The Effect of Yoga Therapy in Premenstrual Syndrome: A Systematic Review and Meta- Analysis of Randomized Controlled Trials

OBJECTIVE

Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga activity lowers harmful inflammatory secretions that provide comfort for premenstrual syndrome (PMS) sufferers.

DATA SOURCES

The following worldwide databases were searched for this systematic review: Scopus, PubMed, Cochrane Library, PEDro, and Google Scholar from inception to August 2022.

STUDY SELECTION

A PICOS framework (Population, Intervention, Comparison, Outcome, and Study Design) was used for searching. Population included those with premenstrual syndrome or premenstrual tension syndromes, intervention included yoga therapy, comparator was with control group, and outcome measures included blood pressure (SBP, DBP) and heart rate (HR).

DATA EXTRACTION AND SYNTHESIS

To evaluate the study, we employed the Methodological Index for Randomised Controlled Trials. Fixed effects meta-analysis and qualitative synthesis were conducted. A total of 14 studies out of 224 were included. The main outcome measures included in this review were SBP, DBP, HR, and Moos Menstrual Distress Questionnaire (MMDQ). For the meta-analysis, 7 studies were considered. 3 studies contributed data of SBP (mean difference (MD) = -0.30; 95% CI: -2.29 to 1.69; heterogenicity (I2) = 96%; P = 0.00001) and DBP (MD = -0.25; 95% CI: -0.99 to 0.49; I2 = 79%; P = 0.009). HR results from 4 studies were included (MD = 0.08; 95% CI: -0.83 to 0.99; I2 = 89%; P = 0.00001). 3 studies contributed data of MMDQ (MD = 1.50; 95% CI: 0.91 to 2.10; I2 = 92%; P = 0.00001.

CONCLUSION

Yoga can help people with both medical and psychological conditions including menstrual pain, irregular periods, stress, tension, and anxiety. It has been shown to lessen women's emotional, behavioural, and physical PMS symptoms, which has enhanced their quality of life.

OBJECTIF

Jusqu'à 80 % des femmes en âge de procréer connaîtraient un syndrome prémenstruel (SPM), qui se caractérise par des changements physiques, psychologiques et comportementaux. Les activités de yoga réduisent les sécrétions inflammatoires nocives et soulagent les symptômes du syndrome prémenstruel. SOURCE DES DONNéES: Pour cette revue systématique, des recherches ont été effectuées dans les bases de données mondiales Scopus, PubMed, Cochrane Library, PEDro et Google Scholar pour la période allant de leur création au mois d'août 2022. SéLECTION DES éTUDES: Une méthode PICOS (population, intervention, comparaison, résultat et conception de l'étude) a été utilisée pour la recherche. La population à l'étude incluait les personnes souffrant du syndrome prémenstruel ou d'une tension prémenstruelle, l'intervention incluait la thérapie par le yoga, le comparateur était le groupe témoin, et les critères de jugement comprenaient la pression artérielle (systolique et diastolique) et la fréquence cardiaque. EXTRACTION DES DONNéES ET SYNTHèSE: Pour évaluer l'étude, nous avons utilisé l'indice méthodologique pour les essais cliniques randomisés. Une méta-analyse à effet fixe et une synthèse qualitative ont été réalisées. Au total, 14 des 224 études relevées ont été retenues. Les critères de jugement principaux de cette revue étaient les pressions artérielles systolique et diastolique, la fréquence cardiaque et le questionnaire de détresse menstruelle de Moos. Dans la méta-analyse, 7 études ont été prises en compte. Au total, 3 études avaient des données sur la pression systolique (différence moyenne [DM] = -0,30; IC à 95 % : -2,29 à 1,69; hétérogénéité [I2] = 96 %; P = 0,00001) et la pression diastolique (DM = -0,25; IC à 95 % : -0,99 à 0,49; I2 = 79 %; P = 0,009). Les données de fréquence cardiaque de 4 études ont été incluses (DM = 0,08; IC à 95 % : -0,83 à 0,99; I2 = 89 %; P = 0,00001). Des données du questionnaire de Moos étaient disponibles pour 3 études (DM = 1,50; IC à 95 % : 0,91 à 2,10; I2 = 92 %; P = 0,00001).

CONCLUSION

Le yoga peut aider les personnes souffrant de troubles médicaux ou psychologiques, notamment les douleurs menstruelles, les menstruations irrégulières, le stress, les tensions et l'anxiété. Les données montrent que le yoga atténue les symptômes émotionnels, comportementaux et physiques du syndrome prémenstruel chez les femmes, ce qui améliore leur qualité de vie.

