The Effects of Mindfulness-Based Exercise on Anxiety, Depression, and Sleep Quality in Postmenopausal Women

Menopause is a natural biological process characterized by the permanent cessation of the menstrual cycle, beginning with the absence of menstruation for 12 consecutive months following a woman's last menstrual bleeding. The basic physiological mechanism of menopause is related to the increase in follicle-stimulating hormone (FSH) levels and the decrease in estrogen levels. This period brings about many biological, physical, and psychological changes, along with changes in reproductive functions. With the decrease in estrogen levels, reproductive functions are lost, leading to various changes in women. The decrease in estradiol and inhibin levels and the increase in FSH and luteinizing hormone levels during the menopausal transition period lead to several physical and psychological effects in women, primarily including impaired sleep quality. Hormonal changes associated with menopause most frequently lead to mood swings, anxiety, depression, stress, and decreased quality of life in women. It is also reported that problems such as hot flashes, sweating, especially in the facial area, sexual dysfunction, increased hair growth, skeletal disorders, osteoporosis, appetite changes and weight problems, difficulty concentrating, and vaginal itching are commonly observed. Problems occurring in this new phase of an individual's life can negatively affect the daily lives and functions of postmenopausal women, creating a need for effective coping with the encountered problems.

Mindfulness refers to an individual's ability to focus on their sensations, thoughts, physical condition, state of consciousness, and environment with non-judgmental awareness. This approach is characterized by fundamental qualities such as openness, curiosity, and acceptance, and helps the individual to deeply understand their present experience. It has two main components: the ability to regulate attention and the ability to focus on the present moment with openness, curiosity, and acceptance. The stronger an individual's ability to maintain mindfulness while coping with life's challenges, the less negative the impact of emotional stress will be. In this context, it is reported that mindfulness-based exercises improve emotional resilience by increasing an individual's capacity to remain mindful. The ability to maintain awareness of life's circumstances has been the foundation of mindfulness practices for centuries and continues to be important in modern clinical practice.

The Mindfulness Based Stress Reduction (MBSR) protocol, developed by Jon Kabat-Zinn in the 1980s, pioneered the therapeutic use of mindfulness. This program aims to increase individuals' mindfulness to support their health and reduce stress.

It is thought that mindfulness-based approaches can be an effective alternative, especially in the management of psychological problems such as anxiety and depression, and can positively affect sleep quality by regulating aroused mental states before sleep.

While the current literature indicates that mindfulness-based interventions provide potential benefits in alleviating psychological and physical symptoms in postmenopausal women, the limited number of studies in the literature and methodological differences indicate that more randomized controlled trials are needed in this area. Based on current studies, the aim of this planned study is to examine the effect of mindfulness-based exercises on psychosomatic complaints such as anxiety, depression, and sleep quality in postmenopausal women.