Yoga For Menopause

Menopause – Introduction

Climacteric is the time in a woman’s life when she is transitioning from a reproductive to a nonreproductive state. It starts at about 40 years old with the first endocrine changes. These changes indicate the depletion of the reproductive organs and the disorganization and desynchronization of neural signals in the hypothalamus and central nervous system. During the climacteric period that menopause occurs and is marked by at least a year of no menstruation (1).

The word menopause is derived from the Greek words ‘meno’ (menses, month) and ‘pause’ (pause) (stop, cease). In the medical community, natural menopause is defined as a period of at least 12 months without menstruation. One-third of women’s lives are spent after menopause due to increased life expectancy.  Some women experience severe menopausal symptoms, while others have minor symptoms, yet others have none.

Mood swings, hot flashes, night sweats, sleeplessness, vaginal dryness, decreased libido, cognitive impairment, and other symptoms are common when a woman’s regular menstrual cycle ends. Most of these issues remain a mystery, with no definitive answer (2).

Menopausal women’s well-being is a priority for medical professionals, who are always looking for new approaches to managing the symptoms of menopause. Hormone therapy is an effective treatment for the symptoms of menopause. Complementary therapies have gained in popularity due to improved awareness of the hazards of medical procedures. Dietary supplements, mind-body medicine, exercise, and herbal medicine are the most common supplementary and alternative therapies among postmenopausal women (3).

Since menopausal symptoms result from estrogen depletion, hormone replacement therapy (HRT) is the most effective treatment. But HRT has been linked to an increased risk of breast, uterine, thromboembolic, and stroke heart disease. According to WHI and Heart Estrogen/Progestin Replacement studies, women randomized to hormone treatment had an elevated risk of cardiovascular system disease and breast cancer. However, the risk is dependent on the type of HRT and when it is started. HRT for menopausal symptoms has reduced as more women are becoming aware of the potential side effects and hazards (3).

The most prevalent symptoms of women entering menopause are vasomotor ones, which account for 70% to 80% of symptoms. These vasomotor symptoms are considered partially responsible for sleep disorders after menopause. Many women present with sleep disorders after menopause. An epidemiological study conducted in Sao Paulo found that 81.6% of the interviewees had sleep complaints, and 52.1% of the respondents complained of insomnia.8 Sleep problems tend to increase with age and are more frequent in women during the menopausal transition.10 A study that used both subjective (questionnaires) and objective (polysomnography) evaluations showed that 61% of postmenopausal women had subjective sleep complaints. However, the objective evaluation revealed that 83% of women had sleep alterations (4).

How Yoga Can Help With Menopause

Yoga and other mind-body therapies are regularly suggested as alternatives or supplements to hormone therapy. Yoga is a form of exercise that includes stretching, breathing exercises, and meditation (5).

Yoga Helps Boost Mood In Menopause Women

Yoga and other mind-body therapies are regularly suggested as alternatives or supplements to hormone therapy. According to a recent survey, yoga is the most popular complementary/alternative therapy in the United Kingdom. Yoga has been shown to have therapeutic benefits on the sympathetic nervous system, boosting psychological well-being, decreasing stress, and lowering the risk of cardiovascular disease. However, there is only a tiny audience to back up its effectiveness. Even when there is, it can be complex and challenging. As a result, a study looking at the impact of yoga on menopausal symptoms appears appropriate (6, 7). 

Menopausal Symptoms Improved Following Yoga Intervention

Yoga’s ability to alleviate the symptoms of menopause was studied in a randomized, controlled trial. Menopause Rating Scale (MRS) total score and three subscale scores (somato-vegetative, psychological, and urogenital) were measured on day 1 and day 90 in the study group that practiced yoga under supervision for three months (asana, pranayama, and meditation) and compared with the control group that did not practice yoga. Age-related health-related quality of life (HRQL) in females has been the focus of MRS research. Eleven symptoms and three subscales are included in the scale. On the first day, the scores of both groups were found to be comparable. It was statistically significant that the scores in the yoga group dropped on all of the subscales on day 90. In the control group, there was no statistically significant difference. This study concluded that yoga could help the symptoms of menopause. Menopausal symptoms can be treated non-pharmacologically with yoga (8).

