Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial A pilot study of a Hatha yoga treatment for menopausal symptoms. Effect of yoga on autonomic functions and psychological status during both phases of menstrual cycle in young healthy females. Yoga decreases insomnia in postmenopausal women: a randomized clinical trial Therapeutic potential of yoga practices in modifying cardiovascular risk profile in middle aged men and women. A Randomized controlled trial of the effect of yoga and peer support on glycaemic outcomes in women with type 2 diabetes mellitus: a feasibility study Effect of Eischens Yoga During Radiation Therapy on Prostate Cancer Patient Symptoms and Quality of Life: A Randomized Phase II Trial. Randomized trial of yoga in women with breast cancer undergoing radiation treatment. Five-week yin yoga-based interventions decreased plasma adrenomedullin and increased psychological health in stressed adults: A randomized controlled trial Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial. Efficacy of an eight-week yoga intervention on symptoms of restless legs syndrome (RLS): a pilot study. Effect of yoga on menopausal symptoms Longitudinal impact of yoga on chemotherapy-related cognitive impairment and quality of life in women with early stage breast cancer: a case series. Evidence-based review of therapies at the menopause. Menopausal quality of life: RCT of yoga, exercise, and omega-3 supplements. Effects of Yoga on Heart Rate Variability and Depressive Symptoms in Women: A Randomized Controlled Trial. The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women.
Goal of workBreast cancer survivors have limited options for the treatment of hot flashes and related symptoms . Further , therapies widely used to prevent recurrence in survivors , such as tamoxifen , tend to induce or exacerbate menopausal symptoms . The aim of this preliminary , r and omized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer ( stages IA – IIB ) . Material s and methods Thirty-seven disease-free women experiencing hot flashes were r and omized to the 8-week Yoga of Awareness program ( gentle yoga poses , meditation , and breathing exercises ) or to wait-list control . The primary outcome was daily reports of hot flashes collected at baseline , posttreatment , and 3 months after treatment via an interactive telephone system . Data were analyzed by intention to treat . Main results At posttreatment , women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency , severity , and total scores and in levels of joint pain , fatigue , sleep disturbance , symptom-related bother , and vigor . At 3 months follow-up , patients maintained their treatment gains in hot flashes , joint pain , fatigue , symptom-related bother , and vigor and showed additional significant gains in negative mood , relaxation , and acceptance . Conclusions This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors OBJECTIVE To assess the feasibility and efficacy of a yoga treatment for menopausal symptoms . Both physiologic and self-reported measures of hot flashes were included . METHODS A prospect i ve within-group pilot study was conducted . Participants were 12 peri- and post-menopausal women experiencing at least 4 menopausal hot flashes per day , at least 4 days per week . Assessment s were administered before and after completion of a 10-week yoga program . Pre- and post-treatment measures included : Severity of question naire-rated menopausal symptoms ( Wiklund Symptom Check List ) , frequency , duration , and severity of hot flashes ( 24-h ambulatory skin-conductance monitoring ; hot-flash diary ) , interference of hot flashes with daily life ( Hot Flash Related Daily Interference Scale ) , and subjective sleep quality ( Pittsburgh Sleep Quality Index ) .  Yoga classes included breathing techniques , postures , and relaxation poses design ed specifically for menopausal symptoms . Participants were asked to practice at home 15 min each day in addition to weekly classes . RESULTS Eleven women completed the study and attended a mean of 7.45 ( S.D. 1.63 ) classes . Significant pre- to post-treatment improvements were found for severity of question naire-rated total menopausal symptoms , hot-flash daily interference ; and sleep efficiency , disturbances , and quality . Neither 24-h monitoring nor accompanying diaries yielded significant changes in hot flashes . CONCLUSIONS The yoga treatment and study procedures were feasible for midlife women . Improvement in symptom perceptions and well being warrant further study of yoga for menopausal symptoms , with a larger number of women and including a control group CONTEXT Premenstrual stress affects 75 % of women of childbearing age and yoga has been found to be beneficial in many psycho-somatic disorders . AIMS To investigate the effect of integrated yoga on autonomic parameters and psychological well-being during both