Yoga reduces premenstrual syndrome symptoms and modulates hormonal and inflammatory blood parameters: single-blind randomized controlled trial

Öz

Objective: This study aimed to investigate the effect of yoga on premenstrual syndrome(PMS) symptoms, pain, blood cell counts, and inflammation parameters in women with PMS. Methods: This study was conducted as a randomized controlled, single-blind trial in the gynecology and obstetrics clinic of a hospital in Istanbul between September 2021-June 2022. In the study, 131 women who presented with complaints of PMS and were diagnosed with PMS and met the sampling selection criteria (Group A yoga group n=65,Group B control group n=66) were randomized into two groups. The intervention group underwent a total of 24 yoga sessions, three days a week, for 8 weeks. Data from the included women were obtained via Personal Information Form, Visual Analog Scale (VAS), Premenstrual Syndrome Scale (PMSS), and blood sample including blood count and inflammation parameters. Results: The yoga group demonstrated a significant and progressive reduction in total PMS severity scores, whereas no significant change was observed in the control group over time. In addition, women in the intervention group showed significant reductions across multiple PMS symptom domains, including affective, somatic, and behavioral symptoms, as well as lower pain intensity scores, while no comparable changes were detected in the control group. The yoga intervention was also associated with significant improvements in hormonal, hematological, and inflammatory parameters. Conclusion: These findings suggest that yoga may represent a safe, non-pharmacological, and accessible complementary approach for the management of premenstrual syndrome, with beneficial effects on symptom severity, pain perception, and physiological regulation.

Anahtar Kelimeler

• Premenstrual Syndrome
• Yoga
• Pain
• Inflammation
• Blood Cell Count

Yoga, premenstrüel sendrom belirtilerini azaltır ve hormonal ve inflamatuar kan parametrelerini düzenler: tek kör randomize kontrollü çalışma

Öz

Amaç: Bu çalışmanın amacı, yoganın premenstrüel sendrom(PMS) belirtileri, ağrı, kan hücre sayımları ve inflamasyon parametreleri üzerindeki etkisini incelemektir. Yöntem: Çalışma, Eylül 2021–Haziran 2022 tarihleri arasında İstanbul’daki bir hastanenin jinekoloji ve obstetri kliniğinde randomize kontrollü, tek kör olarak yürütülmüştür. Çalışmaya PMS şikâyeti olan ve PMS tanısı konulan 131 kadın dahil edilmiştir (Grup A: yoga grubu n=65, Grup B: kontrol grubu n=66). Katılımcılar iki gruba randomize edilmiştir. Müdahale grubuna toplam 8 hafta boyunca, haftada üç gün, 24 yoga seansı uygulanmıştır. Veriler Kişisel Bilgi Formu, Görsel Analog Skalası (VAS), Premenstrüel Sendrom Skalası (PMSS) ve kan sayımı ile inflamasyon parametrelerini içeren kan örnekleri ile toplanmıştır. Bulgular: Yoga grubunda toplam PMS şiddet skorlarında anlamlı ve kademeli bir azalma saptanırken, kontrol grubunda zaman içinde istatistiksel olarak anlamlı bir değişiklik izlenmedi. Ayrıca müdahale grubundaki kadınlarda; duygusal, somatik ve davranışsal semptomlar dâhil olmak üzere birden fazla PMS semptom alanında anlamlı azalmalar ve ağrı şiddetinde belirgin düşüş gözlendi. Buna karşılık kontrol grubunda benzer değişiklikler tespit edilmedi. Yoga müdahalesi ayrıca hormonal, hematolojik ve inflamatuvar parametrelerde anlamlı iyileşmeler ile ilişkili bulundu. Sonuç: Bu bulgular, yoganın premenstrüel sendromun yönetiminde güvenli, farmakolojik olmayan ve kolay erişilebilir tamamlayıcı bir yaklaşım olabileceğini; semptom şiddeti, ağrı algısı ve fizyolojik düzenlenme üzerinde olumlu etkiler sağlayabileceğini düşündürmektedir.

