Yoga originated in ancient India more than 4000 years ago. It’s a holistic art of living aimed at achieving physical, mental, moral and spiritual health and well-being. Patatanjari Muni, the founder of Yoga, described the practice of yoga of eight limbs (Ashtanga) as a practical way to evolve the mind, body and spirit, but the most commonly performed Yoga practices are posture (Asana), controlled breathing (Pranayama) and meditation (Dyana) [1]. Hatha Yoga, the basic of modern yoga style, was developed in India in the 15^th century. Theoretically, the term Hatha is composed of the Sanskrit terms “Ha” and “Tha”, which refer to the sun, or heating and activating properties and to the moon, or cooling and calming properties, respectively. By balancing these opposing qualities, physical and mental health is fostered and the development of self-awareness and mind-body unity are cultivated [2].

Yoga is classified by the National Centre for Complementary and Integrative Health (NCCIH) as one of Mind and Body Practices. In recent years, the overcoming of diseases and health promotion obtained by practicing yoga has been studied from a medical standpoint and it has been applied to actual treatment. Yoga causes sympathetic and parasympathetic reactions and physiological effects in the cardiovascular and respiratory systems can explain the effects on physical and mental health by balancing autonomic nerves [3]. Actually, it is proved that physical and psychological energy activation and relaxation reaction are caused in yoga [4-6].

Yoga and menopausal transition

Menopause is a natural biological process and a point in life that all women experience but does not necessarily require medical care. However, women whose bodies have been dependent on estrogen production to maintain a stable and comfortable level of health will have increased health risks and are likely to experience unpleasant menopausal symptoms caused by hormonal fluctuations that occur at this stage of life. Vasomotor symptoms such as hot flushes and night sweats are one of the most common and troublesome symptoms for women that cause deterioration in the quality of sleep [7,8] and the quality of life [9-11]. Furthermore, there are concerns about chronic diseases that can occur after menopause due to bone loss [12] and obesity [13] caused by a reduction in estrogen. Thus, in many cases, physical and emotional symptoms caused by both menopause and aging are accompanied by other complex physical, environmental and personality factors. For women to successfully overcome these various stresses at these stages in their lives, it is important to consider not only symptomatic relief, but also interventional relief aimed at well-being.

By studying yoga as an interventional means to target the effects of menopause in women, we expect potential improvements on menopausal symptoms in terms of whether it can be used as a complementary therapy for hormone replacement therapy [14,15].

Psychological stress is a general trigger of hot flushes [16]. Practices with relaxation and deep abdominal breathing have been found to be effective for mitigating mild to moderate hot flushes [17]. Also, it is known that the meditation techniques in yoga bring about a clear change in perception, attention and cognition [18]. Yoga actually showed an improvement in cognitive function [19]. Therefore, even in yoga for menopausal women, positive effects can be obtained by basing treatments on Asana which induces relaxation, Pranayama which strengthens mental concentration and Dyana which aims at mental clarity. Moreover, Yoga research for menopausal women did not show any serious adverse effects. Therefore, it can be concluded that yoga can be a safe practice for menopausal women.

By combining both traditional and non-traditional approaches to healthcare for women, wellness and well-being can be achieved [20]. Much evidence showing that yoga as a complementary health approach is effective in improving physical and mental symptoms of menopause has been presented in studies on menopausal women who practice yoga. However, the effect that yoga has on women’s health may not only be limited to healing. In the future, we will investigate the holistic effects of yoga beyond the improvement of symptoms in menopausal women who practice yoga.