HealthHealth Conditions

Over-the-counter birth control is touted as the future of contraception, but we still have a long way to go

Over-the-counter birth control has bipartisan support, and at least one company has begun the process for FDA approval—here's what this could mean for you.

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Photo: <a href="http://www.stocksy.com" target="_blank" rel="noopener noreferrer">Stocksy</a>/ Jamie Grill Atlas
Published Aug 26, 2019

Written by 

Erin Bunch

Earlier this summer, something strange happened on Twitter: Republican Ted Cruz publicly agreed with a Tweet posted by Democrat Alexandria Ocasio-Cortez which read, “Psst! Birth control should be over-the-counter, pass it on.”

Unlike so many political dialogues—particularly those which concern the bodies of people with uteruses—this exchange felt uncharacteristically sensible and non-controversial. It also made the goal at its center sound easily achievable: for people to be able to buy oral contraceptives at the drugstore just like they buy aspirin or foot fungus cream.

This debate isn’t totally new—advocates have long argued that by taking off the requirement of needing a prescription to get a birth control pill, people would have a much easier time accessing contraception, which would in turn lower the rate of unintended pregnancies. The American College of Obstetricians and Gynecologists (ACOG) said as much in a statement in 2014. With this new bipartisan interest, is it finally time for America to join the 100 countries around the world which allow over-the-counter (OTC) access to birth control, especially given that numerous stateside medical organizations—including The American Academy of Family Physicians, The American Academy of Pediatrics, The American Medical Association, and The Society for Adolescent Health and Medicine, to name a few—have come out in support of the idea?

The answer appears to be yes… with many, many caveats.

The health debate over OTC birth control

One of the biggest questions I had when looking into the over-the-counter birth control debate: How safe is it for people to be able to buy hormonal drugs like BC without a prescription? To answer this, you first have to know about how birth control works. There are two broad types of oral contraceptive pills: progestin-only birth control and combination birth control. The former type, also called “mini pills,” use just progestin—a synthetic form of progesterone—to prevent pregnancy by thinning the lining of the uterus and thickening the cervical mucus to make it harder for a sperm to fertilize an egg. Combination birth control pills use a mix of estrogen and progestin (hence the combination) to prevent pregnancy by stopping ovulation, thinning the lining of the uterus, and thickening cervical mucus.

After speaking with several health professionals—including LA-based OB/GYN Sherry Ross, MD,  Emily Rymland, NURX clinical development lead and nurse practitioner, and Birth Control Pharmacist founder Sally Rafie, PharmD, BCPS, APh, NCMP—there seems to be a consensus that progestin-only birth control pills are essentially risk-free to the consumer and are therefore a very safe place to start when it comes to OTC access. “Progestin-only pills are a really great option for an over-the-counter pill because like all birth control pills, they’re highly effective at preventing pregnancy and it’s very rare that there would be a health condition that could make using them risky,” explains Kate Grindlay Kelly, project director for the Free the Pill campaign at the international nonprofit organization Ibis Reproductive Health.

It’s important to emphasize that both types of pill are generally safe and equally effective at preventing pregnancy. But there is concern among the experts I spoke to about making combination birth control available OTC, because it is associated with a slight increased risk of deep vein thrombosis, heart attack, and stroke, per the ACOG. That risk is higher in smokers over the age of 35 and people with multiple risk factors for cardiovascular disease. (Progestin-only pills are not associated with this risk.) That’s why Dr. Ross says while she generally supports OTC access and believes that access is a huge priority, she worries that women would take medications for which they are contraindicated without knowing it, since they are picking it up at the drugstore and not after a consultation with their doctor.