pre and post phases of menstrual cycle in healthy young female subjects . SETTING S AND DESIGN Present study is a r and omized control trial and was conducted in the Department of Physiology , Lady Hardinge Medical College , New Delhi , India . MATERIAL AND METHODS Fifty apparently healthy females in the age group of 18 - 20 years were r and omized into two groups : Group I ( n=25 ) consisted of subjects who practice d yoga 35 - 40 minutes per day , six times per week for the duration of three menstrual cycles . Training was given by qualified yoga instructor . Group II ( n=25 ) subjects acted as controls . Following parameters were recorded at the beginning and after completion of three menstrual cycles in all the subjects : Height , weight ( BW ) , Resting Heart Rate ( HR ) , Resting Systolic ( SBP ) and Diastolic Blood Pressure ( DBP ) , parasympathetic reactivity tests including Expiration-Inspiration Ratio ( E : I ratio ) and 30:15 ratio , sympathetic reactivity tests including BP changes due to Isometric H and Grip ( IHG ) exercise , and Cold Pressor Test ( CPT ) . Assessment of psychological status was done by administering DIPAS ( Defense Institute of Physiology and Allied Sciences ) inventories of Anger self report scale , Trait Anxiety , Sense of well-being and Depression scale . STATISTICAL ANALYSIS Intra-group comparison of physiological parameters was done by using paired ' t ' test , whereas intra-group comparison of non-parameteric data such as scores of anxiety , depression , anger and sense of well-being was done by Wilcoxon signed-rank test . Inter-group comparison of parameters was done by Students ' t ' test for parametric tests and Mann-Whitney ' U ' test for non-parameteric tests . RESULTS There was significantly higher BW , resting SBP , DBP , sympathetic activity and blunting of parasympathetic reactivity and also , significantly higher scores of anger , depression , anxiety and decreased score of well-being in premenstrual phase as compared to postmenstrual phase in both the groups in initial cycle . There was significantly higher percentage decrease in BW , HR , SBP & DBP in yoga group as compared to control group in both the phases from initial to second and onwards between second and third menstrual cycle . Also , decrease in anger , depression and anxiety and increase in well-being score was significant in yoga group as compared to control group from initial to second and third cycle in premenstrual phase while the change was significant only in depression score in postmenstrual phase . CONCLUSION Our study shows that there was significant alteration of autonomic functions and psychological status in premenstrual phase when compared with postmenstrual phase in young healthy females . Also , regular practice of yoga has beneficial effects on both phases of menstrual cycle by bringing parasympathodominance and psychological well-being probably by balancing neuro-endocrinal axis Objective The practice of yoga has been proven to have positive effects on reducing  insomnia . Studies have also shown its effects on reducing climacteric symptoms . To date , however , no studies that evaluate the effects of yoga on postmenopausal women with a diagnosis of insomnia in a r and omized clinical trial have been conducted . The aim of this study was to evaluate the effect of yoga practice on the physical and mental health and climacteric symptoms of postmenopausal women with a diagnosis of insomnia . Methods Postmenopausal women not undergoing hormone therapy , who were 50 to 65 years old , who had an apnea-hypopnea index less than 15 , and who had a diagnosis of insomnia were r and omly assigned to one of three groups , as follows : control , passive stretching , and yoga . Question naires were administered before and 4 months after the intervention to evaluate quality of life , anxiety and depression symptoms , climacteric symptoms , insomnia severity , daytime sleepiness , and stress . The volunteers also underwent polysomnography .  The study lasted 4 months . Results There were 44 volunteers at the end of the study . When compared with the control group , the yoga group had significantly lower posttreatment scores for climacteric symptoms and insomnia severity and higher scores for quality of life and resistance phase of stress . The reduction in insomnia severity in the yoga group was significantly higher than that in the control and passive-stretching groups . Conclusions This study showed that a specific sequence of yoga might be effective in reducing insomnia and menopausal symptoms as well as improving quality of life in postmenopausal women with insomnia AIMS OF STUDY To study effect of yoga on the physiological , psychological well being , psychomotor parameter and modifying cardiovascular risk factors in mild to moderate hypertensive patients . METHODS Twenty patients ( 16 males , 4 females ) in the age group