demoMountain pose (Tadasana)Beginner · No equipment
3D demoBreath reachBeginner · No equipment
3D demoChair pose (Utkatasana)Beginner · No equipment
3D demoWarrior II (Virabhadrasana II)Intermediate · No equipment
3D demoTree pose (Vrksasana)Beginner · No equipment
3D demoHip hinge foldBeginner · No equipmentCat-cow for 8 slow waves, and pelvic floor exercises as 8 slow holds of up to 10 seconds and 8 quick squeezes, three times a day (the moves' pages). Bird dog for 5 slow reaches each side, locust for 3 holds of 3 breaths and bridges for 10 slow lifts (editorial). With osteoporosis, keep the rounding in cat-cow small.
Reclining bound angle for 2 to 5 minutes with a support under each thigh (the move's page). The lying twist for 45 to 60 seconds each side with your knees on a cushion, child's pose for about a minute, and legs up the wall for 3 to 5 minutes (editorial). With glaucoma, ask your eye doctor before legs up the wall.
Strength on 2 to 3 days a week, 2 sets of 8 to 12 stopping with 2 to 3 reps to spare (our exercise for menopause guide); start with sit-to-stands if you're new to it. Heel drops: 20 to 30 at first, building towards about 50 on most days (the move's page, from the UK osteoporosis consensus). If you leak during heel drops, build up your pelvic floor exercises first.
The move's page dose is 5 slow folds with 3 breaths at the bottom. Our osteoporosis guide says to bend from the hips instead of doing deep yoga forward folds, and the UK osteoporosis consensus advises avoiding loaded forward bending and end-of-range movements.
See the movement on the 3D figure: Hip hinge fold
With osteoporosis, swap deep forward folds for the hip hinge and forced twists for the lying twist, and leave out plough, shoulder stand, headstand and deep backbends. With glaucoma or blood pressure that isn't controlled, skip headstand and shoulder stand and keep head-down poses brief, with your hands on a chair.
3D demoSeated forward fold (Paschimottanasana)Intermediate · No equipment
3D demoWide-angle seated forward fold (Upavistha Konasana)Intermediate · No equipment
3D demoHead-to-knee pose (Janu Sirsasana)Beginner · No equipment
3D demoWide-legged standing forward fold (Prasarita Padottanasana)Beginner · No equipment
3D demoPlow pose (Halasana)Advanced · No equipment
3D demoSupported shoulderstand (Salamba Sarvangasana)Advanced · No equipment
3D demoSupported headstand (Salamba Sirsasana)Expert · A wall
3D demoHalf lord of the fishes (Ardha Matsyendrasana)Intermediate · No equipment
3D demoCamel pose (Ustrasana)Intermediate · No equipment
3D demoWheel pose (Urdhva Dhanurasana)Advanced · No equipmentStart with our 35-minute yoga for menopause class 2 or 3 times a week, alongside the strength and balance workout twice a week, the bone workout once and pelvic floor exercises every day, as our menopause guide suggests (our editorial plan). The restorative sequence is for winding down; it includes legs up the wall, so ask your eye doctor first if you have glaucoma.
Thirty-five minutes of standing strength, balance, back strengthening and a long relaxation for the menopause, with no deep forward folds or shoulder stands.
35 minBeginner15 movesFirm cushionA 25-minute gentle yoga class for complete beginners and over-50s: slow breathing, a warm-up, supported standing poses, floor poses and a closing rest.
25 minBeginner14 movesNo equipmentStrength and balance in one session: squats, Romanian deadlifts, push-ups, rows, step-ups, back extensions, carries and single-leg balance.
45 minBeginner14 movesA wall, A dumbbellImpact, strength and balance for stronger bones, following UK osteoporosis consensus advice, with options for every level.
40 minBeginner14 movesA kettlebell, Other / check instructionsA 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentA 45-minute restorative yoga sequence: five fully supported poses held for 4 to 10 minutes each, with slow breathing and a long final rest.
45 minBeginner6 movesFirm cushion, A wallA 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a standing yoga flow for strength and balance.
45 minBeginner12 movesCardio machineA 25-minute Pilates workout for osteoporosis and osteopenia: the Royal Osteoporosis Society's swaps for rounding moves, plus back strength and balance.
25 minBeginner16 movesA wall, A bench or boxStrength, bone and cardio across the week, with room for a yoga session.