Birth control isn’t the only important aspect of female health—here’s what it’s like to get fertility testing: 



Rymland agrees, and says that while “all access is good access,” it worries her a bit those at risk demos—like women who smoke and are over 35,  women who have hypertension, and women who have migraine with aura, for example—might put themselves on a combination pill unwittingly. That said, she thinks women should be trusted to sort this stuff on their own—and research supports the idea that women and adolescent girls are able to safely regulate their own health (gasp!), too. “People have done studies on patients’ ability to self-assess their medical needs, and they found that people are really good at it, women are good at it, and even young women are good at it,” Rymland explains.

Contraindications aren’t the only issue raised by these health professionals. Dr. Ross also worries that OTC birth control access will result in a drop in critical doctor visits, since many women find their way to the OB/GYN when they need birth control. “My concern would be that women would then forget the basic service and women’s health care routine that needs to happen every year—STI checks, breast exams, talking about mental health issues…. things that gynecologists do as gatekeepers for women, especially [those] under 50,” she says. In their statement of support for OTC birth control, the ACOG caveats that this access should not stand in for regular gynecological exams.

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Personally, I wish I had gotten more counseling around birth control from my gyno, even with the prescription requirement, so it worries me that if the pill moves OTC that education could drop to nil. Aumatma Shah, ND, who runs a holistic fertility practice, shares my concern, especially when it comes to educating people about what happens once you’ve stopped the pill and are trying to get pregnant. For example, while hormone conditions like PCOS are often managed with birth control, Dr. Shah says BC can also mask those conditions in undiagnosed people, which can ultimately hinder fertility. These risks are not be adequately addressed with patients as is, she says, so it’s her belief that education needs to improve, regardless of how OTC birth control shakes out.

A complicated legal battlefield

Beyond the concerns in the medical community, congressional support around the issue is not without its disagreements and controversies. Separate bills regarding OTC birth control have been introduced by both sides of the aisle this year, and each includes unique stipulations. The Democratic-led bill, titled “The Affordability is Access Act,” seeks to prevent insurance companies from ceasing to cover birth control if it moves over the counter—a critical step, say its proponents, in ensuring the pill remains financially accessible as it becomes more logistically accessible. The Republican bill, titled “Allowing Greater Access to Safe and Effective Contraception Act,” is focused more on allowing the FDA to fast-track its approval of OTC birth control options, with a stipulation that these options be for people aged 18 and over.

These both may seem promising, but critics are concerned about the Republican-sponsored bill. “The difference between what we’ve seen in the Republican bill, which was introduced earlier this year, and the Democrat bill, which was introduced a couple months later, is that the Democrat bill is focused on affordability through insurance coverage whereas the Republican bill appears to impose an age restriction and it does not include anything on insurance coverage,” explains Kelly. (Instead, the bill focuses on allowing people to use health savings accounts for OTC medications.) The insurance aspect matters because currently, the Affordable Care Act mandates that insurers cover prescription contraception at no additional cost to women. If the pill moves OTC without insurance mandates, insurance companies will cease to be required to cover it—which could undermine the ACA, a long-held goal of the Republican party. In fact, when Republican legislators hoped to strip away certain aspects of the ACA in 2014, they introduced a bill that in part championed OTC birth control access as a way to give women contraception without having to have it covered by insurance, or compel health providers to prescribe it against their personal religious beliefs.

These discrepancies aren’t the only—or the biggest, even—bureaucratic roadblock to OTC access, either. No drug can switch from prescription-only to OTC, regardless of what’s happening in Congress, unless the FDA approves it to do so. This cannot be done quickly or in one fell swoop, either. “There is no precedent for a class switch—one pill would move over the counter at a time, and that means companies would have to apply one by one for their specific pill, and there are many formulations of the pill,” explains Kelly. “Plus, the process for an OTC switch is generally three to five years on average.” So far, only one company—Paris-based HRA Pharma—has begun the application process, and Ibis has been working with them since 2016 to help make the switch. The progestin-only pill they’re trying to bring to market is not one which is currently available, even by prescription, in the U.S., Kelly tells me.