Yoga Improves Menopausal Women’s Quality Of Sleep

Menopausal women go through a wide range of physical, emotional, and hormonal changes. Menopausal women are more likely to develop sleep disturbances and insomnia than women of other sexes. Menopausal symptoms can be alleviated with a variety of dietary and lifestyle modifications. It has been shown that menopausal women’s symptoms can be alleviated via physical and mental relaxation techniques such as yoga. The goal of this study was to explore the effects of yoga interventions on women’s sleep quality during menopause. The Pittsburgh Sleep Quality Index was used to gauge how well people were sleeping (PSQI). After the yoga intervention, there was a 10.73-point reduction in the poor quality of sleep score. The study concluded that yoga improves sleep quality in menopausal women (9).

Yoga Is Beneficial In Decreasing Insomnia In Postmenopausal Women

Yoga has been shown to have a positive impact on insomnia reduction.   Randomized clinical trials have been undertaken to examine the effects of yoga on postmenopausal women with a diagnosis of insomnia. Postmenopausal women with insomnia were the subjects of this study, which aimed to examine the impact of yoga practice on their physical and mental health and climacteric symptoms. A total of 44 individuals participated in the research. Post-treatment scores for climacteric symptoms and insomnia severity were significantly lower in the yoga group than in the control group. Still, the yoga group’s quality of life and stress resistance were significantly higher. The yoga group dramatically reduced insomnia severity compared to the control and passive-stretching groups. According to this study, a specific yoga sequence may help reduce insomnia and menopausal symptoms and improve the quality of life in postmenopausal women who have insomnia (10).

Yoga Can Help With Menopause Belly Fat And Other Issues

Both menopause and aging significantly impact total body fat and visceral fat in body composition. Body composition changes, primarily fat transfer to the abdomen region, can occur even when there are no significant changes in weight. During menopause, women may feel out of balance and unable to control their bodies due to hormonal changes. Yoga is found to be an excellent strategy for achieving a healthy balance and managing the symptoms of menopause (11, 12).

Yoga Poses, Breathing Exercises for Menopause

Yoga Poses

Yoga can help post-menopausal women achieve favorable psychophysiological changes and improve their quality of life (13).

Child Pose (Balasana)

A child’s pose is a simple pose that can stretch your hips and spine while soothing your mind and body.

How To Practice

• Kneel on the ground. Knees should be separated by the width of your hips when sitting on the heels of your feet. To get a more intense massage on the front of your body, keep your knees closer together than usual.
• Fold forward, tucking your torso between your knees, and exhale. Reduce the width of your hips to rest on the inner thighs. At the sacrum, stretch your tailbone and widen your pelvic muscles. Raise the base of your head away from the back of your neck by tucking your chin in slightly.
• Toto practiced Child’s Pose, walk your hands out in front of your mat. It’s also an option to lean forward toward your toes while simultaneously relaxing the fronts of your shoulders toward the floor by reaching back to them. Spread your shoulder blades out across your back as you carry your weight on your shoulders.
• For 30 seconds to several minutes, remain in this resting position.
• With an inhalation, rise from the tailbone as it presses down and into the pelvis to come up.

Fish Pose (Matsyasana)

When the Matsya bandha is practiced, it helps to stretch and improve the functioning and efficiency of the digestive system. Blood supply to the legs is reduced and redirected to the reproductive and genital systems. The stagnant blood around the spinal column is flushed out.

How To Practice

1. Rise to the point where your upper arms are parallel to the floor, with your forearms flat on the mat.
2. Keep your forearms tucked in and your chest inflated by rolling back your shoulders and tucking your shoulder blades into your back. By now, you should be able to feel the backward bend in your muscles.
3. Your palms should be on the floor. If it makes them feel safer, you can tuck your hands under your buttocks.
4. Open your mouth and lower your head till the crown of your head meets the floor.
5. Legs and toes should remain active throughout the exercise.
6. To get out, lift your chin off the floor and squeeze your forearms tightly together. After that, bring your body down to the mat.