These are the same warning signs as our exercise for menopause guide. A&E means accident and emergency. In the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Stop exercising and call 999 for:
Call 999 or go to A&E if you have palpitations that don't go away, or that come with chest pain, shortness of breath, or feeling faint or fainting. See a GP if they keep coming back, last more than a few minutes, or you have a heart condition or a family history of heart problems.
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About osteoporosis or a past spinal fracture, glaucoma, high blood pressure or a prolapse, so they can suggest changes. A pelvic health physiotherapist can help with leaking or heaviness.
In the largest trial, with daily diaries, flushes fell about as much with usual activity, pooled trials agree, and the North American Menopause Society doesn't recommend yoga for flushes. Questionnaire studies look more positive but are open to bias.
Slow paced breathing didn't reduce flushes in two trials, and we found no study that tested cooling breath for them. Slow breathing is still a good way to calm down.
In 11 studies, yoga or Pilates changed bone density no more than control groups, and the study behind the "12-minute routine" claim had no comparison group. Strength training and impact are what build bone.
For flushes, NICE says to offer HRT, with menopause-specific CBT as an option and fezolinetant when HRT isn't suitable; yoga didn't reduce flushes in the diary trials. Yoga can sit alongside treatment, and your GP can talk you through the options.
NICE stresses keeping muscle strength, and the UK osteoporosis consensus recommends strength and balance training at least twice a week. Women's Health Concern counts strength-based, walking and restorative exercise as "equally important": restorative yoga is one part, not the whole.
We found no study that tested hot yoga in the menopause, heat can set off flushes, and the NHS suggests keeping cool.
Yes, as part of an active week. It builds strength and balance, can improve sleep a little, and small trials found small improvements in overall symptom scores. It won't switch off hot flushes and doesn't build bone on its own, so pair it with strength training.
Not much. In the largest trial, where women counted their flushes every day, flushes fell by about the same amount with or without yoga, and the newest review of 24 trials found no difference. If flushes are hard to live with, a GP can talk you through HRT, menopause-specific CBT and other treatments.
Poses that build strength and balance, such as chair, warrior II, tree, locust and bridge, gentle movement such as cat-cow, and a long supported rest. With osteoporosis, bend from your hips instead of folding forward deeply, twist gently, and skip shoulder stand and plough.
Yes: the trials included women before and after their last period. In one trial of 208 women, yoga improved sleep in perimenopausal and postmenopausal women. Symptoms often start in perimenopause, so it's a good time to build the habit, alongside strength training.
A little. Insomnia scores improved modestly in the largest trial, and reviews find small to moderate gains in sleep quality. CBT for insomnia does more and is the most effective treatment for long-term insomnia, so talk to your GP if poor sleep is affecting your life.
It may help you feel calmer, but the evidence for yoga itself is weak; exercise in general reduced depressive symptoms in a review of 16 trials in menopausal women. If low mood or anxiety is hard to live with, see a GP: for low mood linked with the menopause, NICE suggests HRT or CBT may help.
We wouldn't choose it if heat sets off your flushes. We found no study that tested hot yoga in the menopause, and the NHS suggests keeping cool, so a normal room with a fan suits most people.
Most yoga is light activity, so it burns few calories. Fat around the middle responds to your total activity and what you eat, as our yoga for weight loss and exercise for menopause guides explain. Yoga still helps you stay strong and active.
Both have small trials showing modest gains in symptom scores, and neither has been shown to reduce flushes or build bone on its own. Choose the one you'll keep doing, and add strength training.
Joint aches are a common symptom, and reviews found yoga helped physical symptoms, including joint pain, in small trials. Keep moving within a comfortable range and add strength work, and see a GP if pain keeps getting worse or stops you doing things.
A 12-week pelvic floor yoga programme reduced leaking about as much as general stretching and strengthening in 240 women aged 45 to 90. Daily pelvic floor exercises come first; see a GP or a pelvic health physiotherapist if leaking isn't improving.
Yes, with changes. The UK osteoporosis consensus encourages yoga for strength and balance but advises avoiding loaded forward bending and end-of-range movements, and fractures have been reported with yoga poses that bend the spine far forward. Bend from your hips, keep your back long, twist gently, and skip shoulder stand and plough.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition such as glaucoma, high blood pressure or osteoporosis, or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