Making accessible birth control a reality

Advocates argue that OTC isn’t the only way to make birth control more accessible. One current prescription-requirement workaround recently enacted in California, Colorado, District of Columbia, Hawaii, Idaho, Maryland, New Mexico, Oregon, Utah, and West Virginia allows pharmacists to prescribe birth control as well as doctors. “We see more and more states trying to pass similar legislation, and actually it’s bipartisan, which is really nice,” says Birth Control Pharmacist founder Sally Rafie, PharmD, BCPS, APh, NCMP. This movement could expand access and education efforts simply because, as Kelly points out, pharmacists are trained to counsel on the side effects of medications, and her organization is working to get them specific training around the pill, too. In this case, a person could utilize a well-informed pharmacist at their local drugstore to help them make the right BC choice, rather than waiting the average 24 days to get an appointment with their OB/GYN.

“In order for an over-the-counter pill to truly be successful in our minds, and to truly increase access, we believe that affordability is crucial.” —Kate Grindlay Kelly, project director for the Free the Pill campaign

This convenient service, however, isn’t free. “One of the biggest hurdles has been around making sure that patients who have insurance are able to use their insurance to cover the visit,” Rafie explains. While the medications are still covered by insurance in this context, she tells me that sometimes insurance companies won’t cover the pharmacist consultation because they don’t recognize pharmacists as health care providers.

The bottom line: More accessible birth control is coming…but slowly. If you’re interested in throwing your weight behind OTC birth control, Kelly tells me you can follow Free the Pill on social media and visit their website for more information. “We also encourage people to help raise their voices in support of this issue generally,” she says. You could also call your Congressional representatives and senators to ask them to support the OTC birth control legislation you’re passionate about. Similarly, if you want to advocate for pharmacy access or coverage, Rafie says her organization is happy to work with anyone trying to organize an effort in their state.

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At the end of the day, advocates say the most important thing is remembering to keep birth control as legitimately accessible to as many people as possible. “FDA approval process is one of the key parts of getting an over-the-counter pill, but in order for an over-the-counter pill to truly be successful in our minds, and to truly increase access, we believe that affordability is crucial and that’s why we’re working to ensure that an over-the-counter pill would be covered by insurance without requiring a prescription,” says Kelly. Psst… back to you on that one, then, AOC.

OTC access would be a major accessibility win, but did you know you can already order birth control online? You can get comprehensive STI test kits and medications by mail, too.

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‘It’s Amazing How It’s All Connected.’ Here’s How Trauma Can Affect Your Pelvic Floor

Trauma and your pelvic floor are connected. Here's how trauma affects your pelvic floor, according to health experts.

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Photo: Stocksy/Marija Savic
Published Feb 2, 2025

Written by 

Heather Mayer Irvine

Content warning: This story contains references to suicide and physical and emotional trauma, which may be upsetting or triggering for some readers.

Experts in This Article

Alexandra T. Milspaw

an international consultant and educator for chronic pelvic and sexual pain

Lauren Garges

a women’s clinical specialist and the director of the pelvic health rehab program at St. Lukes University Health Network

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The only thing that stopped Zoe* from taking her own life was the love she had for her two children. But the indescribable chronic pain she was experiencing was all-encompassing. And none of her doctors—nearly a dozen—knew what was wrong. Worse, perhaps, they wrote her off, condescended her, passed her around from physician to physician. “They washed their hands of me,” Zoe, now 48, tells Well+Good.

After a year of medication and doctor visits and dismissed cries for help, for what was first suspected (never confirmed) to be a urinary tract infection that morphed into excruciating pelvic pain, Zoe found herself speaking with a pelvic floor physical therapist. She was diagnosed with a hypertonic—tight, overactive—pelvic floor. Now, the healing and treatment could begin.

What is the pelvic floor?