Anahtar Kelimeler

• Premenstrüel Sendrom
• Yoga
• Ağrı
• İnflamasyon
• Kan Hücre Sayımı

Kaynakça

1. 1. Pearce E, Jolly K, Jones L, et al. Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomized controlled tri-als. BJGP open, 2020;4(3): bjg-popen20X101032. https://doi.org/10.3399/bjgpopen20X101032
2. 2. Talebpour A, Mohammadifard M, Zare Feyza-badi R, et al. Effect of curcumin on inflammato-ry biomarkers and iron profile in patients with premenstrual syndrome and dysmenorrhea: A randomized controlled trial. Physiol Rep. 2023;11(13). doi:10.14814/PHY2.15763
3. 3. Itriyeva K. Premenstrual syndrome and premen-strual dysphoric disorder in adolescents. Curr Probl Pediatr Adolesc Health Care. 2022;52(5). doi:10.1016/J.CPPEDS.2022.101187
4. 4. Granda D, Szmidt MK, Kaluza J. Is Premenstrual Syndrome Associated with Inflammation, Oxi-dative Stress and Antioxidant Status? A Sys-tematic Review of Case–Control and Cross-Sectional Studies. Antioxidants. 2021;10(4):604. https://doi.org/10.3390/antiox10040604
5. 5. Barcikowska Z, Zbieta Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory markers in dysmenorrhea and therapeutic options. International Journal of Environmental Research and Public Health, 2020; 17(4):1191. doi:10.3390/ijerph17041191
6. 6. Erbaş N, Altunbaş N. Determining the ıntensity of premenstrual syndrome and perceived stress level according to some variables in high school female students Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2021;12(2): 479-486.https://doi.org/10.31067/acusaglik.849971
7. 7. Racine ML, Terwoord JD, Ketelhut NB, et al. Rho-kinase inhibition improves haemodynamic responses and circulating ATP during hypoxia and moderate intensity handgrip exercise in healthy older adults. J Physiol. 2022;600(14):3265-3285. doi:10.1113/JP282730
8. 8. Hantsoo L, Rangaswamy S, Voegtline K, Salim-garaev R, Zhaunova L, Payne JL. Premenstrual symptoms across the lifespan in an internation-al sample: data from a mobile application. Arch Womens Ment Health. 2022;25(5):903-910. doi:10.1007/S00737-022-01261-5