of 35 to 55 years with mild to moderate essential hypertension underwent yogic practice s daily for one hour for three months . Biochemical , physiological and psychological parameters were studied prior and following period of three months of yoga practice s , biochemical parameters included , blood glucose , lipid profile , catecholmines , MDA , Vit . C cholinesterase and urinary VMA . Psychological evaluation was done by using personal orientation inventory and subjective well being . RESULTS Results showed decrease in blood pressure and drug score modifying risk factors , i.e. blood glucose , cholesterol and triglycerides decreased overall improvement in subjective well being and quality of life . There was decrease in VMA catecholamine , and decrease MDA level suggestive decrease sympathetic activity and oxidant stress . CONCLUSION Yoga can play an important role in risk modification for cardiovascular diseases in mild to moderate hypertension Background Type two diabetes is a complex and dem and ing chronic disease and its impact in a state ( Kerala ) which leads India in terms of the number of people with Diabetes is profound . Though the male to female ratio among the people with diabetes is roughly equal , women are uniquely and more severely affected . Management of type two Diabetes requires considerable dexterity on the part of the patient to manage drugs , diet and exercise . Therefore , in a low middle-income country like India it is necessary to look at low cost interventions that can empower the patient and build on available re sources to help manage diabetes . Hence , we studied the feasibility and effect of two low cost interventions ; yoga and peer support on glycaemic and other outcomes among women with type two diabetes . Methods An open label parallel three armed r and omized control trial was conducted among 124 recruited women with Diabetes for three months . Block r and omization with a block length of six was carried out with each group having at least 41 women . In the Yoga arm , sessions by an instructor , consisting of a group of postures coordinated with breathing were conducted for an hour , two days a week . In the peer support arm each peer mentor after training visited 13–14 women with diabetes every week followed by a phone call . The meeting was about applying disease management or prevention plans in daily life . Results There was a trend in decline of fasting plasma glucose in the peer and yoga group and of glycosylated haemoglobin ( HbA1c ) in the yoga group only , though not significant . A significant decrease was observed in diastolic blood pressure and hip circumference in the yoga group . The process indicated that most ( 80 % ) of the women in the yoga group attended classes regularly and 90 % of the women in the peer group reported that peer mentoring was useful . Conclusion The effect of yoga and peer support on glycaemic outcomes was incremental . Longer term studies are necessary to ascertain the benefits shown by this feasibility study .Trial registration CTRI/2011/12/002227 date d 14/12/2011 PURPOSE A r and omized phase II study was performed to measure the potential therapeutic effects of yoga on fatigue , erectile dysfunction , urinary incontinence , and overall quality of life ( QOL ) in prostate cancer ( PCa ) patients undergoing external beam radiation therapy ( RT ) . METHODS AND MATERIAL S The participants were r and omized to yoga and no-yoga cohorts ( 1:1 ) . Twice-weekly yoga interventions were offered throughout the 6- to 9-week courses of RT . Comparisons of st and ardized assessment s were performed between the 2 cohorts for the primary endpoint of fatigue and the secondary endpoints of erectile dysfunction , urinary incontinence , and QOL before , during , and after RT . RESULTS From October 2014 to January 2016 , 68 eligible PCa patients underwent informed consent and agreed to participate in the study . Of the 68 patients , 18 withdrew early , mostly because of treatment schedule-related time constraints , result ing in 22 and 28 patients in the yoga and no-yoga groups , respectively . Throughout treatment , those in the yoga arm reported less fatigue than those in the control arm , with global fatigue , effect of fatigue , and severity of fatigue subscales showing statistically significant interactions ( P<.0001 ) . The sexual health scores ( International Index of Erectile Function Question naire ) also displayed a statistically significant interaction ( P=.0333 ) . The International Prostate Symptom Score revealed a statistically significant effect of time ( P<.0001 ) but no significant effect of treatment ( P=.1022 ) . The QOL measures had mixed results , with yoga having a significant time by treatment effect on the emotional , physical , and social scores but not on functional scores . CONCLUSIONS A structured yoga intervention of twice-weekly classes during a