The effects of yoga and progressive muscle relaxation exercises on premenstrual syndrome: a randomized controlled trial

In this study, university students with premenstrual syndrome (PMS) were evaluated for their responses to the practices of yoga and progressive muscle relaxation (PMR) to combat PMS, and the depression, anxiety, and stress associated with it. A total of 68 students participated in a randomized controlled trial. They were divided into four parallel groups: a yoga intervention group (n = 17), a PMR intervention group (n = 17), a yoga and PMR intervention group (n = 17), and a control group (n = 17). Data were collected between April 2022 and June 2022, from students who practiced only yoga, who practiced only PMR, and who practiced both yoga and PMR. A Personal Information Form, the PMS Scale, and the Depression, Anxiety, and Stress Scale were used as measurement tools. The yoga and yoga + PMR groups had lower scores for the PMS Scale in the posttest than the other groups (p < .05). Depression, anxiety, and stress sub-dimension mean scores were lower in the yoga, PMR + yoga, and PMR groups compared to the control group (p < .05). The results suggest that yoga and PMR interventions are beneficial non-pharmacological treatments for PMS, depression, anxiety, and stress.Clinical Registration Name, Registration Number, Registration Date: The Effects of Yoga and Progressive Muscle Relaxation Exercises on Premenstrual Syndrome, NCT05396976, April 5, 2022.

Management of Premenstrual Dysphoric Disorder: A Scoping Review

Premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) refer to physical, cognitive, or affective symptoms that arise in the late luteal phase and remit with menses. The present work is a clinically focused scoping review of the last twenty years of research on treatment for these disorders. A search of key terms using the PubMed/Medline, the Cochrane Library, Embase, and Web of Science databases was performed, and 194 studies of adult women met initial inclusion criteria for review. Research studies concerning medications, pharmacological and non-pharmacological complementary and alternative medicine treatments, and surgical interventions with the most available evidence were appraised and summarized. The most high-quality evidence can be found for the use of selective serotonin reuptake inhibitors (SSRIs) and combined oral contraceptives (COCs), with gonadotropin releasing hormone (GnRH) agonists and surgical interventions showing efficacy for refractory cases. While there is some evidence of the efficacy of alternative and complementary medicine treatments such as nutraceuticals, acupuncture, and yoga, variability in quality and methods of studies must be taken into account. Reprinted from Int J Womens Health 2022; 14:1783-1801, with permission from Dove Medical Press Ltd. Copyright © 2022.

The Role of Benson's and Mitchell's Relaxation Techniques in the Management of Premenstrual Syndrome: An In-Depth Review

Premenstrual syndrome (PMS) is a menstrual disorder characterized by physical, behavioral, and emotional symptoms typically occurring during the luteal phase. These symptoms are usually mild and somatic and often subside during or just before the start of menstruation. Medical professionals employ pharmacological and non-pharmacological treatments as the primary approach to managing PMS. One effective non-pharmacological method is Laura Mitchell's physiological relaxation treatment, which has been shown to enhance immunological function, reduce depression, and improve the overall quality of life. Another beneficial technique is Benson's relaxation technique, established by Herbert Benson in 1970, providing a simple yet powerful stress-release strategy. For this study, research papers were searched using various reputable databases such as PubMed, Scopus, Web of Science, and Google Scholar websites, with data collected up to the end of 2021. The publication dates of the review articles were not restricted, allowing for a comprehensive overview. However, it is important to note that only a limited number of accessible studies have been found, underscoring the need for further research. Future investigations should focus on high-quality evidence with reliable outcome measures to draw more conclusive results about which relaxation technique offers better relief for PMS.

Effects of Kinesio Taping method on menstrual pain: A randomized, single-blind, placebo-controlled crossover study

Current research promotes complementary methods of coping with menstrual pain (MP). Our objective was to examine the effectiveness of the Kinesio Taping (KT) intervention on MP and determine whether KT has therapeutic impact or whether there is presence of placebo. We used crossover design, dividing 30 female participants into KT and placebo KT groups. Every phase included one menstrual cycle. The average age of participants was 23.5 years (ranging from 18 to 39 years). In the assessment, we used VAS, Brief Pain Inventory Scale, and some SF-36 subscales. In KT phase all types of pain (the average MP, the worst experienced MP, the mildest one, and the current MP) were significantly less intense. KT has beneficial effect in reducing MP and its consequences and it is significantly superior to placebo. The order of intervention showed no statistical significance, which also confirms the therapeutic effect of KT.

