Summary: 

The fascia forms a continuous network throughout the body, ensuring communication and interdependence between all structures. It is sensitive to sex hormones: estrogen and relaxin influence its elasticity and stiffness, which helps explain the occurrence of myofascial pain in women and how it varies across the menstrual cycle, pregnancy, and menopause. In yoga practice, it is essential to adapt poses and use props to protect the ligaments and encourage stability rather than excessive mobility. Restorative Yoga, especially Supta Baddha Konasana practiced for 20 minutes with bolsters, blankets, and an eye pillow, helps relax the fascia, reduce inflammation, and support connective tissue regeneration, while honoring hormonal variations and joint health.


In recent years, there has been a growing interest in the fascia. Thanks to a deeper understanding of its structure and functions, fascia is no longer seen as a useless wrapping tissue. Researchers have even identified a correlation between fascia and chronic pain, which affects about one in four adults in the US.

What is fascia?

Fascia is a continuous network that maintains interdependence and communication between all parts of the body.
This elastic web extends from the surface of the skin deep into the body, reaching every cell — and even beyond. It represents more than one-third of the musculoskeletal system.

The hormonal component of the fascia is essential to understanding differences between men and women in myofascial pain, which is more prevalent in women and varies across hormonal cycles.

There is a direct relationship between changes in fascia and fluctuations in estrogen and progesterone levels. Hormonal variations also influence tissue elasticity during pregnancy, which can lead to stiffness, inflammation, and pain.

For example, estrogen and relaxin receptors have been identified in musculoskeletal fascia (such as the crural, thoracolumbar fascia, and fascia lata), showing that fascia responds to hormonal variations. After menopause, the number and sensitivity of these receptors tend to decrease.

The impact of estrogen and relaxin on fascial elasticity

In 2019, Professor Carla Stecco from the University of Padua (Italy), internationally recognized for her work on fascia, studied how the female hormonal cycle affects fascial properties.

Estrogens tend to reduce the production of type I collagen (made of thick, strong fibers that provide stiffness and tensile strength) and increase the production of type III collagen (made of thinner, more elastic fibers) as well as fibrillin, a molecule that contributes to fascial elasticity.
Type III collagen production also increases during pregnancy to accommodate the body’s changes.

Stecco’s research showed that type III collagen and fibrillin rise during the ovulatory phase, while type I collagendecreases by 6% during the follicular phase (when estrogen increases) and by 1.9% during the peri-ovulatory phase (at the estrogen peak). After menopause, type I collagen levels rise again.

During pregnancy, the hormone relaxin is produced in large quantities. Relaxin reduces the production of extracellular matrix (ECM) due to its antifibrotic properties. This leads to a loosening of ligaments and tissues, resulting in hypermobility throughout the body.

With hormonal contraception, estrogen and progestin are supplied in constant doses, inhibiting the secretion of pituitary and hypothalamic hormones — much like during pregnancy.

Sex hormones therefore play a key role in remodeling the extracellular matrix, adjusting fascial tension and contributing to the sensitization of fascial nociceptors (pain receptors).

Implications for women’s yoga practice

During pregnancy and in the high-estrogen phases of the menstrual cycle (follicular, ovulatory, and to a lesser extent, luteal phases), or when using hormonal contraception, it is important to prioritize stability over mobility.
Using multiple props helps prevent passive stretching in long-held postures, which could otherwise destabilize the joints.

Ligaments are designed to provide stability, not mobility. When ligaments and tendons are repeatedly overstretched — especially during hormonally sensitive phases — they can lose their elasticity and cause pain.
You may have heard of yoga practitioners who experience sacroiliac pain — or perhaps you have felt it yourself. This is exactly what we want to prevent.

The asanas were originally designed by men, for men. As cyclical beings, women are invited by yoga to adapt their practice to the rhythms of their lives. Props help us care for our bodies and sustain a lifelong practice without developing myofascial pain.

Hypermobility and the importance of stability

Hypermobility affects about 1 in 10 people, more commonly women. It is also overrepresented among yoga practitioners, as the postural nature of asana practice can aggravate it — especially when one doesn’t learn how to manage it.
Many hypermobile practitioners are drawn to yoga precisely because of their flexibility. Over time, pushing beyond one’s natural range of motion can damage the tissues surrounding the joints and lead to pain.
It is therefore essential to cultivate stability as a foundation of practice.

For menopausal women, the focus shifts to maintaining mobility while hydrating the fascia through gentle myofascial release and restorative yoga techniques.

Restorative Yoga and fascia health

This is where Restorative Yoga becomes an ideal ally.
Restorative Yoga supports women at all stages of hormonal life. It helps open key areas of the body, reduces inflammation, releases fascial tension, and promotes regeneration of connective tissue — all while respecting hormonal fluctuations and joint integrity.

A 20-Minute Restorative Yoga Practice: Supta Baddha Konasana

Adapted from my book The Art of Restorative Yoga (pre-order on Amazon)

Photo credit: Carlo Cattadori

Props needed: a mat, two to three blocks, two bolsters, four blankets, and an eye pillow.

Setup:

  1. Place a bolster lengthwise on your mat, resting it on two blocks tilted slightly forward (the top block vertically, the middle one horizontally) to create a gentle 45° incline.

  2. Add a folded blanket at the top of the bolster: the higher fold supports your head and upper cervical spine, the lower fold your shoulders.

  3. Sit in front of the bolster with your legs extended. Lie back, ensuring your pelvis is fully supported by the bolster to protect your lower back.

  4. Bend your knees, bring the soles of your feet together, and allow your knees to fall open into a supported butterfly position. Place a second bolster under your thighs. If using a rectangular bolster, slide a block beneath it for extra height. The inner thighs should feel relaxed, not stretched.

  5. Wrap the edges of your upper blanket around your shoulders and neck for full support.

  6. Rest your hands softly on your belly and support your elbows with rolled blankets on each side of your torso.

  7. Cover yourself, place the eye pillow over your eyes, and relax here for 20 minutes.


To come out of the pose:


Begin by deepening your breath and becoming aware of your surroundings.
On an exhale, place your feet one at a time on the mat, roll gently to one side (remaining supported by the bolster), and let the eye pillow fall away naturally.
When ready, use your hands to slowly come back to a seated position.