| Women who are anemic or have a problem with heavy menstrual bleeding tend to be very tired; they often find that moderate to brisk exercise is difficult for them because they lack stamina and endurance. The fatigue problem tends to resolve as the anemia and bleeding are corrected nutritionally. In the meantime, women with these conditions may completely stop their regular exercise program in an attempt to avoid feeling tired.
However, complete avoidance of exercise is not healthy, for it reduces oxygenation and circulation to vital organs, such as the brain and heart, as well as all the cells of the body. Gentle exercise such as deep breathing exercises, progressive muscle relaxation, range-of-motion exercises to keep the joints mobile, and slow relaxed walking promote good oxygenation and circulation and can even help to increase energy. The key is to exercise in a gentle, slow fashion.
I have included in this chapter several general fitness and flexibility exercises you can use to promote health and well-being. You may want to combine them with gentle aerobic exercise like walking. You can also combine them with the yoga stretches and acupressure points described in Chapters 10 and 11.
Exercise Techniques
Exercise 1: Deep Breathing
Deep, slow abdominal breathing is very important for your health and vitality. It expands your lungs and allows you to bring adequate oxygen, the fuel for metabolic activity, to all the tissues of your body. Rapid, shallow breathing decreases your oxygen supply and keeps you devitalized. Deep breathing helps to relax the entire body and strengthens the muscles in the chest and abdomen. Women with heavy menstrual bleeding and anemia have reduced hemoglobin and red blood cell counts, so less oxygen is available than under normal conditions.
- Lie flat on your back with your knees pulled up. Keep your feet slightly apart. Try to breathe in and out through your nose.
- Inhale deeply. As you breath in, allow your stomach to relax so that the air flows into your abdomen. Your stomach should balloon out as you breathe in. Visualize your lungs filling up with air so that your chest swells out.
- Imagine that the air you breathe is filling your body with energy.
- Exhale deeply. As you breathe out, let your stomach and chest collapse. Imagine the air being pushed out, first from your abdomen and then from your lungs.
Exercise 2: Progressive Muscle Relaxation
Women who are anemic may have muscles that are tense and tight because of inadequate oxygenation and blood flow. Lactic acid tends to accumulate in these muscles, and muscle tension can become a chronic problem. Movement effectively breaks up this pattern of chronically tight muscles. Unfortunately, women with anemia tend to become less active as their fatigue worsens. While strenuous exercise may be too difficult for a woman with anemia, it is still very important to keep the muscles loose and limber. Besides feeling more relaxed, supple muscles have a beneficial effect on mood and induce a sense of peace and calm. The following exercise will aid in releasing muscle tension.
- Lie in a comfortable position. Allow your arms to rest limply, palms down, on the surface next to you. Practice your deep abdominal breathing as you do this exercise.
- Clench your hands into fists and hold them tightly, for 15 seconds. As you do this, relax the rest of your body. Then let your hands relax.
- Now, tense and relax the following parts of your body in this order: face, shoulders, back, stomach, pelvis, legs, feet, and toes. Hold each part tensed for 15 seconds and then relax your body for 30 seconds before going on to the next part.
- Visualize the tense part contracting, becoming tighter and tighter. On relaxing, see the energy flowing into the entire body like a gentle wave, making all the muscles soft and pliable.
- Finish the exercise by shaking your hands. Imagine the remaining tension flowing out of your fingertips.
Exercise 3: Joint Flexibility
It is very important that women with heavy menstrual bleeding and anemia maintain full range of motion and flexibility in all the joints of the body to reduce the tendency of muscle tension. The following exercise helps to stretch and release tension in the muscles around the joints. This exercise is similar to the "range-of-motion" sequence that physicians may use when testing a patient for joint limitations such as arthritis produces. The exercises are also thought to stimulate the acupuncture meridians as based on the work of Motoyama, a Japanese researcher. In his book, Theories of the Chakras: Bridge to Higher Consciousness, Motoyama discusses the importance of these exercises in opening the acupuncture meridians.
Sit on the floor with your legs stretched out in front. Place your hands at your sides.
- Toes: Slowly flex and extend the toes without moving your feet or ankles. Repeat 10 times.
- Ankles: Slowly flex and extend the ankle joints. Repeat 10 times. Separate your legs slightly, then rotate your ankles in each direction 10 times. Be sure to keep your heels on the floor.
- Knees: Still resting in the sitting position, bend the right leg at the knee, bringing the heel near the right buttock. Then lift the right leg off the floor, straightening the right knee. Repeat 10 times. Then do the same exercise with the left leg.
Hold the thigh near the chest with both hands. Rotate your lower leg in a circular motion about the knee 10 times clockwise and then 10 times counterclockwise. Repeat with the left leg.
- Hips: Bend the right leg so that you can place your right foot on the left thigh. Hold the right knee with the right hand and hold the right ankle with the left hand. Then gently move the right knee up and down with the right hand. Repeat with the left leg.
While you are sitting in the same position, rotate the right knee clockwise 10 times and then counterclockwise 10 times. This improves the flexibility of the hip joints. Repeat on the left side.
While sitting, bring the soles of the feet together, bringing the heels close to the body. Using your hands, gently push the knees to the floor and then let them come up again. Repeat 10 times.
- Fingers: Sit on the floor with your legs stretched out in front of you. Lift your arms up to shoulder height, keeping them straight. Open your hands wide. Flex the fingers, closing them over the thumbs to make a fist. Repeat 10 times.
- Wrists: Flex and extend your wrists. Repeat 10 times.
Sitting in the same position, rotate your wrist clockwise and counterclockwise. Repeat 10 times.
Sitting in the same position, hold your hands in extension and move each hand from side to side at the wrist. Repeat 10 times.
- Elbows: Remaining in the same position, stretch out your arms at shoulder height with the palms facing upward. Then bend your arms at the elbow so that your fingers touch the shoulders, and straighten out your arms again. Repeat 10 times with arms extended sideways and ten times with arms facing forward.
- Shoulders: From the same sitting position, with your arms bent and fingertips touching the shoulders, make a circular motion with your elbows. Repeat 10 times clockwise and 10 times counterclockwise.
- Spine: Remain sitting with your legs together straight out in front of you. Reach over and touch your legs or, without straining, your toes without bending your knees. Repeat 10 times.
- Waist: Stand up and slowly reach over and touch your lower legs or, without straining, your toes as you bend at the waist. Try to keep your knees straight. Repeat 10 times. If you have lower back problems do these two positions with caution.
Suggested Reading
Caillet, R., M.D., and L. Gross. The Rejuvenation Strategy. New York: Pocket Books, 1987.
Hanna, T. Somatics. Reading, MA: Addison-Wesley, 1988.
Huang, C. A. Tai Ji. Berkeley, CA: Celestial Arts, 1989.
Jerome, J. Staying Supple. New York: Bantam Books, 1987.
Kripalu Center for Holistic Health. The Self-Health Guide. Lenox, MA: Kripalu Publications, 1980.
McLish, R., and V. Joyce, Ph.D. Perfect Parts. New York: Warner Books, 1987.
Pinkney, C. Callanetics: 10 Years Younger in 10 Hours. New York: Avon, 1984.
Principal, V. The Body Principal. New York: Simon & Schuster, 1983.
Tobias, M., and M. Stewart. Stretch and Relax. Tucson, AZ: The Body Press, 1985.
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Dr. Susan M. Lark is one of the foremost authorities on women's health issues and is the author of nine books. She has served on the faculty of Stanford University Medical 