Forward Bend (Paschimothanasana)

This pose can help you relax and boost your mood by reducing tension.

How To Practice

1. Sit on the ground with your legs spread out in front of you.
2. Slowly exhale and try to place your head on your knees while holding the thumbs of your feet in your hands
3. Then slowly bring the head back to its original position. This Aasan should be practiced 10–15 times per day.

Half Bridge Pose (Setu Bandhasana)

Menopause symptoms and menstruation pain are both alleviated by this pose.

How To Practice

1. Bend your knees and pull your feet close to your hips while lying on your back. Maintain a hip distance between your feet, with your heels flat on the floor.
2. Put your hands at your sides with your palms facing down.
3. Slowly raise your hips to the ceiling by putting your hands on the floor and inhaling.
4. As you bring your chest nearer your chin, reach your hands down to your ankles.
5. Breathe in and out evenly while maintaining a raised pelvis and a raised head.

Half Twist Pose (Ardha Matsyendrasana)

This asana aids in mobility and lengthening, allowing the spine to return to its natural posture. Also, it relieves lower back discomfort by releasing the lower back muscles. It also helps to keep your spinal cord rotating usually.

How To Practice

1. Sit in Sukhasana for the first step. Bring your feet in line with your hips and cross your right knee on top of your left.
2. Your right foot’s soul should now be outside of your left knee when you raise your right knee.
3. As support, place your right hand on the floor just outside your right hip. Sit with your back straight and your sitting bones engaged.
4. Lift your left hand toward the sky as you inhale. Draw your left elbow up to your right outer knee as you exhale. Strike a resistance pose by putting pressure on your knee and elbow.
5. Your right shoulder should be visible through your right eye. Keep your neck in a straight line, and don’t overdo it.
6. While holding the pose, inhale to stretch and exhale to twist.
7. Using an inhalation, bring your right arm up and release the posture. Inhale and exhale to return to your core. Afterward, switch sides.

Shoulder Stand (Sarvangasana)

Practicing this pose can help alleviate the symptoms of menopause and aid indigestion.

How To Practice

1. Hands by your side while you recline in a supine position.
2. Lift your knees, buttocks, and back in a single motion to raise your shoulders high. The hands can be used to support your back.
3. Bring your elbows closer together and glide your hands up your back, towards your shoulder blades, as if you were meditating. Firmly press the elbows onto the floor while maintaining a straight spine. Use your shoulders and upper arms instead of relying on your head and neck to support your weight.
4. Keep your legs firmly in place. As if you were leaving a footprint on the ceiling, raise your heels higher. Strike a straight line from the tips of the big toes to the bridge of the nose. Step your toes up now. Pay attention to your head and neck position when standing or sitting. The neck should not be pressed against the floor during this exercise. Instead, maintain a strong neck by imagining that the muscles in the neck are somewhat tense. Your sternum should be pressed toward your chin. Come out of the pose if you feel any strain on your neck.
5. Keep inhaling and exhaling for 30-60 seconds, and don’t let go of the pose.
6. Lower the legs to the forehead to exit the pose. To begin, place your palms face-down on the floor. Slowly lower your spine, vertebra by vertebra, to the floor without lifting your head. Bring your thighs to the floor. For at least 60 seconds, take a deep breath.

Staff Pose (Dandasana)

To ease the symptoms of menopause, practice Dandasana (Staff Pose), a basic sitting pose that improves posture and sets the tone for the rest of your yoga postures.

How To Practice

1. Sit upright with your legs out in front of you.
2. Straighten your arms and place your hands on your hips.
3. Keep a slight distance between your heels and your big toes.
4. Draw your toes back as you flex your ankles to a 90-degree angle.
5. Your big toe mounds should propel you forward as you walk. Use your femurs to press down while rotating your inner thighs in and out.
6. You can widen your collarbones by extending your sternum.
7. The heads of your upper arms should be dragged back as your front ribs are softened.
8. Exit the stance by shaking your legs and releasing your arms.