The pelvic floor is made of important muscles and tissues that hold pelvic organs, including the bladder, bowel, and uterus. Lauren Garges, PT, DPT, a women’s clinical specialist and the director of the pelvic health rehab program at St. Lukes University Health Network, likens the pelvic floor to a hammock of muscles. And, like the muscles in your neck, legs, or back, they can be too weak or too tight. But when a person experiences trauma, acute or over an extended period of time, it can lead to pelvic floor dysfunction, explains Garges.

Pelvic floor dysfunction is an umbrella term that refers to a host of issues, including urinary incontinence, pain during intercourse, constipation, and urinary frequency and urgency, Garges says. If left untreated, pelvic floor dysfunction can lead to chronic conditions, including back and hip pain. It can be hard to diagnose at this point because the root of the problem, in the pelvic floor, presents itself in the hip and back.

How trauma can affect the pelvic floor

Not only does the pelvic floor hold numerous organs, but it’s also where the vagal nerves are rooted. These nerves are part of the autonomic nervous system, which controls digestion, heart rate, and immune system, explains Alexandra T. Milspaw, PhD, an international consultant and educator for chronic pelvic and sexual pain.

The human fight-or-flight response to stress is linked to the autonomic nervous system, which means it’s impossible for a person to experience fight-or-flight without the pelvic floor tightening, Milspaw says.

Garges, who frequently refers her physical therapy clients to mental health professionals, says that trauma is incredibly individualized and subjective. Giving birth, for example, falls into the realm of trauma.

“Birth trauma would be the physical things that need to heal—torn muscles, stitches, nerve damage,” Garges says. “Some people recover quickly, in three to six months, but for others, it can persist for much longer, and that’s when you should see someone who can treat it.” Birth trauma can also be emotional, if, say, a woman’s healthcare team didn’t listen to her wishes, or the labor and delivery were traumatic.

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Garges also treats patients who have suffered from sexual assault or abuse, and she describes vaginismus, a type of dysfunction, as a protective mechanism—the body is literally closing itself off. (This can happen after other forms of trauma, too.)

But not all trauma, Garges explains, has to be physical for the pelvic floor to experience distress. “Emotional trauma presents physically in the body, tightness in the muscles,” she says, reiterating that the pelvic floor is made up of muscles. Someone who’s stressed or anxious might have tension in their shoulders and neck, others in their pelvic floor muscles.

Physical tension and stress create a cycle of inflammation that isn’t typically visible on imaging or through bloodwork, Milspaw says, which can make diagnosing these complaints and concerns incredibly challenging. “Anxiety or stress or a head injury can lead to a tight pelvic floor, which can cause [gastrointestinal] upset, which creates inflammation, which can be felt in the brain, and then we’re trapped in this cycle until we can turn off the switch at both ends at the same time,” Milspaw explains.

Eventually, Zoe started working with a pelvic floor physical therapist, who told her, “Your brain has learned this pattern [of pain],” Zoe recalls. “It goes far beyond the acute symptoms, which have resolved. Now your neurons are remembering this pain pattern.”

So in addition to pelvic floor physical therapy, which includes manual therapy, exercises, and breathing techniques, Zoe started seeing Milspaw for counseling. She says although she was surprised at the connection between mental health and pelvic floor dysfunction, “ultimately it made sense. If your nervous system is in constant fight-or-flight mode, it’s bound to have physical effects.”

What happens if trauma goes unchecked

The body is designed to protect itself, sometimes at all costs. This became apparent to Dianna B., 55, when she found herself begrudgingly speaking to a therapist at the request of her husband who was seeing a sex therapist. The couple, who had four children, had stopped having sex when Dianna was 43 and her sister was diagnosed with breast cancer.

On top of that, Dianna had a traumatic second birth, one that required 75 internal stitches. For years, she experienced unidentified pain near her where her stitches had been and bathroom accidents—bowel movement and incontinence. She was sure she had an anal fissure (tests showed she didn’t). “I sat there crossing my arms, saying, ‘I don’t have a mental health issue. I have a physical issue,” Dianna recalls.