course of RT was associated with a significant reduction in pre-existing and RT-related fatigue and urinary and sexual dysfunction in PCa patients 8505 Background : Yoga , an ancient Indian science , incorporates stress-reduction techniques that include regulated breathing , visual imagery , and meditation , as well as various postures that may be useful for cancer patients . METHODS A yoga program was developed that including loosening and breathing exercises , postures , alternate nostril breathing , a deep relaxation technique , and meditation for patients with breast cancer who were undergoing radiotherapy . Women participated in bi-weekly classes during their 6 weeks of radiation treatment . Sixty-one women with breast cancer were r and omly assigned to either the yoga program or to a waitlist control group . Patients completed measures of intrusive thoughts and avoidance behaviors ( Impact of Events Scale : IES ) , depressive symptoms ( CES-D ) , sleep disturbances ( Pittsburgh Sleep Quality Index ) , fatigue ( BFI ) , and quality of life ( SF-36 ) at baseline , 1 week , and 1 and 3 months after the last radiation therapy . We report on the outcomes 1 week after the end of radiotherapy . RESULTS The average age of the women was 52 , 3 % stage 0 , 28 % stage I , 43 % stage II , and 26 % stage III , 48 % had undergone breast-conserving surgery , and 75 % had received chemotherapy prior to starting radiotherapy . Analysis of covariance , controlling for baseline , revealed that the yoga group had significantly better SF-36 physical function scores ( adjusted means : yoga 81.8 vs. control 68.6 , P < 0.01 ) , significantly higher SF-36 general health scores ( adjusted means : yoga 78.3 vs. control 67.9 , P < 0.03 ) , marginally better SF-36 social functioning scores ( adjusted means : yoga 85.3 vs. control 76.0 , P > 0.1 ) , significantly lower levels of sleep-related daytime dysfunction ( adjusted means : yoga 0.5 vs. control 1.2 , P < 0.04 ) , and marginally lower levels of fatigue ( adjusted means : yoga 1.9 vs. control 3.1 , P < 0.06 ) than the control group . There were no other group differences on the SF-36 subscales or for the CES-D or IES scores . CONCLUSIONS The results indicated that the yoga program was associated with statistically and clinical significant improvements in aspects of quality of life . No significant financial relationships to disclose Background Non-communicable diseases ( NCDs , e.g. cardiovascular disease ) are responsible for high rates of morbidity and the majority of premature deaths worldwide . It is necessary to develop preventative interventions that can reduce the associated risk factors of NCDs . Research ers have found that the biomarker adrenomedullin ( ADM ) becomes elevated years before the onset of NCDs and might play an important role in their development . ADM has also been linked to psychological problems such as stress , anxiety , and depression , which are known risk factors of NCDs . In this r and omized controlled trial , we examined whether participating in a five-week yoga intervention reduces ADM and increases psychological health in middle-aged adults who self-report as moderately to highly stressed , but who otherwise exhibit no physical complaints . Methods One hundred and five adults ( 78 % women ; mean age = 53.5 , SD = 6.7 ) were r and omly assigned to ( 1 ) a five-week Yin yoga intervention , ( 2 ) a five-week intervention combining Yin yoga with psychoeducation and mindfulness practice ( called the YOMI program ) , or ( 3 ) a control group who did not practice yoga or mindfulness for five weeks . Results Compared to the control group , we observed significantly greater pre-post reductions in plasma ADM levels ( p < .001 ) , anxiety ( p ≤ .002 ) , and sleep problems ( p ≤ .003 ) in both intervention groups . Furthermore , the YOMI group exclusively showed significantly greater pre-post reductions in stress ( p = .012 ) and depression ( p = .021 ) compared to the control group . Significant correlations ( p < .05 ) were found between pre-post reductions in ADM and anxiety symptoms ( p = .02 ) and depression ( p = .04 ) in the entire sample . Conclusion The five-week Yin yoga-based interventions appeared to reduce both the physiological and psychological risk factors known to be associated with NCDs . The study suggests that incorporating Yin yoga could be an easy and low-cost method of limiting the negative health effects associated with high stress . Trial registration Clinical Trials.gov Women with premenstrual syndrome ( PMS ) often complain about depression when their menstrual cycle begins . This study investigated the effects of yoga on women with PMS suffering from depression during menstrual cycle . METHODS This r and omized controlled clinical trial was conducted from April to October 2015 in Tabriz , Iran . All subjects ( 20 - 45 years old ) , who were frequently referred to the private obstetrics and gynecology clinics , were initially monitored for PMS and depression . Subjects completed the demographic and Beck Depression Inventory-II ( BDI-II ) question naires before and after intervention . In addition , subjects were monitored for eligible and ineligible criteria . In this study 62 subjects were r and omly selected for the yoga group and control groups .  