9. 9. Elvan A. Does premenstrual syndrome affect physical activity and quality of life? A cross-sectional study. J Exerc Ther Rehabil. 2023;10(2):115-121. doi:10.15437/jetr.1229555
10. 10. Mohammadi MM, Dehghan Nayeri N, Mashhadi M, Varaei S. Effect of omega‐3 fatty acids on premenstrual syndrome: A systematic review and meta‐analysis. Journal Obstet Gynaecol Res. 2022;48(6):1293-1305. doi:10.1111/jog.15217
11. 11. Yilmaz Esencan T, Rathfısch G. The spiritual ef-fects of yoga during the birth process. Indian J Tradit Knowl. 2023;22(4):891-898. doi:10.56042/IJTK.V22I4.39354
12. 12. Yildiz Karaahmet A, Sule Bilgic F, Yilmaz T, Dinc Kaya H. The effect of yoga on sexual func-tion and body image in primiparous pregnant Women: A randomized controlled single-blind study. Eur J Obstet Gynecol Reprod Biol. 2022;278:100-106. doi:10.1016/j.ejogrb.2022.09.014
13. 13. Pal A, Nath B, Paul S. Evaluation of the effec-tiveness of yoga in management of premenstrual syndrome: A systematic review and meta-analysis. Journal Psychosom Obstet Gynecol. 2022;43(4):517-525. doi:10.1080/0167482X.2022.2086457
14. 14. Alkhalaf Z, Kim K, Kuhr DL, et al. Markers of vitamin D metabolism and premenstrual symp-toms in healthy women with regular cycles. Hum Reprod. 2021;36(7):1808-1820. doi:10.1093/HUMREP/DEAB089
15. 15. Kaye SL. An overview of premenstrual voice syndrome: Definition, treatment, and future tra-jectories. Med Probl Perform Art. 2020;35(1):59-65.
16. 16. Sharma P, Chand S, Ratn A. A systematic review report on impact of yoga practices on ımmune response with special reference to SARS-COV-2 Pandemic. Indian J Anc Med Yoga. 2023;16(2):81-89. doi:10.21088/ijamy.0974.6986.16223.3
17. 17. Palmer MJ, Henschke N, Villanueva G, et al. Targeted client communication via mobile de-vices for improving sexual and reproductive health. Cochrane Database Syst Rev. 2020;(8).
18. 18. Grant S, Mayo-Wilson E, Montgomery P, et al. “CONSORT-SPI 2018 explanation and elabora-tion: guidance for reporting social and psycho-logical intervention trials.” Trials 19.1 2018;1-18.
19. 19. Kamalifard M, Yavari A, Jafarabadi MA, et al. The effect of yoga on women’s premenstrual syndrome: A randomized controlled clinical tri-al. Int J Womens Health Reprod Sci. 2017;5:2015–11.
20. 20. Hisli N. Availability and reliability of the Beck depression inventory for university students. (A reliability and validity study of Beck De-pression Inventory in a university student sam-ple). J. Psychol.1989;7:3-13.
21. 21. Gençdoğan B. A new scale for premenstrual syndrome. Psychiatry in Turkey 2006; 8(2): 81-87
22. 22. Lee YK, Chung CY, Koo KH, et al. Transcultur-al adaptation and testing of psychometric prop-erties of the Korean version of the Hip Disabil-ity and Osteoarthritis Outcome Score (HOOS), Osteoarthritis and Cartilage, 2011;(19):853- 857.
23. 23. Prasad D, Wollenhaupt-Aguiar B, Kidd KN, De T, Cardoso A, Frey BN. Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: A systematic review and meta-analysis. Journal of Women’s Health. 2021;30(12):1693-1707.
24. 24. Sundström-Poromaa I, Comasco E, Sumner R, Luders E. Progesterone – Friend or foe? Front Neuroendocrinol. 2020;59. doi:10.1016/J.YFRNE.2020.100856
25. 25. Demiralp Ovgun C, Tuzun EH. The effect of progressive muscle relaxation technique and myo-fascial release technique on premenstrual symptoms, blood circulation, and quality of life in women with premenstrual syndrome: A single-blind randomized controlled study. Medicine (Baltimore). 2023;102(27):E34223. doi:10.1097/MD.0000000000034223
26. 26. Vaghela N, Mishra D, Sheth M, Dani VB. To compare the effects of aerobic exercise and yoga on Premenstrual syndrome. Journal of educa-tion and health promotion, 2019;8(1): 199.
27. 27. Tarverdizadeh B. The effect of an aerobic train-ing course and consumption of curcumin on prostaglandin E2 and prolactin levels in women with premenstrual syndrome. J Endocrinol Metab. 2018;19(6):441-445.
28. 28. Shehata MMA, Maged AM, Kotb A, et al. Whole-body vibration versus supervised aero-bic exercise on hormonal parameters and inflammatory status in women with premenstrual syndrome: A randomized controlled trial. Int J Gynaecol Obstet. 2023;162(2):493-501. doi:10.1002/IJGO.14737
29. 29. Foster R, Vaisberg M, Luis A, et al. Premenstrual syndrome, inflammatory status, and mood states in soccer players. Neuroimmunomodula-tion.2019;26(1):1-6. doi:10.1159/000494559