Effectiveness of Yoga for Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 1

Characteristics of the included studies.

Author, year	Sample size, no. of groups	Mean age ± standard deviation	Inclusion criteria	Treatment group: Intervention Program length, frequency, duration	Control group: Intervention Program length, duration, frequency	Outcome assessment; (a) Short-term followup; (b) Long-term followup	Outcome measures; (1)  Total menopausal symptoms; (2)  Psychological symptoms; (3)  Somatic symptoms; (4)  Vasomotor symptoms; (5)  Urogenital symptoms; (6)  Safety	Results^a; (a)  Short-term followup; (b)  Long-term followup; (1)  Total menopausal symptoms; (2)  Psychological symptoms; (3)  Somatic symptoms; (4)  Vasomotor symptoms; (5)  Urogenital symptoms; (6)  Safety
Afonso et al., 2011 [42]	𝑁=61,; 3 groups	NR	Postmenopausal women (50–65 years); Diagnosed insomnia not due to dyspnea	Yogasana and Tibetan yoga: yoga postures, breathing techniques, relaxation; 4 months, twice weekly, 60 minutes	(1)  Passive stretching 4 months, twice weekly, 60 minutes; (2)  Wait-list, no treatment 4 months	(a)  month 4; (b)  NA	(1)  Total menopausal symptoms (KMI); (2)  Anxiety (BAI), depression (BDI), insomnia (ISI); (3)  NA; (4)  NA; (5)  NA; (6)  Safety	(a); (1)  Yoga < wait-list; (2)  BAI: NS, BDI: NS, ISI: Yoga < wait-list; (3)  NA; (4)  NA; (5)  NA; (b)  NA; (6)  No adverse events
Carson et al., 2009 [43]	𝑁=37,; 2 groups	Yoga: 53.9 ± 9.0 years; Control: 54.9 ± 6.2 years	Breast cancer survivors ≥ 1 hot flash/day on ≥ 4 days/week; No hormone replacement therapy within last 3 months; No regular yoga	Yoga of awareness: yoga postures, breathing techniques, meditation, study of pertinent topics, group discussion; 8 weeks, once weekly, 120 minutes	Wait-list, no treatment; 8 weeks	(a) Week 6; (b) Week 20	Daily diary (numerical rating scale): (1)  NA; (2)  Negative mood, sleep disturbances, bother; (3)  Joint pain, fatigue; (4)  Hot flashes (frequency, severity, total score), night sweats; (5)  NA; (6)  NA	(a); (1)  NA; (2)  Negative mood: NS, sleep disturbances: Yoga < wait-list, bother: Yoga < wait-list; (3)  Joint pain: Yoga < wait-list, fatigue: Yoga < wait-list; (4)  Hot flashes frequency: Yoga < wait-list, severity: Yoga < wait-list, total score: Yoga < wait-list, night sweats: NS; (5)  NA; (b); (1)  NA; (2)  Negative mood: Yoga < wait-list, sleep disturbances: NA, bother: Yoga < wait-list; (3)  Joint pain: Yoga < wait-list, fatigue: Yoga < wait-list; (4)  Hot flashes frequency: Yoga < wait-list, severity: Yoga < wait-list, total score: Yoga < wait-list, night sweats: NS; (5)  NA; (6)  NA
Chattha et al., 2008 [44]	𝑁=120,; 2 groups	Yoga: 49.0 ± 3.6 years; Control: 48.0 ± 4.0 years	Women (45–55 years) with menopausal symptoms; FSH level ≥ 15 mlU/ml; No hormone replacement therapy	Integrated approach to yoga therapy: yoga postures, breathing techniques, meditation, lectures on lifestyle; 8 weeks, 5 times weekly, 60 minutes	Exercise: walking, stretching, rest, lectures on lifestyle; 8 weeks, 5 times weekly, 60 minutes	(a) Week 8; (b) NA	(1)  NA; (2)  Psychological symptoms (GCS); (3)  Somatic symptoms (GCS); (4)  Vasomotor symptoms (GCS); (5)  NA; (6)  NA	(a); (1)  NS; (2)  NS; (3)  NS; (4)  Yoga < exercise; (5)  NS; (b)  NA; (6)  NA
Elavsky and McAuley, 2007 [45]	𝑁=164,; 3 groups	Yoga: 50.0 ± 3.7; Walking: 50.5 ± 3.4; Wait-list: 48.6 ± 3.5	Women (45–55 years) with menopausal symptoms; No hormone replacement therapy	Iyengar yoga: yoga postures, meditation; 4 months, twice weekly, 90 minutes	(1)  Walking; 4 months, 3 times weekly, 60 minutes; (2)  wait-list, no treatment; 4 months	(a) Month 4; (b) NA	(1)  Total menopausal symptoms (GCS); (2)  Psychological symptoms (GCS), affect (Affectometer 2), Depression (BDI); (3)  Somatic symptoms (GCS); (4)  Vasomotor symptoms (GCS); (5)  Urogenital symptoms (GCS); (6)  NA	(a); (1)  NS; (2)  GCS: NS, Positive affect: Wait-list < yoga, BDI: NS; (3)  NS; (4)  NS; (5)  NS; (b)  NA; (6)  NA
Joshi et al., 2011 [46]	𝑁=200,; 2 groups	Yoga: 45.6±3.9 years; Control: 46.3±3.5 years	Women (40–55 years) with irregular cycle or postmenopausal; No hormone replacement therapy; No yoga practice	Yoga: yoga postures, breathing techniques, meditation; 90 days, daily, 60 minutes	Wait-list, no treatment; 90 days	(a) Day 90; (b) NA	(1)  Total menopausal symptoms (MRS); (2)  Psychological symptoms (MRS); (3)  Somatovegetative symptoms (MRS); (4)  NA; (5)  Urogenital symptoms (MRS); (6)  NA	(a); (1)  Yoga < wait-list; (2)  Yoga < wait-list; (3)  Yoga < wait-list; (4)  NA; (5)  Yoga < wait-list; (b)  NA; (6)  NA

Abbreviations: BAI: beck anxiety inventory; BDI: beck depression inventory; GCS: Greene climacteric scale; ISI: insomnia severity index; KMI: Kupperman menopausal index; MRS: menopause rating scale; NA: not applicable; NS: not significant.
^a< indicates significantly lower scores.