Subjects practice d yoga over two months in three sessions , the duration of each session was 60 min . RESULTS The general score of the depression after yoga intervention was statistically significant compared to the control group ( P < 0.036 ) and yoga group before intervention ( P < 0.001 ) . The diastolic pressure decreased significantly after yoga intervention ( P < 0.029 ) . Yoga decreased the state of depression and diastolic pressure of the subjects with PMS complaining from depression . CONCLUSION We conclude that yoga has strong effects on depression symptoms and blood pressure , therefore it can be used as a complementary or alternative remedy for PMS patients BACKGROUND Restless legs syndrome ( RLS ) is a common and highly burdensome sleep disorder . While relaxation therapies , including yoga , are often recommended for RLS management , rigorous supporting research is sparse . The goal of this preliminary study was to assess the effects of yoga on RLS symptoms and related outcomes in women with RLS . METHODS Participants were 13 nonsmoking women with moderate to severe RLS , who did not have diabetes , sleep apnea , or other serious concomitant chronic conditions , and who were not pregnant . The intervention was a gentle , 8-week Iyengar yoga program . Core outcomes assessed pre- and post-treatment were RLS symptoms and symptom severity ( International RLS Scale [ IRLS ] and RLS ordinal scale ) , sleep quality ( Medical Outcomes Study Sleep Scale ) , mood ( Profile of Mood States ) , and perceived stress ( Perceived Stress Scale ) . Participants also completed yoga logs and a brief exit question naire regarding their experience with the study . RESULTS Ten ( 10 ) women , aged 32 - 66 years , completed the study . Participants attended an average 13.4±0.5 ( of 16 possible ) classes , and completed a mean of 4.1±0.3 ( of 5 possible ) homework sessions/week . At follow-up , participants demonstrated striking reductions in RLS symptoms and symptom severity , with symptoms decreasing to minimal/mild in all but 1 woman and no participant scoring in the severe range by week 8 . Effect sizes ( Cohen 's d ) were large : 1.6 for IRLS total , and 2.2 for RLS ordinal scale . IRLS scores declined significantly with increasing minutes of homework practice per session ( r=0.70 , p=0.025 ) and total homework minutes ( r=0.64 , p<0.05 ) , suggesting a possible dose-response relation . Participants also showed significant improvements in sleep , perceived stress , and mood ( all p's≤0.02 ) , with effect sizes ranging from 1.0 to 1.6 . CONCLUSIONS These preliminary findings suggest that yoga may be effective in attenuating RLS symptoms and symptom severity , reducing perceived stress , and improving sleep and mood in women with RLS Objectives . To observe the effect of yoga on  menopausal symptoms  using a prospect i ve , r and omized , controlled and interventional study . Main outcome measures . Total Menopause Rating Scale ( MRS ) score and three subscale scores ( somatovegetative , psychological and urogenital ) were measured on day 1 and day 90 in the study group which performed yoga ( asana , pranayam and meditation ) under supervision for three months , and were compared with the control group that did not perform yoga .  MRS has been design ed to measure health-related quality of life of ageing women . It consists of 11 symptoms and three subscales . Results . It was observed that on day 1 the scores in both the groups were comparable . On day 90 , the scores in the yoga group showed a reduction in score on all the subscales , which was statistically significant . No significant difference was noted in the control group . Conclusion . Yoga is effective in reducing menopausal symptoms and should be considered as alternative therapy for the management of menopausal symptoms PURPOSE Adjuvant chemotherapy for women with breast cancer has significantly improved the cure rate ; however , it has been associated with chemotherapy-related cognitive impact ( CRCI ) . The literature provides preliminary support for the feasibility and efficacy of yoga interventions for the general cancer population , however , controlled trials are scarce and no studies have examined the effect of yoga on cognition for women with breast cancer during chemotherapy . This case series aims to identify the impact of yoga on measures of cognition , functional outcomes , and quality of life ( QOL ) for breast cancer survivors ( BCS ) . METHODS Four women with a diagnosis of