Eventually, Dianna started to open up. She recalled being held down by her legs when she was 10 years old while doctors took bone marrow from her hips to give to her older sister who had leukemia. “She was going to die unless she got a bone marrow transplant,” Dianna tells Well+Good. “I was her donor.”

These repressed memories, Dianna says, came flooding back during therapy, and she started to see the correlation: She held trauma in her legs from her childhood and was retraumatized during her second delivery as an adult. “It’s amazing how it’s all connected.”

Milspaw, who has been working with Dianna for years, explains that if a person experiences intense stress, anxiety, or depression for a period of just 10 days, the hardware of the brain starts to change. For example, a 2021 study1 published in Translational Psychiatry, found that trauma exposure during childhood could contribute to structural changes in the developing brain. “It can shrink and deteriorate,” Milspaw says. “This hardware is specifically related to emotional regulation, memory, executive function, and communication.”

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Milspaw says this trauma is cumulative, that “the body keeps score.” She explains that people assume if there is pelvic or sexual pain, it has to be related to sex-related trauma, but that’s just not true. “People forget the nervous system is one whole system,” she says. “The pelvis is the center of the wheel.”

“People forget the nervous system is one whole system. The pelvis is the center of the wheel.” —Alexandra T. Milspaw, PhD

What to do if you have trauma that’s affected your pelvic floor

Once people know where to turn, trauma to your pelvic floor is treatable. But there are more than a few barriers to treatment, Milspaw says. “People don’t want to touch pelvic pain with a 10-foot pole,” she says. “There is a lot going on in the pelvis, and no one wants to be responsible for it.” The example she gives is the reality Zoe faced: See a gynecologist who sends you to a urologist, who passes you to a gastroenterologist, who kicks you back to a urologist.

Part of this problem, Milspaw says, is that most healthcare professionals are not trained in pelvic health. Another part of the problem is the taboo around sexual health and pelvic pain. People, especially women, do not want to discuss their concerns—Zoe and Dianna are examples of how even when they did try to seek help, they were treated like petulant children with no obvious illness or problem. “The shame piece is huge,” Milspaw says. “You can’t talk about how your vagina hurts as easily as you can talk about how your head hurts.”

Some women think what they’re experiencing is normal because they don’t know anything else. Milspaw gives an example of a high school girl who had incredibly heavy periods—soaking through five pads an hour. She was told, “It’s your period. Get over it.”

Savannah T., 25, suspected what she was experiencing was not normal. She was diagnosed with endometriosis in her late teens and has been through a pharmacy full of medications to manage her symptoms, including debilitating pain. Savannah, a nurse, slipped into a deep depression in 2021 because of her worsening health and working in the COVID-19 intensive care unit. She had to take a leave of absence.

She searched for a pelvic floor physical therapist—something not many people know to do. “My pelvic floor physical therapist educated me on what the floor is and what it does. She validated all of the symptoms I was having,” Savannah tells Well+Good.

Pelvic floor physical therapists provide treatment that can be a mix of exercises, stretches, breathing techniques, and manual tissue release. “When it comes to manual therapy, we have to be mindful of that trauma and maintain an alliance with the patient,” Garges says, noting that a physical therapist will follow a patient’s lead, and hands-on work might not happen for weeks or months.

Garges will prescribe yoga stretches that focus on the lower back to relieve tension, and pelvic exercises like lunges, squats, and hip work. Garges and Milspaw guide their patients through breathing techniques as well.

Milspaw teaches her clients a variety of tools, including emotional freedom techniques—a type of tapping that can assist with anxiety relief—bilateral stimulation music2 to help balance brain activity between the two hemispheres, and pendulation, which can help regulate the nervous system by alternating, or pendulating, between feelings of safety and discomfort.

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Once Milspaw establishes balance and a feeling of safety in her clients, then more traditional forms of therapy, including talk therapy, she says, are more effective.

