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Yogic management for Pre- Menstrual Syndrome: A review

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Kala : The Journal of Indian Art History Congress
ISSN : 0975-7945

YOGIC MANAGEMENT FOR PRE-MENSTRUAL SYNDROME: A

REVIEW

Ms. Riddhi Sahu

Research Scholar
Dev Sanskriti Vishwavidyalaya Shantikunj, Haridwar,

Prof. Suresh Lal Barnwal

Dean & Head Dept. of Yogic Sciences and Human Consciousness
Dev Sanskriti Vishwavidyalaya, Shantikunj, Haridwar

Dr. Radhika Chandrakar

Assistant Professor
Shri Rawatpura Sarkar University Raipur, Chhattisgarh

Abstract:
There is an important and powerful role of a woman in a family as well as in a society. In this high
tech era, where women are succeeding in every picture of life, many physical problems in their life
prevent them from moving forward and in today's time, one of the main aims of health is women
health. Premenstrual Syndrome is one of them which affect women in their reproductive age.
Premenstrual Syndrome (PMS) also called Premenstrual Tension (PMT) refers to the cyclic
recurrence, of a combination of distressing physical, cognitive, affective, and behavioral symptoms
that occur cyclically during the luteal phase of the menstrual cycle that interface with family, social
and work related activities. The exact cause of PMS is unknown but it has been linked to imbalance
secretion of hormones and neurotransmitters. The sedentary lifestyles, dietary variations, lack of
exercise, stress are also the contributory factors. This is important because the symptoms of PMS
are also responsible for socio-economic loss and it’s also effects on quality of life. Yoga is widely
used to improve health and to attenuate or cure disease. Yoga therapy was integrated to the low
cost, self care treatment for premenstrual syndrome. The purpose of this review propounds yogic
management of Premenstrual syndrome and adaptation of a holistic treatment in the form of good
stress-free lifestyle.
Keywords: Premenstrual Syndrome, Yogic Management, Women Health.
Introduction:
In this high tech era, where women are succeeding in every picture of life, many physical
problems in their life prevent them from moving forward and in today's time, one of the main
aims of health is women health. It has impact on their social and economic development as
well as to their country.
Premenstrual Syndrome (PMS) also called Premenstrual Tension (PMT) refers to the
cyclic recurrence, of a combination of distressing physical, cognitive, affective, and behavioral
symptoms that occur cyclically during the luteal phase of the menstrual cycle that interface
with family, social and work related activities (Rivera-Tovar, 1990)i.
First Christ, Hippocrates demonstrated physical and psychological changes in women.
In 1931, Robert Frank, an American physician in the New York Academy of Medicine, raised

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the issue and explained that it can also be caused by ovarian dysfunction. He described this
phenomenon as luteal action or Pre-menstrual Tension. In 1953, Greene and Dalton described
it as Pre-menstrual Syndrome (Kamalifard, 2017) ii. In the mid-1980s, the severe form of
Premenstrual Syndrome was defined as a term of Pre-menstrual Dysphoric Disorder (Reid,
1985)iii.
Research study showed that during premenstrual syndrome sadness, loss of confidence,
low self-esteem, and less energy are more common among females (Nisar, 2008)iv. Women
with PMS report significant impairment in personal relationships compromised work levels
and increased absence from work, school, or college (Raval, 2016) v . Besides, youngster
unsettling influence and family brutality in the groups of the patients with PMS were accounted
for. In this sense, PMS may influence the individual, yet in addition her family and the local
area (Bakhshani, 2009vi).
PMS is significant for two reasons, first and foremost, on the grounds that, the side
effects of PMS are answerable for financial misfortune and Secondly, due to related legitimate
and women right issues that has emerged related to individual responsibility during the PMS
(Rapkin, 2003vii).
Symptoms of PMS: American College of Obstetrics and Gynecology (ACOG) mentioned that this
syndrome are at least six effective psychological symptoms (depression, irritability, anger outburst,
confusion and social withdrawal) and somatic symptoms (breast-tenderness, abdominal bloating,
headache, swelling of extremities) have started before 5 days of menstruation and at each of three
previous menstrual cycles and relived within 4 days of the onset of bleeding.
Another symptoms are stress and anxiety, change of mood (feeling sad or crying all of a
sudden), depressed mood, persistent anger or personal clashes, reduced interest in social
relationships and work, being out of control, change in appetite (overeating or having little appetite),
difficulty in sleeping (oversleeping or insomnia), lack of concentration, fatigue and lethargy, and
physical symptoms ( abdominal pain, abdominal bloating, chest pain, chest sensitivity, joint or
muscle pain, frequent urination, weight gain, back pain, acne, nausea, and headache)( Henshaw,
2007viii).
Prevalence:
The worldwide prevalence of PMS was obtained 48%. Pooled prevalence of PMS was reported
40% in Europe, 85% in Africa, 46% in Asia and 60% in South America. In India, about one-fourth
(27.7%) of the female population falls in the 15-24 years age group (Deuster, 1999ix).
Another study estimated a prevalence of PMS were 58.1%. Premenstrual syndrome was
significantly higher in students who smoked, drink alcohol, and consumed a large amount of fatty
and high-calorie foods, who had a bad to very bad perception of their economic situation, and those
who had any chronic disease or anemia Premenstrual syndrome was significantly higher in students
who had a risk of depression (Acikgoz, 2017x).
Epidemiological Surveys have shown that 80% of women experience these symptoms
during reproductive age. In this modern life as stress level is increasing, PMS / PMDD is reducing
the Quality of Life (Joshi, 2010xi).
Etiology: The exact cause of PMS is not known but previous studies shown that various lifestyle
factors which included inadequate sleep, lack of physical activity, caffeine intake, and fast food
intake were cause of Premenstrual syndrome. The patho-physiology of PMS may include the effect
of progesterone on neurotransmitters such as Serotonin, Opioids, Catecholamine and GABA,