early-stage breast cancer prior to chemotherapy treatment were administered the following physiologic measures at baseline , 6 , and 12 weeks during chemotherapy , and at one and three months after the conclusion of the study : Functional Reach test ( balance ) and Sit and Reach test ( flexibility ) , and QOL , POMS ( Mood ) and FACT-B ( QOL ) , at baseline . Primary outcomes of cognition were measured with the Perceived Cognition Question naire ( PCQ ) and CogState , a computerized measurement of cognition . Women attended an Iyengar-inspired yoga program twice a week for 12 weeks . Qualitative question naires were administered after the completion of the study to determine perceived benefits and challenges of the yoga program . RESULTS Four women with Stage II breast cancer ranged in age from 44 - 65 years . CogState computerized testing showed changes in varying domains of cognition through treatment and follow-up . Improved balance , flexibility , and QOL were also noted over time . No adverse events were observed . Analysis of qualitative data revealed the yoga classes were helpful and subjects continued the practice elements of yoga including relaxation , breathing , and stretching . The most challenging aspect of the study was physical limitations due to various medical complications and included fatigue , decreased range of motion , and pain . CONCLUSION This case series suggests that yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures . Women describe yoga as improving various domains of QOL through the treatment trajectory . This mind-body intervention may stave off CRCI ; however , further investigation is needed for additional r and omized controlled trials on the effects of yoga on cognition for women with breast cancer undergoing adjuvant chemotherapy treatment Background and Objective The highest level of scientific evidence available for each therapy for menopausal symptoms was sought , for example , systematic review s of r and omised controlled trials ( RCTs ) . Results There is reasonable evidence that some symptoms are modified by lifestyle , for example , cessation of smoking , exercise , reduction of alcohol , diet and alleviation of psychosocial stress . No complementary medicine , for example , phytoestrogens , black cohosh , herbal or homeopathic medicines or complementary therapies , for example , acupuncture , yoga , chiropractic manipulation , reflexology or magnetic devices have a greater effect than the usual placebo effect seen in quality blinded RCTs . Some have potential side-effects . So-called ' bioidentical hormones ' have no evidence -base and potential for harm . None of the above therapies have evidence of efficacy and long-term safety . Selective serotonin and noradrenaline re-uptake inhibitors ameliorate vasomotor symptoms and sometimes menopausal depression better than placebo . The most effective therapy for menopausal ( oestrogen ) deficiency symptoms is oestrogen which is the main component of hormone replacement therapies ( HRT ) . Compared with placebo HRT is highly effective in relieving hot flushes , night sweats , dry vagina and dyspareunia . It also improved joint pains , sexuality and sleeplessness and reduced subsequent fractures in RCTs . The increased risk of oral HRT for thromboembolism is small around menopause , for those without thrombotic risk factors , and is not elevated with non-oral routes . Cardiovascular disease may be reduced when HRT is initiated near menopause . Breast cancer risk increases after several years with the use of oral HRT containing progestogens at an annual rate of 8/10 000 ( < 0.1 % ) . No increase in breast cancer risk was seen with oestrogen-only HRT OBJECTIVE The purpose of this study was to determine the efficacy of 3 nonhormonal therapies for the improvement of menopause-related quality of life in women with vasomotor symptoms . STUDY DESIGN We conducted a 12-week 3 × 2 r and omized , controlled , factorial design trial . Peri- and postmenopausal women , 40 - 62 years old , were assigned r and omly to yoga ( n = 107 ) , exercise ( n = 106 ) , or usual activity ( n = 142 ) and also assigned r and omly to a double-blind comparison of omega-3 ( n = 177 ) or placebo ( n = 178 ) capsules . We performed the following interventions : ( 1 ) weekly 90-minute yoga classes with daily at-home practice , ( 2 ) individualized facility-based aerobic exercise training 3 times/week , and ( 3 ) 0.615 g omega-3 supplement , 3 times/day . The outcomes were assessed with the following scores : Menopausal Quality of Life Question naire ( MENQOL ) total and domain ( vasomotor symptoms , psychosocial , physical and sexual ) . RESULTS Among 355 r and omly assigned women who average age was 54.7 years , 338 women ( 95 % ) completed 12-week assessment s.  