Savannah didn’t realize how much her depression, stress, and anxiety connected straight to her pelvic floor. Whenever she had feelings of distress, they could be directly correlated to an increase in her pelvic symptoms. “With the combination of pelvic floor physical therapy and working with Dr. Milspaw, I’ve seen a huge difference,” Savannah says. She still takes medications for her endometriosis, but she knows what her life looks like without her physical and mental therapies. It’s dark.

There are brighter days ahead for Savannah, Zoe, and Dianna. They encourage others to advocate for themselves, even if a doctor—or doctors—is dismissive. They knew something wasn’t right and wouldn’t quit until someone took them seriously. “It’s been a journey,” Zoe says. “I’ve learned a lot about myself. I’ve rebuilt myself from the ground up, from the floor up.”

Dianna, who resented her husband for insisting she see a therapist because they weren’t having sex, now says it was the best gift he could have given her. They’re not quite on the same page yet, but Dianna says there’s hope. “That’s what I’m striving for.”

*Names have been changed, where indicated, to protect privacy.

  1. Jeong, H.J., Durham, E.L., Moore, T.M. et al. The association between latent trauma and brain structure in children. Transl Psychiatry 11, 240 (2021). https://doi.org/10.1038/s41398-021-01357-z

    ↩︎

  2. Amano T, Toichi M. The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study. PLoS One. 2016 Oct 12;11(10):e0162735. doi: 10.1371/journal.pone.0162735. PMID: 27732592; PMCID: PMC5061320.

    ↩︎

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How a Yoga Practice Helped Me Navigate My Relationship With Alcohol During Dry January

Read one writer's experience with how yoga helped them navigate their relationship with alcohol during Dry January.

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Photo: Stocksy/Jayme Burrows
Published Jan 31, 2025

Written by 

Colleen McNally Arnett

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Whether unwinding after a long day with a cocktail, toasting a celebratory moment with bubbly, or sharing a bottle with friends over dinner, alcoholic beverages—when enjoyed responsibly in moderation—have long been a one of my favorite rituals for bringing people together and feeling present in the moment.

Experts in This Article

Courtney Scott

medical director of Momentous Recovery Group

Rosalie Kennedy

a yoga instructor and director of marketing at Athletic Brewing Company

Rostislav Ignatov

chief medical officer at The Haven Detox and a board-certified expert in general psychiatry and addiction medicine

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But the soaring popularity of the sober-curious movement in the past decade, however, has led more people—myself included—to reevaluate the role alcohol plays in our lives and our health.

Trends like Dry January encourage people to reimagine how they drink and navigate their social lives. And with new health guidelines in the U.S. warning that even moderate alcohol consumption is linked to an increased risk of cancer, staying dry—or at least damp—beyond January is becoming increasingly common.

Still, like breaking any habit, going dry can be challenging at first. Even with the rise of delicious, zero-proof beverages becoming more easily available, cutting back on up booze requires strong mental stamina, clear intention setting, and a community support system.

Enter: yoga. While the Western world most commonly associates yoga with exercise, the ancient practice is so much more than physical postures. As the Kripalu Center for Yoga & Health teaches, in accordance with the Bhagavad Gita, “yoga is skillfulness in action—a reference to a yogi’s capacity to act dynamically in ways that reliably produce positive life results.” Another definition drawn from the Yoga Sutra teaches that “yoga is the cessation of the fluctuations of the mind, a reference to a yogi’s capacity to see life and reality as it is, without the filters of fears, fantasies or other distortions.”

Considering alcohol can color our reality, a yoga practice can be a helpful tool for those learning to navigate a sober-curious life.

The benefits of taking a break from alcohol (during any time of the year)

“Alcohol is a depressant, and even moderate drinking can contribute to anxiety, low mood, or mental fog,” says Rostislav Ignatov, MD, chief medical officer at The Haven Detox and a board-certified expert in general psychiatry and addiction medicine. “When you stop drinking, your brain starts to balance itself, and many people feel more focused, emotionally stable, and even happier. It’s like lifting a weight off your shoulders.”