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increased prolactin level or increased sensitivity to the effect of prolactin, insulin resistance,
sensitivity to endogenous hormones, abnormal hypothalamic-pituitary-adrenal axis function,
nutritional deficiencies, alteration of glucose metabolism, and fluid and electrolyte imbalance (Rad,
2018xii).
Serotonin is an important neurotransmitter of the central nervous system. Serotonin also
plays role in depression. Researchers have found that Women suffering from PMS have serotonin
deficiency due to decreased concentration of platelets and blood-serotonin (Dimmock, 2000xiii).
Prolactin promotes retention of sodium, potassium and water, stimulates breast and is called a
stress hormone. Hence its role has been researched in PMS. Prostaglandins also play role in
suppress vascular response to angiotensin II. A breakdown of this leads to renal, cerebral and
vascular changes in premenstrual syndrome (PMS). Pyriodoxine is a coenzyme in the metabolism
of serotonin and dopamine (mood and behavior regulator). Its deficiency leads to serotonin
deficiency causing symptoms of PMS (Sengupta, 2007xiv).
Presently, in view of the problem of PMS, it is necessary to manage it naturally so that
complications such as Infertility, PCOD, Breast cancer etc. are not encountered due to this disease.
Symptoms, problems and complications related to this disease can be reduced through yogic
exercises.
Yoga is a comprehensive discipline, which includes physical postures, breathing techniques,
and meditation, relaxation techniques for improving health and well-being. A carefully adapted set
of yoga poses can result in better rejuvenation and mobility. Studies have found that Yogic practices
reduced the psychological conditions like stress, tension, depression and anxiety, and also reduced
the physiological problems like pain during menstruation and irregular periods (Joshi, 2010).
Yoga, which is a way of life, is the need of the hour in all fields of human endeavor. The
scope of yoga is extended to bring about changes in the lifestyle, which is at the base of prevention
and treatment of non-communicable diseases. Yoga for promotion of positive health is being
nurtured by many who do not want to be the victims of modern ailments (Yogitha, 2010xv).
In the research presented, the following Yogic Management is presented by the researcher
for Pre-menstrual syndrome -
Shatkarmas: Jal-neti (practice within 3 days), Kunjal (according to need), Laghoo Sankh
Prakshalana (once a month). Laghoo Sankh Prakshalana is recommended for remove constipation.
Asanas: Tadasna, Vrikshasana, Shashankasana, Yogamudrasana, Bhujangasana, Shalabhasana,
Ardha-halasana (2-3 rounds daily), Savasana (2minutes for relaxation). Ptractice of bhujangasana,
shalabhasana and ardhahalasan, Yogamudrasana help to remove energy barriers in the pelvic
region. Tadasana and Vriksasana have a positive effect on the pituitary gland. Shashankasana also
effects in adrenal secretion ( Sarswati, 1998xvi).
Pranayam/ breathing techniques: Nadi-Shodhan, Bhstrika, Yogic Breathing (5 rounds each).
These pranayamas remove the stress and headache related to menstruation. The practice of
Bhastrika Pranayama removes toxic elements (Sarswati, 1998).
Meditation: Om Meditation (5 minutes daily) and Chanting of Gayatri Mantra (5 times daily). This
practices help to relax the nerve and calm the mind (Swami, M., 2003xvii).
Yoga-nidra (15-20 minutes) . Practice of Yoga-nidra helps to relax physically and mentally. The
practice of Yoga-nidra removes irritability, frustration, mental stress and heaviness. (Swami, M.,
2003).