Mean baseline vasomotor symptoms frequency was 7.6/day , and the mean baseline total MENQOL score was 3.8 ( range , 1 - 8 from better to worse ) with no between-group differences . For yoga compared to usual activity , baseline to 12-week improvements were seen for MENQOL total -0.3 ( 95 % confidence interval , -0.6 to 0 ; P = .02 ) , vasomotor symptom domain ( P = .02 ) , and sexuality domain ( P = .03 ) scores . For women who underwent exercise and omega-3 therapy compared with control subjects , improvements in baseline to 12-week total MENQOL scores were not observed . Exercise showed benefit in the MENQOL physical domain score at 12 weeks ( P = .02 ) . CONCLUSION All women become menopausal , and many of them seek medical advice on ways to improve quality of life ; little evidence -based information exists . We found that , among healthy sedentary menopausal women , yoga appears to improve menopausal quality of life ; the clinical significance of our finding is uncertain because of the modest effect OBJECTIVES The purpose of the study was to investigate the effects of a 12-week yoga program on heart rate variability ( HRV ) and depressive symptoms in depressed women . METHODS This was a r and omized controlled trial . Twenty-six sedentary women scoring ≥14 on the Beck Depression Inventory-II were r and omized to either the yoga or the control group . The yoga group completed a 12-week yoga program , which took place twice a week for 60 min per session and consisted of breathing exercises , yoga pose practice , and supine meditation/relaxation . The control group was instructed not to engage in any yoga practice and to maintain their usual level of physical activity during the course of the study .  Participants ' HRV , depressive symptoms , and perceived stress were assessed at baseline and post-test . RESULTS The yoga group had a significant increase in high-frequency HRV and decreases in low-frequency HRV and low frequency/high frequency ratio after the intervention . The yoga group also reported significantly reduced depressive symptoms and perceived stress . No change was found in the control group . CONCLUSIONS A 12-week yoga program was effective in increasing parasympathetic tone and reducing depressive symptoms and perceived stress in women with elevated depressive symptoms .  Regular yoga practice may be recommended for women to cope with their depressive symptoms and stress and to improve their HRV Menopause impacts 25 million women world wide each year , and the World Health Organization estimates 1.2 billion women will be postmenopausal by 2030 . Menopause has been associated with symptoms of hot flashes , night sweats , dysphoric mood , sleep disturbance , and conditions of cardiovascular disease , depression , osteoporosis , osteoarthritis , depression , dementia , and frailty . Conventional hormone replacement therapy results in increased thrombotic events , and an increased risk of breast cancer and dementia as evidence d in large prospect i ve clinical trials including Heart and Estrogen/Progestin Replacement Study I and the Women 's Health Initiative . A possible mechanism for these adverse events is the unfavorable net effects of conjugated equine estrogens and medroxyprogesterone acetate on the hemostatic balance and inflammatory and immune factors . Physiologic sex steroid therapy with transdermal delivery for peri/postmenopausal women may offer a different risk/benefit profile , yet long-term studies of this treatment model are lacking . The objective of this study was to examine the long-term effects of compounded bioidentical transdermal sex steroid therapy including estriol , estradiol , progesterone , DHEA , and testosterone on cardiovascular biomarkers , hemostatic , inflammatory , immune signaling factors ; quality -of-life measures ; and health outcomes in peri/postmenopausal women within the context of a hormone restoration model of care . A prospect i ve , cohort , closed-label study received approval from the Human Subjects Committee . Recruitment from outpatient clinics at an academic medical center and the community at large result ed in three hundred women giving signed consent . Seventy-five women who met strict inclusion /exclusion criteria were enrolled .  Baseline hormone evaluation was performed along with baseline experimental measures . Following this , women received compounded transdermal bioidentical hormone therapy of BiEst ( 80%Estriol/20%Estradiol ) , and /or Progesterone for eight weeks to meet established physiologic reference ranges for the luteal phase in premenopausal women . The luteal phase hormone ratios were selected based on animal and epidemiologic studies demonstrating favorable outcomes related to traumatic , ischemic , or neuronal injury . Follow-up testing was performed at eight weeks and adjustment to hormone regimens were made including addition of and rogens of DHEA and Testosterone if indicated . Experimental subjects were monitored for 36 months . Baseline , 2-month , and annual