Cobra Pose (Bhujangasana)

Menopausal women who practiced Cobra Pose regularly reported better sleep.

How To Practice

1. Put your hands directly beneath your shoulders, flat on the ground. Straighten your elbows and hug your sides together.
2. Pause for a second and keep your neck neutral while staring down at your mat. Make sure your pubic bone is firmly anchored to the ground.
3. Let go of the floor with a big sigh of relief. Keep your low ribs flat on the floor, and your shoulders rolled back. Maintain the position of your elbows about your body. Please don’t allow them to veer off in any direction.
4. Keep your neck straight. Don’t go over the top. It would help if you kept your eyes fixed on the floor.

Corpse Pose (Shavasana)

Menopausal symptoms include hot flashes, tension, sadness, and sleep deprivation.

How To Practice

1. Using a soft cloth or eye cushion to cover your eyes can help you unwind and relax.
2. A folded blanket or a block placed horizontally across your lower belly can provide relief for your tummy.
3. Placing a folded blanket or cushion beneath your chin and neck will help keep it from getting sore.
4. Place a rolled-up blanket or cushion under your knees to alleviate lower back pain.

Crocodile Pose (Makarasana)

Makarasana is a profoundly relaxing pose that improves the back muscles. As a result of consistent practice, menopausal symptoms can be alleviated.

How To Practice

1. With your knees bent and in Thunderbolt Pose, you’re ready to start (Vajrasana). Make sure your hands are on the yoga mat before beginning this exercise. Extend your legs behind you so that the balls of your feet rest on the yoga mat while you are still safe from injury.
2. Slowly bring your body down to the floor. To begin, lower your legs until the soles of your feet are flat on the floor.
3. Bring your hips, stomach, chest, and shoulders to the mat. It would help if you were lying on your back with your palms facing down and elbows tucked in at your sides.
4. Your hands should be placed on the mat in front of you. Make sure your forehead is supported by your arms when you cross them in front of you.
5. Alternatively, you can press your forehead against the ground while keeping your arms by your sides. Straighten the spine and legs by placing the toes on the mat.
6. Lift your upper body like Upward-Facing Dog to increase your difficulty level while also stretching your lower back (Urdhva Mukha Svanasana). This will expand the chest and relieve stress in the back and shoulders. Your lower back will also benefit from this exercise.
7. Return to the starting position to end the posture. Once elevated, lower the chest gradually. Rotate your arms in a way that doesn’t cause pain in your shoulders.

Sun Salutation (Surya Namaskara)

Surya namaskar can help restore the body’s hormonal equilibrium. This exercise directly affects the adrenal, thyroid, and pituitary glands. In addition to boosting metabolism, it can ease the many physical and emotional symptoms of menopause (13).

How To Practice

1. Start by standing with your feet and your hands pressed together in front of your chest.
2. Take a deep breath, arch your back, and raise your arms.
3. Bend forward and put your hands on the floor.
4. Take a deep breath and lunge with the right leg.
5. Step the left leg back and do a push-up on the other side.
6. Make sure that your knees, chin, and chest are all on the ground. Take a deep breath and do this.
7. The hips should go down on each exhalation. The head and shoulders should then rise off the ground.
8. Take a deep breath, curl the toes under, and push the hips up to the ceiling to start.
9. Taking a deep breath, you lunge by putting the right leg between your hands into a lunge.
10. Take a deep breath. Then, move your left leg forward, rest your hands on the floor, and lower your head to the level of your knees.
11. It’s time to take a deep breath, then raise both arms above your head and arch your back,
12. Return the arms to where they were before.

The sun salutation is done when you do the whole thing again, starting with your left leg.

Breathing Techniques (Pranayama)

Menopausal women who suffer from night sweats, hot flushes, and other symptoms of pitta dosha can find relief with pranayama (13).

Kapalbhati

Kapalbhati is proven to cleanse the body of impurities. As a result, the metabolic rate increases, aiding in weight loss. It stimulates brain cells, enhancing memory and focus.

