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Summary

Recently Abiç et al. [1] conducted a randomized controlled study aiming to determine the effect of yoga on climacteric symptoms in menopausal women aged 40 to 60 years. There were 31 menopausal women in each of 2 groups, for a total of 62. To collect data a descriptive characteristic form and the Menopause Rating Scale (MRS) were used. The yoga group practiced yoga for 60 minutes twice a week for 10 weeks. In the final session of the 10 weeks of yoga training, the MRS was applied to the women again. No intervention was performed on the control group. The median total score of the MRS of the women in the yoga group was 16 (11-21) in the pretest, and 5 (3-9) in the posttest (p < 0.05). The median scores of the psychological, urogenital and somatic complaint subscales of the MRS decreased significantly compared to baseline after the 10 weeks (6 to 1, 3 to 1 and 7 to 1, respectively, p < 0.05). The authors conclude that 60 minutes of yoga 2 days a week for 10 weeks may reduce the psychological, somatic, and urogenital symptoms experienced in menopause.

Commentary

Yoga is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India. It involves movement, meditation, and breathing techniques to promote mental and physical well-being. While yoga is widely employed in all ages for various purposes, the medical literature related to yoga and menopause is somewhat limited. Basically, yoga combines the mind and the body and since menopausal symptoms, as well known, involve physical, neurological and psychological interactions, it seems logical to use yoga as a complementary or alternative therapy to the traditional medical approaches. The conclusion of a meta-analysis, which was published in 2018 and included 13 randomized controlled trials (RCTs) with 1,306 participants, was phrased cautiously: “yoga seems to be effective and safe for reducing menopausal symptoms” [2]. Recent publications have reaffirmed the advantages of yoga in the setup of menopause. The small RCT by Abiç et al. that appears above is among these studies. It concluded that one hour of yoga twice weekly “may reduce the psychological, somatic, and urogenital symptoms experienced in menopause [1]. In another RCT yoga significantly improved menopausal symptoms and sleep quality in peri- and postmenopausal women after controlling for social support, depression, anxiety and stress [3].

Looking at a different perspective, the positive effects of yoga in breast cancer survivors were summarized in a Cochrane review [4]. However, a recent, small qualitative study focused on postmenopausal women [5]. It aimed at expectations and experiences related to practicing yoga. The investigators concluded that yoga was reported to have contributed to an increased body awareness and self-efficacy, which are very important in such a clinical set-up.

Interestingly, the 2023 nonhormone position statement of NAMS addressed exercise yoga as not recommended (Level II class) because of “limited or inconsistent scientific evidence” [6]. Despite this, it should be remembered that yoga is a roof for various types of practices, so each study results has to be considered within its own specific frame. Nevertheless, in my opinion, and after reading the core available data in the literature, my conclusion is very simple – why not try it?

Take home key points

  • Yoga is a very commonly used practice globally that potentially improves physical and mental health.
  • Yoga may be recommended as an adjunct or an alternative approach to reduce menopause symptoms and improve quality of life.

Amos Pines, MD
Sackler Faculty of Medicine, Tel-Aviv University, Israel

References

      1. Abiç A, Yilmaz Vefikuluçay D. The Effect of Yoga on Menopause Symptoms: A Randomized Controlled Trial. Holist Nurs Pract. 2024;38(3):138-147.
        https://pubmed.ncbi.nlm.nih.gov/38709129/
      2. Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas. 2018;109:13-25.
        https://pubmed.ncbi.nlm.nih.gov/29452777/
      3. Susanti HD, Sonko I, Chang PC, Chuang YH, Chung MH. Effects of yoga on menopausal symptoms and sleep quality across menopause statuses: A randomized controlled trial. Nurs Health Sci. 2022;24(2):368-379.
        https://pubmed.ncbi.nlm.nih.gov/35191141/
      4. Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017;1(1):CD010802.
        https://pubmed.ncbi.nlm.nih.gov/28045199/
      5. Bilc M, Pollmann N, Buchholz A, Lauche R, Cramer H. Yoga and meditation for menopausal symptoms in breast cancer survivors: a qualitative study exploring participants’ experiences. Support Care Cancer. 2024;32(7):413.
        https://pubmed.ncbi.nlm.nih.gov/38842686/
      6. “The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society” Advisory Panel. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590.
        https://pubmed.ncbi.nlm.nih.gov/37252752/

If you would like to add a comment or contribute to a discussion based on this issue, please contact Menopause Live Editor, Peter Chedraui, at  peter.chedraui@cu.ucsg.edu.ec.

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