Management of dysmenorrhea through yoga: A narrative review

Menstrual pain also known as dysmenorrhea is one of the most common and underrated gynecological disorders affecting menstruating women. Although the symptoms and impact might vary greatly, it is defined by cramps in the lower abdomen and pain that radiates to lower back and thighs. In some cases it is also accompanied by nausea, loose stool, dizziness etc. A primary narrative review was conducted on the impact of yoga on dysmenorrhea experienced by women. The English-language literature published until 2022 was searched across databases such as PubMed, Google Scholar and Scopus. “Yoga” and “menstrual pain” OR “dysmenorrhea” were used as keywords for the search across several databases. A total of 816 title searches were obtained across all the database searches. This review article included 10 studies based on the selection criteria. The studies examined the impact of a varied set of 39 asanas, 5 pranayamas and Yoga nidra on dysmenorrhea. The studies demonstrated a significant relief in dysmenorrhea among those who practiced Yoga (asanas/pranayama/yoga nidra) with improved pain tolerance and reduced stress levels. Regulating the stress pathways through yoga was found to be a key in regulating hormonal balance and reduction in dysmenorrhea.

Management of Premenstrual Dysphoric Disorder: A Scoping Review

Premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) refer to physical, cognitive, or affective symptoms that arise in the late luteal phase and remit with menses. The present work is a clinically focused scoping review of the last twenty years of research on treatment for these disorders. A search of key terms using the PubMed/Medline, the Cochrane Library, Embase, and Web of Science databases was performed, and 194 studies of adult women met initial inclusion criteria for review. Research studies concerning medications, pharmacological and non-pharmacological complementary and alternative medicine treatments, and surgical interventions with the most available evidence were appraised and summarized. The most high-quality evidence can be found for the use of selective serotonin reuptake inhibitors (SSRIs) and combined oral contraceptives (COCs), with gonadotropin releasing hormone (GnRH) agonists and surgical interventions showing efficacy for refractory cases. While there is some evidence of the efficacy of alternative and complementary medicine treatments such as nutraceuticals, acupuncture, and yoga, variability in quality and methods of studies must be taken into account.

Evaluation of the effectiveness of yoga in management of premenstrual syndrome: a systematic review and meta-analysis

Aim: The management of Premenstrual Syndrome (PMS) is still evolving due to the modest effect sizes of the available treatment modalities. Yoga as therapeutic intervention in PMS has been gathering interest amongst researchers. The current manuscript reviews the evidence surrounding yoga in PMS.Methods: This manuscript was a systematic review and meta-analysis evaluating the effectiveness of yoga on the total scores and sub-domains of PMS after studies were identified using a pre-defined selection criterion after a search in PubMed, Google Scholar, Scopus and Web of Science. Both quantitative and qualitative analysis of the accumulated data was performed. Overall, 14 studies were identified for the review, 11 of which were used for the purpose of quantitative analysis.Results: The studies were heterogenous in terms of the design, yoga regimes, nature of interventions and tools used for outcome measures. It was found that yoga was beneficial in the management of PMS. This benefit was also seen when all the sub-domains of PMS were individually examined except physical sub-domain.Conclusion: Though there were certain limitations in our review like heterogeneity in studies, possibility of publication bias and restrictive selection criterion; it supported that yoga can be beneficial in patients with PMS.

The relationship between high physical activity and premenstrual syndrome in Japanese female college students

BACKGROUND

In recent years, moderate physical activity has attracted the attention of experts and women as a way to cope with premenstrual syndrome (PMS). Studies investigated the effects of exercise on PMS, but only a few reports focused on the relationship between physical activity, which included not only exercise but also routine bodily movements, and PMS. Therefore, the present study investigated the relationship between the amount of physical activity and PMS symptoms among sexually mature female students.

METHODS

A total of 381 female university students in Japan were surveyed using a paper or web-based questionnaire with the same content. The questionnaire consisted of basic information, PMS symptoms, and physical activity based on the International Physical Activity Questionnaire (IPAQ). Participants were divided into two groups (≥ 3000 The Metabolic Equivalent of Task (MET)-minutes/week and < 3000 MET-minutes/week) based on their total physical activity as calculated using the IPAQ guidelines. The two groups were then compared in terms of the severity of their PMS physical and psychological symptoms as calculated based on the American College of Obstetricians and Gynecologists' PMS diagnostic criteria. The Wilcoxon's rank-sum test was used for statistical analyses. We then divided the participants based on the presence or absence of each symptom and used the chi-square test to compare the intergroup differences in ratios. The statistical significance level was set at p < 0.05.