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Other recommendation: Take 1 to 2 glasses of lukewarm water in the morning as well as if
possible walk for few kilometers. Leave the habit of always taking something throughout the day.
Try to avoid the junk and spicy food.
Many complementary and alternative therapies have been used for treatment of PMS but
with frequently poor quality and conflicting data. Calcium and Vitamin B6 were used for treatment
of PMS for many years. Research has shown that over doses 100mg/daily have increased risk of
peripheral neuropathy (Wyatt, 1999xviii). Evening primrose oil has failed to indicate a benefit over
placebo except for cyclical mastalgia (Sarayloo et al. 2017xix).
Many allopathic medicines are used for the treatment of PMS. Allopathy treatment
provides immediate relief, but some of its side effects have also been reported (Mazumdar,
& Gupta, K2007xx). The most common side-effects were tiredness, lack of energy and nausea
with some evidence of negative sexual symptoms. Other antidepressants without the
serotonergic activity have not been proven to be beneficial for PMS, indicating the role of
serotonin and providing a plausible explanation for the rapid onset of action of SSRIs in the
luteal phase.
Avoidance of triggers including alcohol, smoking and caffeine can also help reduce
their intensity. Good sleep hygiene and increased exercise may improve well-being and
endorphin release such that the threshold for distress and bother is higher (Mars, & Fiedler,
2014xxi).
Discussion:
Regular practices of yogic postures help to balancing the function of hormones and toned
the nerve system which help to reduce psychological symptoms of premenstrual syndrome
(Chaudhary et al, 2013xxii). Yogic postures significantly decreased in the negative affect and
impaired concentration. Improving general health and helped to relieve nervous tension and
anxiety in females with PMS (Įiįek, 2018xxiii). The yogic postures invigorate and regulate the
working of muscles; viscera, glands, and vascular, nervous, and lymphatic systems. Circulation
is increased and the nerves are ensured their supply of nutrients and oxygen. Intervention
studies demonstrate that aerobic exercise increases hemoglobin, red cell count, and platelet
count, and decreases the levels of prolactin, estradiol, and progesterone; resulting in
improvement of fatigue, impaired concentration, confusion, and most other premenstrual
symptoms (Borenstein, 2007 & Farrokh 2015xxiv). The physical benefits of yoga are linked
to the release of β-endorphins and the shift caused in neurotransmitter levels linked to emotions
such as dopamine and serotonin (Williams, 2009xxv). Yoga reduces the negative effects
of induced stress to immune system by regulating positively the adjustment of
immunoglobulin A. (Brotto et al 2008 xxvi )Yogic practices help to significantly decreased
abdominal swelling, breast tenderness, abdominal cramps and cold sweats in women with PMS
(Tsai, et al., 2016 xxvii ). Bhujangasana also effect in reproductive organs. It also improves
digestion, improves blood circulation and help to reduce back –pain (Aggarwal, 2020xxviii).
Pranayama is a simple yogic practice through which the person increases his life power.
Pranayama is the science of breath. Prana means ‘life, vitality, wind, and energy’ and Ayama
means ‘Expansion, stretching, or restraint.’(Nirmala, 2004xxix).
Research study shown that long time practice of Pranayam effect autonomic function and
increase in well-being score was significant in yoga group as compared to control group
(Kanojia, 2013xxx). Another study also proved that practice of Anulome-vilome Pranayama

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and yogic posture have significant reduction on heart rate, systolic blood pressure, galvanic
skin response(GSR,), respiratory rate(RR/min), peripheral temperature ,skin response and
significant decrease on anxiety levels as compared to control group (Sharma et al.,2013xxxi).
Regular practice of Pranayama reduces the stress, induced negative effects to immune system
by regulating positively the adjustment of immunoglobulin A and reduces harmful
inflammatory secretions, which makes women with PMS comfortable (Ganesh, 2015xxxii).
An investigation was accounted for that reciting of ‘Om’ reduces pulse, B.P, and
diminishes skin resistance. Prior investigations revealed that successful ‘Om’ reciting creates
vibration uproar around the ears, which is communicated through the auricular part of the vagus
nerve and stimulates vagal nerve. Henceforth, hyperactivity of parasympathetic sensory system
because of Om reciting could exhibit bringing down of B.P. (Ajay, 2009xxxiii). Om chanting
and Bhramari pranayam may be useful to promotes sympathovagal balance and to improves
pulmonary functions ( Mooventhan, & Khode, 2014xxxiv). A randomized controlled trial in
India demonstrated that Yoga- nidra practice was helpful in patients with hormone imbalances
(Rani, 2013xxxv).
Yoga reduces sympathetic activation and cognitive and somatic arousal and
recommended for the treatment of pain, stress and anxiety. It promotes the innate healing
resources of the body, helping restore the proper functioning of the various bodily systems
(Ghaffarilaleh, et al.2019xxxvi).
Conclusion:
PMS affects physical, mental performance and social relationship of women. PMS also
responsible for many other problems like breast cancer, Polycystic Ovarian Syndrome,
Uterine fibroids, Infertility and other mental disorders. Irregular life-style, wrong eating
habits, caffeine, alcohol and smoking are causal factor for PMS. Therefore, it is not possible
to treat it only with medicines but regularity of lifestyle, proper diet, and regular practice of
exercise is also very important. So Yoga as a safe treatment has also been introduced for
premenstrual syndrome.
Regular practice of Yoga brings harmony in bodily system and mind. It calms the central
nervous system and increases the flow of oxygenated blood to the reproductive
organs, and it eases stress and encourages deep relaxation, which further mutes the
cognitive, behavioral, somatic and psychological symptoms of PMS. Yoga also reduces
stress as well as increases self-esteem, positive effect, wellness and quality of sleep
(Kamalifard, 2017).
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