According to Dr. Ignatov, one of the first things many people notice when taking a break from alcohol is better sleep. “Alcohol might help you fall asleep, but it actually disrupts deep, restful sleep, leaving you tired the next day,” he explains. “Without it, your sleep cycles improve, and you wake up feeling more refreshed and energized.”

Physically, you’ll likely see changes over time, too. “Your liver gets a much-needed break, which can lower inflammation and help your body work more efficiently,” Dr. Ignatov adds. “People often notice reduced bloating, better digestion, and even healthier skin. If you’ve been dealing with high blood pressure or sluggish energy levels, you might see improvements there as well.”

How a yoga practice can help you navigate your relationship with alcohol

For Rosalie Kennedy, a yoga instructor and director of marketing at Athletic Brewing Company, a non-alcoholic beer company, opting for a non-alcoholic beer instead of booze allows her to be social and enjoy whatever the occasion might be without the typical next-day pitfalls of alcohol consumption. “I can give 100 percent to the next activity whether that’s yoga, work, or taking care of my family,” says Kennedy.

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After casually practicing yoga for 15 years, Kennedy opted to pursue her 200-RYT certification in 2023. As a result, she says she has not only elevated her understanding of her body and mental health, but has improved her overall quality of life. “Now, I can bring that mindfulness into other facets of my life, like alcohol consumption,” Kennedy says. “I’ve noticed that I’m more aware of how my body reacts to alcohol, how I’m enjoying the taste, or whether I even want to consume alcohol at a given moment.”

On a biological level, one of the best things yoga does is reduce stress, which in turn, can reduce the likelihood of wanting to drink alcohol. “Yoga relaxes the nervous system and lowers cortisol—the stress hormone,” says Courtney Scott, MD, medical director of Momentous Recovery Group.

Dr. Scott points out that when we’re less stressed, we’re less likely to rely on alcoholic substances as coping mechanisms for life challenges. “Cravings often come when you’re feeling overwhelmed or anxious, and yoga helps calm your mind and body,” Dr. Ignatov adds. By focusing on your breath and movement, you can activate your body’s parasympathetic nervous system (PNS)— also known as the body’s relaxation response—a network of nerves that helps the body relax and digest food. Simply put, this state makes it easier to handle stress without reaching for a drink.

“Yoga also teaches mindfulness, which is all about staying present in the moment,” says Dr. Ignatov “When a craving shows up, yoga helps you pause and acknowledge it without reacting right away. That moment of pause can be all you need to choose a healthier way to cope, like taking a walk or calling a friend.”

A yoga practice helps individuals to understand themselves better physically and emotionally, explains Dr. Scott. “This enables them to be mindful about what triggers their emotions hence evading an urge for alcohol.” From my own personal experience, I know that if I have more than a couple of drinks in the evening, I will feel the effects when I show up on my yoga mat the next day.

The bottom line

For those who are re-evaluating their relationship with alcohol and are interested in deepening their yoga practice, Kennedy advises to focus on what makes you feel good.

“Yoga is for you, not anyone else,” Kennedy says. “You’re always allowed to modify a posture to suit your preferences, and alcohol consumption should be no different. I recommend checking in with yourself during a night out or a social occasion where alcohol might be involved. Ask yourself, ‘Does this feel good?’ If not, what adjustments do you want to make in the moment?”

Reaping the benefits of yoga, however, will require a consistent practice. “Whatever chemicals make you feel good, such as endorphins, will naturally rise when you become used to practicing yoga every day, which provides a safe, alternative mood-booster compared to a temporary alcohol high,” says Dr. Scott. “Consistent training brings about an enduring feeling of joy and stability in one’s life.”

If you or someone you know is struggling with substance abuse, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or go to FindTreatment.gov for resources and treatment options.

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