Efficacy of Integrated Yoga on the symptoms of premenstrual syndrome, biomarkers, heart rate variability, quality of life and cognitive functions among female university students with premenstrual syndrome: a randomised controlled trial

Premenstrual syndrome (PMS) is a complex disorder characterized by periodic and recurring physical, psychological, emotional, and behavioral symptoms experienced by some females during their reproductive age. PMS significantly impairs quality of life, affecting personal relationships, academic performance, and professional efficiency, thereby highlighting its multifaceted burden on patients’ overall well-being. Evidence shows that yoga has numerous health benefits on female reproductive health, by facilitating hormonal regulation, improving blood circulation. Yoga increases vagal tone and thereby reducing stress, enhancing mood, cognitive function and emotional-mental health. Previous studies on the effects of yoga in managing premenstrual syndrome (PMS) have primarily focused on subjective assessments, such as symptom severity, quality of life, and related variables like pain. However, no research to date has incorporated objective measures, such as biomarkers, and heart rate variability which could enhance the robustness and reliability of the findings. In this study, we propose to evaluate the impact of a newly developed and validated yoga module specifically tailored to the four phases of the menstrual cycle (Menstrual, follicular, ovulation, and luteal phase). This module is designed to align with the natural hormonal dynamics and includes practices such as loosening exercises, yoga postures, bandhas, mudras, breathing techniques, relaxation, and meditation and assess its impact on progesterone and serotonin, heart rate variability, cognitive functions, symptoms of PMS, PMS related quality of life, mood states, pain, and quality of sleep. The intervention will be assessed among female university students experiencing PMS (as screened by "Premenstrual Syndrome Screening Tool") within the age range 18-30 years old. The experimental group will follow a 60 minutes module for 3 sessions per week 2 months. While, the control group will follow their usual routine. If successful, the study could position yoga as a low-cost, community-based intervention for managing premenstrual syndrome and its associated challenges, contributing to the growing field of mind-body research