How To Practice

1. Place your hands on your lower tummy while sitting up straight and comfortably. If you’re seated in a chair, make sure both feet are on the ground.
2. Take a big breath through your nose and exhale through your mouth before beginning.
3. Close your mouth and nostrils and take a deep breath in.
4. Draw your navel toward your spine quickly and forcefully expel the air from your lungs. The diaphragm serves as the primary engine of your breathing.
5. Relax and let the expansion of your abdomen naturally fill your lungs.
6. Allow your breathing to return to normal and pay attention to your body’s sensations after completing this cycle ten more times.
7. Three to four times more, repeat the ten-movement cycles.

Alternate Nostril Breathing (Anuloma Viloma)

It aids relaxation by reducing anxiety and calming the neurological system.

How To Practice

1. You may ensure that your spine is straight and your heart is open by sitting in a comfortable high chair.
2. Relax your left palm into your lap with your right hand in front of your face.
3. Use your right hand’s pointer and middle fingers as a small anchor between your brows. Using the thumb and ring fingers will be the most common.
4. Take a few deep breaths in and out through your nose as you close your eyes.
5. Close your right nostril with your thumb. Take a deep breath in through your left nostril.
6. Using your ring finger, gently squeeze both nostrils shut, and then inhale deeply for a bit of time while holding your breath in.
7. At the bottom of the exhalation, take a brief pause and slowly exhale through your right nostril.
8. Take a deep breath in from your right side.
9. Keep your mouth and nostrils closed (with your ring finger and thumb).
10. Slowly inhale through the left nostril, then slowly exhale through the right. This is an excellent way to relax. Allow yourself a small respite at the very end.
11. For at least ten repetitions, let your attention follow your in-and out-breath.

Diaphragmatic Breathing

Diaphragmatic breathing can be practiced while seated or standing once a person is comfortable with the technique. Keep your shoulders, head, and neck relaxed as you practice diaphragmatic breathing in these postures.

How To Practice

1. Place a pillow under your head and knee pillows to help you relax. There are many benefits to using pillows.
2. Put your index or middle finger on the center of your upper chest.
3. The other hand should be placed on the stomach, just below the rib cage but above the diaphragm.
4. Draw the breath down toward your stomach as you inhale softly through your nose. While the chest remains motionless, the stomach should press up against the hand.
5. To exhale, purse your lips and tighten your abdominal muscles before taking a deep breath out through your mouth. Keep your chest motionless once more.
6. It is recommended that people perform this breathing exercise three to four times a day for five to ten minutes.

Vase Breathing

Performing this exercise may help you relax and improve your performance quality of life. It also increases the amount of oxygen in your blood and makes it easier for your body to expel gas from your lungs.

How To Practice

1. Lie on your back with your knees bent, and your head supported on a flat surface or in bed. To keep your legs from sagging, place a pillow under your knees.
2. Focus on the area above and below the ribcage with one hand. This will help you become more aware of the movement of your diaphragm when you inhale and exhale.
3. Slowly inhale through your nose to raise your hand while your tummy moves out. As much as possible, keep your hand on your chest still.
4. Pull your stomach in and lower your hand as you exhale through pursed lips by tightening your stomach muscles. It’s essential to keep your hand on your upper chest as still as possible.

Meditation Techniques (Dhyana)

Anxiety, irritability, and depression are common symptoms among women going through menopause. Meditating may be helpful in alleviating these symptoms (13).

Calm Abiding Meditation (Shine)

Shi-ne, pronounced “shi-nay, “1 is a meditation that aims to empty the mind of thoughts and other mental phenomena, such as visual impressions or ideas. Tibetans use the word “shi-ne,” which means “quiet abiding” in the Sanskrit language, or “shamatha” in Pali. It’s a tremendous preparatory meditation for concentrating on the breath (13, 14).

How To Practice

To practice shi-ne, all you need to do is keep your awareness present and not get caught up in what comes up in your mind.

You may not be able to do this at first if you’ve never meditated before or if you’ve been meditating on the breath or using focused concentration to retain awareness. Maintaining awareness without focus may seem unattainable if your conscious awareness has always included attention.

