Hormones, Fascia, and Yoga: What Ovulation and Menopause Mean for Your Practice

Fascial changes in response to hormones is a topic that fascinates me and is now gaining attention in scientific research, especially among my Yoga Medicine colleagues. It always brings me back to a pivotal moment in my own life.

Model knee joint anatomy isolated on white background.

As a teenager, during basketball practice, I planted for a layup when my left knee audibly popped and I collapsed in pain. After a few days on the sidelines, I was diagnosed with a complete ACL rupture and scheduled for reconstructive surgery. That one injury set me on the path that would eventually lead to two knee replacements, and also to a deep love affair with yoga, the body, and its ability to heal from the inside out.

What I didn’t know then is what research now confirms: female hormones influence fascia—the connective tissue matrix— in ways that can increase our susceptibility to overstretching and injury.

Fascia, Collagen, and Hormones: The Basics

Fascia is a form of connective tissue that surrounds and supports muscles, bones, and organs. Its qualities shift depending on the type of collagen it contains:

Type 1 Collagen: Rigid and stabilizing, provides structure.

Type 3 Collagen: More elastic, provides flexibility and stretch.

Hormonal changes throughout life alter this balance. In particular, rising estrogen during ovulation shifts tissues toward more Type 3 collagen, creating greater laxity and less structural stability. This is both a gift (more freedom of movement) and a risk (greater potential for overstretching).

Ovulation: When Stability Is at Its Lowest

During ovulation, the anterior cruciate ligament (ACL) — already a vulnerable structure — becomes more lax, increasing the risk of injury. Studies confirm that joint laxity is highest in the first half of the menstrual cycle, and risk spikes further with high-impact sports or workouts performed in hot environments.

Female physician educating a patient on ovulation.

This explains why women are more prone to ACL injuries during ovulation and why my own basketball injury may not have been just bad luck, but biology.

The effects aren’t limited to the knees. In the plantar fascia, hormonal changes can thin the tissue, lengthen the arch, and reduce balance perception. For athletes, this may change stride mechanics and proprioception. Even if you’re not an athlete, you may notice your body simply feels different across your cycle — sometimes looser, sometimes stiffer.

Temperature and Tissue Laxity: Why Heat Matters

Temperature compounds hormonal changes. Heat increases hyaluronic acid activity, which improves slide-and-glide between fascial layers but also magnifies tissue laxity in deeper fascia. The result? More potential for overstretching.

This is especially relevant for hot yoga, Yin yoga, or workouts in heated environments. Research shows the risk of overstretching is highest during the first half of the menstrual cycle. For this reason, Yin yoga or long static holds are best practiced post-period, when tissues regain stability and the body is better supported hormonally.

Pro tip for athletes: Follow the 60% rule when practicing yoga during menses. Work at about 60% of your maximum effort or stretch capacity to reduce ligament and tendon strain.

Menopause and Beyond: When Stiffness Replaces Laxity

As women enter perimenopause and menopause, lower estrogen levels reverse the pattern. The fascia shifts toward more Type 1 collagen, increasing stiffness and reducing elasticity.

For some, this may feel like tightness or rigidity where flexibility once came more easily. In orthopedic patients, especially those with scar tissue from surgery (like me, with bilateral knee replacements), this rigidity is amplified. Scar tissue, an unorganized form of connective tissue, decreases responsiveness around joints and can limit movement.

The takeaway? While ovulation increases flexibility but decreases stability, menopause decreases flexibility but can compromise adaptability. In both phases, yoga for menopause practices help restore balance by honoring the body’s current state.

Woman tracks her menstrual cycle on a calendar.

Why This Matters for Yoga and Exercise

Hormonal shifts are not simply background processes — they directly shape how our tissues respond to load, stretch, and stress. This awareness can guide smarter decisions in both yoga and athletic training:

• During ovulation: Prioritize stability, avoid excessive stretching, and be mindful in hot environments.

• During menopause: Focus on mobility practices, breath, and strength to maintain resilience and ease.

• At any stage: Adapt your yoga to your body’s changing needs rather than forcing your body to adapt to yoga.

Final Thoughts

This is such an exciting area of science because it helps us move beyond “just stretching” and toward yoga that is informed, safe, and deeply supportive. For women, understanding how hormones influence fascia brings autonomy, body connection, and smarter training decisions.

Whether you’re an athlete timing your workouts or a woman navigating the transitions of menopause, yoga therapeutics offers a practical framework: build resilience, decrease injury risk, and cultivate awareness that extends beyond the mat.

Want to learn more about developing a confident yoga practice that adapts to your body now and protects your future movement health? In my classes, I fuse the latest fascia science with therapeutic yoga to create greater awareness, safety, and confidence — helping you make wiser choices and feel more at ease in your body.

Client testimonial cites Joy Zazzera, owner of Yoga with Joy as Prepared and Adaptable in her teaching.

References Katja Bartsch, Sports Scientist & lead Yoga Medicine Researcher. Yoga Medicine Research Lecture Notes. Tiffany Cruikshank, Yoga Medicine Founder, Lead Teacher; Yoga Medicine Research Lecture Notes.

Fede C, Pirri C, Fan C, Albertin G, Porzionato A, Macchi V, De Caro R, Stecco C. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One. 2019 Sep 26;14(9):e0223195. doi: 10.1371/journal.pone.0223195. PMID: 31557257; PMCID: PMC6762168.

Hansen M, Miller BF, Holm L, Doessing S, Petersen SG, Skovgaard D, Frystyk J, Flyvbjerg A, Koskinen S, Pingel J, Kjaer M, Langberg H. Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissue in young women. J Appl Physiol (1985). 2009 Apr;106(4):1435-43. doi: 10.1152/japplphysiol.90933.2008. Epub 2008 Oct 9. PMID: 18845777.

Herzberg SD, Motu'apuaka ML, Lambert W, Fu R, Brady J, Guise JM. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017 Jul 21;5(7):2325967117718781. doi: 10.1177/2325967117718781. PMID: 28795075; PMCID: PMC5524267.

Lee H, Petrofsky JS, Daher N, Berk L, Laymon M, Khowailed IA. Anterior cruciate ligament elasticity and force for flexion during the menstrual cycle. Med Sci Monit. 2013 Nov 29;19:1080-8. doi: 10.12659/MSM.889393. PMID: 24287619; PMCID: PMC3862144

Petrofsky J, Lee H. Greater Reduction of Balance as a Result of Increased Plantar Fascia Elasticity at Ovulation during the Menstrual Cycle. Tohoku J Exp Med. 2015 Nov;237(3):219-26. doi: 10.1620/tjem.237.219. PMID: 26537843.