values were obtained for : blood pressure , body mass index , fasting glucose , Homeostasis Metabolic Assessment of Insulin Resistance ( HOMA-IR ) , fasting triglycerides , total Factor VII , Factor VIII , fibrinogen , Antithrombin III , Plasminogen Activator Inhibitor1(PAL-1 ) , C-reactive protein ( CRP ) , Interleukin-6 ( IL-6 ) , Matrix Metalloproteinase-9 ( MMP-9 ) , Tumor Necrosis Factor-alpha ( TNF ) , Insulin-like Growth Factor ( IGF-1 ) , and sex steroid levels . Psychosocial measures included : Greene Climacteric Scale , Visual Analog Pain Scale , Hamilton Anxiety Scale , Hamilton Depression Scale , Holmes Rahe Stress Scale , Job Strain , and Home Strain . Health outcome measures included the number of prescribed medications used , number of co-morbidities , and endometrial thickness in postmenopausal women with intact uteri . Subjects receiving  compounded transdermal bioidentical hormone therapy showed significant favorable changes in : Greene Climacteric Scale scores , Hamilton Anxiety Scale , Hamilton Depression Scale , Visual Analog Pain Scale , fasting glucose , fasting triglycerides , MMP-9 , C-reactive Protein , fibrinogen , Factor VII , Factor VIII , Insulin-Like Growth Factor 1 , and health outcomes of co-morbidities and a number of prescribed medications . Antithrombin III levels were significantly decreased at 36 months . All other measures did not exhibit significant effects . Administration of compounded transdermal bioidentical hormone therapy in doses targeted to physiologic reference ranges administered in a daily dose significantly relieved menopausal symptoms in peri/postmenopausal women . Cardiovascular biomarkers , inflammatory factors , immune signaling factors , and health outcomes were favorably impacted , despite very high life stress , and home and work strain in study subjects . The therapy did not adversely alter the net prothrombotic potential , and there were no associated adverse events . This model of care warrants consideration as an effective and safe clinical therapy for peri/postmenopausal women especially in population s with high perceived stress and a history of stressful life events prior to , or during the menopausal transition
A recent cross-sectional analysis in the multiethnic Study of Women ’s Health Across the Nation found that 53 % of the participants used some form of CAM ( excluding diet , vitamins , exercise , and prayer ) and that rates of use generally did not vary by menopausal status or by presence of vasomotor symptoms .
Significant improvements were also found in sleep quality ( P = 0.02 ) and
I n the wake of serious health concerns raised by the Women ’s Health Initiative and Heart and Estrogen/ progestin Replacement Study clinical trials , prescriptions for hormone therapy have declined dramatically , leaving many women without effective treatment for menopausal symptoms .
Several nonhormonal pharmacologic therapies have shown promise for reducing vasomotor symptoms , including selective serotonin reuptake inhibitors , gabapentin , and clonidine .
However , most are only modestly effective , and all have side effects that may limit their use .
A number of herbal therapies are marketed to women as being safe and effective in reducing menopausal symptoms , including phytoestrogens , black cohosh , dong quai , evening primrose oil , and red clover .
Still , interest in nonhormonal and particularly in complementary and alternative medicine ( CAM ) therapies for menopausal symptoms remains strong .
The term yoga is derived from the Sanskrit term yuj , meaning Bto yoke^ or Bto unite,^ and the goal of yoga has been described as uniting the body and mind to achieve enlightenment .
Yoga has become increasingly popular outside of India , with a 2008 survey of 5,050 people estimating that 7 % of US adults practice yoga .
Clinical trials have also demonstrated many potential health benefits of yoga , including reductions in blood pressure , dyslipidemia , and insulin resistance .
Although the exact mechanisms of hot flashes remain unknown , physiologic studies have demonstrated that heightened sympathetic nervous system activity plays an important role .
Small uncontrolled studies have shown that yoga increases heart rate variability and decreases oxygen consumption , heart rate , and blood pressure , all indicative of decreased sympathetic activity .
In addition to its biological effects , yoga may also have beneficial psychological effects that could lead women to find physical symptoms less bothersome and /or help them to cope better with changes during menopause .
In this issue of Menopause , Chattha and colleagues report results from one of the largest published trials of yoga for menopausal symptoms .
Despite the increasing popularity of yoga , a yoga intervention requiring 60 minutes of supervised instruction five times per week may not be practical for many Western women .