To avoid becoming overwhelmed, there are several paths to shi-ne meditation. These preliminary activities are not shi-ne proper but rather preliminaries to shi-ne. Their approach, language, and goal are distinct from those of expansive shi-ne, which are more akin to shamatha concentrative approaches. The way we speak and act shapes our life experiences.

Mantra Meditation

Our endocrine systems and our subconscious thoughts can all benefit from mantras. Many studies have improved alertness and sensory perception in people who repeatedly say the sacred mantra “Om” aloud in their minds.

How To Practice

1. Meditate on a favorite word, phrase, prayer, or poem fragment. A mantra should be formed of only a few words or syllables, so you can quickly repeat it without becoming lost. Choose something inspiring and heartfelt. Avoid terms that cause mental agitation.
2. Sit comfortably in a chair or on the floor, with a blanket or pillow for support. Find a comfortable position aligned with the natural curvature of your spine. Close your eyes and take a few slow, deep breaths to calm your breath entirely.
3. Repeat your mantra slowly and deliberately, focusing on its tone. Rep it in time with your breath. Either split it and repeat half the mantra on inhalation and half on exhalation, or repeat it on both.
4. To finish the mantra silently, move only your lips after 10 recitations (this helps you keep a steady pace). Then recite it 10 times internally without moving your lips.
5. Return to the chant as thoughts come, recognizing this is part of the process. Bring your focus back to the internal sound as often as you can.
6. Keep going for the time allotted for meditation. Take a few deep breaths, and then sit quietly to evaluate your feelings. You may feel relaxed. Or you may be overwhelmed by unpleasant subconscious ideas and feelings.

Body Scan Meditation

This meditation can help reduce the intensity of menopausal hot flashes by reducing stress.

How To Practice

1. Begin by focusing your attention on your surroundings and realizing that you are safe at this moment.
2. Focus on the sensations in your own body.
3. Keep a soft glance, but keep your eyes slightly closed without focusing on anything. If you choose, you can close your eyes.
4. If you’re sitting on a chair or the floor, you may feel the support of your body.
5. Take a few long, deep breaths to relax your body and mind.
6. As you inhale, you’ll draw in extra oxygen, which will energize your body. Then, when you exhale, you may feel yourself relaxing even further.
7. You can feel the sensations of your feet on the floor as you walk. Vibration, heat, and mass are all factors.
8. As you lean back in your chair, you’ll feel the weight of your thighs pressing against the seat.
9. Notice how the chair supports your back. It’s okay if you can’t feel everything in your body simultaneously. At different times of the day, we are more attached to some parts of our bodies than others.
10. Focus on the area in the middle of your tummy. What if you let go of tension in your stomach? Breathe in and out.
11. Pay attention to the position of your hands. What is going on with your hands? Permit them to relax for a while and see if that makes any difference.
12. Look at your biceps. Your arms should be tingling or numb at all times. Make an effort to keep your shoulders relaxed.
13. Keep an eye on the area around your throat and the back of your neck. Allow them to be supple. See if you can create an atmosphere conducive to rest.
14. Try to relax your jaw. Allow your face and facial muscles to be as supple as possible.
15. Then pay attention to your entire body. Take a deep breath.
16. As much as possible, pay attention to your entire body. Breathe in and out. Focusing on nothing in particular, slowly open your eyes and breathe normally. Gently swivel your head and neck to take in the surroundings. You can return to your steady gaze as soon as you feel ready.

White Tara Meditation

The White Tara mantra is one of the most effective mantras to overcome life-threatening challenges. Regular recitation of the White Tara mantra has extended one’s life. Although this mantra can be used for oneself, it can also be used for another person.

How To Practice

• This mantra may only be used when your aim is precise. It doesn’t matter how you do it. For example, “I dedicate the Chanting of White Tara mantra to…” (name your request).
• Chant the White Tara mantra 108 times and practice the visualization below while chanting.
• In your mind’s eye, imagine the seed syllable “TAM” above your head or in front, at the level of your brow. White Tara rises from the TAM as a gorgeous, smiling, and surrounded by a large number of Buddhas.
• In your mind, picture Tara’s heart as a fountain of eternal nectar. Your Crown Chakra is filled with pleasant white-light energy.
• Your negative karma, obstructions, spirit harm, and illnesses are thoroughly cleansed from your body and mind.