RESULTS

Those with total physical activity of ≥ 3000 MET-minutes/week had lower total PMS symptom scores (p < 0.01), physical symptom scores (p = 0.01), and psychological symptom scores (p = 0.01) compared with those with total physical activity of < 3000 MET-minutes/week.

CONCLUSION

These results suggest that young women with high physical activity (≥ 3000 MET-minutes/week) have milder symptoms of PMS.

N. The Mystery behind Relaxation Therapy: Adieu to Premenstrual Syndrome

Premenstrual syndrome (PMS) is a very common condition leading to physical, emotional, and psychological distress in females during their reproductive years. Researchers found that as many three of every four menstruating women have experienced some form of PMS. Although the severity of this problem is great, a lot of confusion exists in both medical and lay communities about what is and is not effective for the treatment of PMS. It has a wide variety of signs and symptoms and it may tend to recur in a predictable pattern. The physical and emotional changes experienced with PMS may vary from just slightly noticeable to very intense. Lifestyle adjustments in every kind can help to reduce or manage the signs and symptoms of PMS. Apart from all these, one of the most beneficial methods to reduce the difficulties of PMS is relaxation therapy which includes meditation, visualization, autogenic, Tai Chi, hydrotherapy, exercise, massage, aromatherapy, biofeedback, relaxation breathing, progressive muscle relaxation (Jacobson’s progressive relaxation therapy and The Mitchells progressive relaxation therapy) and yoga. Thus when remedies are available why not we celebrate the inborn power of relieving PMS in women.

Increased Incidence of Premenstrual Syndrome in Females with Palmar Hyperhidrosis

Background: Premenstrual syndrome (PMS) is a common disorder affecting the quality of life of women of reproductive age. In a previous study, sex hormone imbalances and alterations in autonomic function were present in PMS, with parasympathetic dysfunction and sympathetic overactivity during the late luteal phase. Palmar hyperhidrosis (PH) presents with oversweating, heat and emotional stimulation, sympathetic hyperactivity and parasympathetic hypofunction. We hypothesized that the incidence of PMS is increased in females with PH. Methods: Data were retrieved from the Taiwanese National Health Insurance Database. The patients with PH were identified by the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) disease code 780.8. Female patients matched by age and index day were used as the control group. The incidence of PMS was considered an outcome by the ICD-9-CM disease code 625.4. The factors related to PMS were analyzed by Cox regression. Results: The adjusted hazard ratio for the incidence of PMS was 1.276 (95% confidence interval: 1.05–1.488) in females with PH. Conclusions: This study found a positive correlation between PMS and female PH patients. Patients and physicians must understand the relationship of PMS with autonomic function alterations and other risk factors to prevent this problematic disorder.

The effects of health belief model-based education and acupressure for coping with premenstrual syndrome on premenstrual symptoms and quality of life: A randomized-controlled trial

PURPOSE

This study investigated the effects of health belief model-based education and acupressure for coping with premenstrual syndrome (PMS) on premenstrual symptoms and quality of life.

DESIGN AND METHODS

The sample size was identified as 163 women. While the acupressure education group-administered education and acupressure, the education group-administered only education. No intervention made to the control group.

FINDINGS

There was a significant difference between the pretest and posttest total mean scores of the intervention groups compared with the control group (P < .001).

PRACTICE IMPLICATIONS

The education given to women for coping with PMS and acupressure both reduced premenstrual symptoms and improved quality of life.

The effects of acupressure and yoga for coping with premenstrual syndromes on premenstrual symptoms and quality of life

OBJECTIVE

This study aims to identify the effects of acupressure and yoga for coping with premenstrual syndromes (PMS) on the premenstrual symptoms and quality of life.

METHODS

This study adopted a randomized intervention design with a pretest-posttest control group. The sample consisted of 155 students with PMS complaints (50 in yoga, 51 in acupressure, and 54 in control group). The students in the intervention groups did yoga and received acupressure throughout 12 weeks.

RESULTS

It was found that the Premenstrual Syndrome Scale posttest mean score of the students was lower, and the physical health, psychological health, and environment sub-scale mean scores of the World Health Organization Quality of Life Questionnaire were higher in the yoga group in comparison to the other groups (p < 0.05).

CONCLUSION

Yoga was found to be a more effective non-pharmacological method for coping with premenstrual symptoms.

Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials

Background

Exercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.

Aim

To systematically review the evidence for the effectiveness of exercise as a treatment for PMS.

Design & setting

This systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.

Method

Randomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.

Results

A total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion (n = 717). Seven trials contributed data to the primary outcome meta-analysis (n = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity (I² = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.

Conclusion

Based on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.