Effects of yoga on quality of life and flexibility in menopausal women: a case series.

Research suggests that exercise can be one effective strategy for menopausal symptoms. Physically active people have lower anxiety and depression and are more inclined to handle stress better. Some health benefits of exercise include an increased ability to stay lean and avoid obesity, lower blood pressure, improve threshold and tolerance of pain, and increase bone mineral content. 2 Lack of exercise has been reported to increase the risk of heart attack by 190%, whereas adequate exercise increases bone-mineral content and density in certain areas of the body. 3 It has also been shown that a consistent exercise program incorporating aerobic and weight lifting is important for menopausal women, 4 and aerobic exercise in particular can be effective in decreasing some symptoms of menopause, including hot flashes. 5 Women who exercised on a regular basis had significantly fewer vasomotor symptoms, a lesser degree of negative moods, a lesser degree of decreased sexual desire, and significantly higher well-being scores than women who did not exercise. 3,6 Recent observational studies have shown that women who are inactive and do not exercise are more likely to experience severe hot flashes than those women who actively exercise. 7 One intervention study concluded that fitness level and quality of life (QOL) of postmenopausal women could be improved by a regular controlled exercise program of six weeks. 8 Yoga has for centuries been regarded as an exercise for the body, mind, and spirit. The theory behind yoga practice is that the union of mind and spirit in exercise brings balance to the body and promotes healing. 9,10 The physiologic effects of yoga on both the cardiovascular and respiratory systems are well documented. Sympathetic physiologic responses of yoga include increased heart rate, stroke volume, increased vagal tone, increased muscle tension, increased muscular circulation, and dilation of bronchi. Parasympathetic responses include decreased heart rate, stroke volume, low vagal tone, decreased pain perception, decreased blood pressure, and optimized immune system. 9 In addition to its effects on blood pressure, heart rate, and heart rate variability, yoga also seems to have mood-modulating effects that may be clinically relevant. 11-18 Specifically, yoga practice has been associated with improved vitality 18 and the reduction of anger, 16 anxiety/tension, 13 depression, 13 and fatigue. 17 It has been associated with improved QOL, as well. 12 Yoga can also have physiological benefits similar to those of a regular aerobic program. 9,19 Based on the growing consensus that exercise can reduce menopausal symptoms, it follows that yoga may have a positive effect on the symptoms of menopause, particularly given the potential additional benefits from the relaxation/meditation aspects of yoga practice. This case series describes the impact of yoga practice on menopausal symptoms in a group of six women studying Iyengar yoga. The specific sequence of poses used was one designed to address menstrual disorders, menopause, and pregnancybyfocusingonposesthatenergeticallyandphysically open the pelvic region. 20