There are numerous ways to chant the White Tara mantra. Two of them — Sanskrit and Tibetan

As a Sanskrit phrase, it reads like this- OM TARE TUTTARE TURE MAMA AYUH PUNYA JNANA PUSTIME KURU SVAHA

For the Tibetan language, use this- OM TARE TUTTARE TURE MAMA AYUR PUNE GYANA PUNTIN KURU SOHA

Conclusion

Menopause is a time for renewal and attention to the body’s needs; the transitional heat can be alleviated with cooling foods, relaxing techniques, lots of rest, and conscious activity that nourishes the body, mind, and soul.

According to serval studies, yoga should be suggested to all women in their menopausal years. Daily yoga and vigorous exercise will help the body’s inherent ability to maintain balance amid hormonal swings; yoga techniques remove tension, massage, support the liver and work the entire body.

References and Further Reading

1. Gracia, C. R., Sammel, M. D., Freeman, E. W., Lin, H., Langan, E., Kapoor, S., & Nelson, D. B. (2005). Defining menopause status: the creating a new definition to identify the early changes of the menopausal transition. Menopause, 12(2), 128-135.
2. Nedrow, A., Miller, J., Walker, M., Nygren, P., Huffman, L. H., & Nelson, H. D. (2006). Complementary and alternative therapies for menopause-related symptoms: a systematic evidence review. Archives of internal medicine, 166(14), 1453-1465.
3. Dorval, M., Vallée, M. H., Plante, M., Chiquette, J., Gaudet, M., & Simard, J. (2007). Effect of the Women’s Health Initiative study publication on hormone replacement therapy use among women undergoing BRCA1/2 testing. Cancer Epidemiology and Prevention Biomarkers, 16(1), 157-160.
4. https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.29330
5. McMillan TL, Mark S. Complementary and alternative medicine and physical activity for menopausal symptoms. J Am Med Womens Assoc 2004;59:270-277.
6. Innes, K. E., Selfe, T. K., & Taylor, A. G. (2008). Menopause, the metabolic syndrome, and mind-body therapies. Menopause (New York, NY), 15(5), 1005.
7. Hutchinson, S. C., & Ernst, E. (2003). Yoga therapy for coronary heart disease: a systematic review. Focus on alternative and complementary therapies, 8(1), 144-144.
8. Newton, K. M., Reed, S. D., Guthrie, K. A., Sherman, K. J., Booth-LaForce, C., Caan, B., … & LaCroix, A. Z. (2014). Efficacy of yoga for vasomotor symptoms: a randomized controlled trial. Menopause (New York, NY), 21(4), 339.
9. Fara, Y. D., Pujiastuti, R. S. E., & Hadisaputro, S. (2019). Yoga Increases the Quality of Sleep in Menopause Women. Indonesian Journal of Medicine, 4(3), 278-284.
10. Afonso, R. F., Hachul, H., Kozasa, E. H., de Souza Oliveira, D., Goto, V., Rodrigues, D., … & Leite, J. R. (2012). Yoga decreases insomnia in postmenopausal women: a randomized clinical trial. Menopause, 19(2), 186-193.
11. Milewska, M., Mioduszewska, M., Pańczyk, M., Kucharska, A., Sińska, B., Dąbrowska-Bender, M., … & Szabla, A. (2016). Two compartment model of body composition and abdominal fat area in postmenopausal women-pilot study. Wiadomosci Lekarskie (Warsaw, Poland: 1960), 69(2 Pt 2), 169-173.
12. https://www.nia.nih.gov/health/hot-flashes-what-can-i-do
13. Cramer, H., Rabsilber, S., Lauche, R., Kümmel, S., & Dobos, G. (2015). Yoga and meditation for menopausal symptoms in breast cancer survivors—a randomized controlled trial. Cancer, 121(13), 2175-2184.

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