Yoga as a therapeutic modality for hormonal and metabolic regulation in premenopausal women with polycystic ovary syndrome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260180Keywords:
Yoga therapy, Premenopausal women, Polycystic ovary syndrome, Non-pharmacological intervention, Hormonal balance, Inflammatory markers, Metabolic healthAbstract
Background: Polycystic ovary syndrome represents a significant health challenge for women during the premenopausal phase, characterized by hormonal imbalances, metabolic dysfunction, and chronic inflammation. Traditional pharmacological approaches often provide incomplete relief and may be associated with unwanted side effects. This investigation examined yoga practice as a non-pharmacological therapeutic strategy for addressing the multidimensional pathophysiology of PCOS.
Methods: Forty premenopausal women aged 35-55 years diagnosed with PCOS participated in this three-month randomized controlled investigation at GVN Hospital, Trichy, Bangalore. Participants were allocated to control (n=10) and yoga intervention (n=30) groups. The yoga protocol consisted of structured 30-minute sessions held three times per week, incorporating physical postures, breathing techniques, and meditation. Comprehensive assessments included reproductive hormone profiles, inflammatory biomarkers, metabolic parameters, and clinical outcomes.
Results: Participants engaging in yoga interventions demonstrated substantial improvements across multiple physiological domains. Significant reductions were observed in high-sensitivity C-reactive protein and interleukin-6 levels, indicating decreased systemic inflammation. Hormonal assessments revealed favorable changes in luteinizing hormone, estradiol, and prolactin concentrations. Metabolic indices showed improvement, with enhanced insulin sensitivity and reduced markers of metabolic dysfunction. Enhanced pregnancy rates were observed among participants seeking conception.
Conclusions: A structured 12-week yoga intervention effectively modulates hormonal balance, reduces inflammatory burden, and improves metabolic health in premenopausal women with PCOS. These findings support yoga as a valuable complementary therapeutic approach that addresses multiple pathophysiological aspects of the syndrome, offering a holistic, sustainable, and patient-centered management strategy for women with PCOS.
Metrics
References
Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report. Fertil Steril. 2006;86(5):1705-7.
Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Fertil Steril. 2016;106(7):1791-805. DOI: https://doi.org/10.1038/nrdp.2016.57
Bansal B, Priya S, Sharma R, Kumar P. A systematic review of inflammatory markers in polycystic ovary syndrome (PCOS) and meta-analysis of interleukin-6 (IL-6) in case-control studies. Cureus. 2025;17(1):e82350. DOI: https://doi.org/10.7759/cureus.82350
Berding K, Vlckova K, Marx W, Schellekens H, Stanton C, Clarke G, et al. Diet and the microbiota-gut-brain axis: Sowing the seeds of good mental health. Adv Nutr. 2021;12(4):1239-85. DOI: https://doi.org/10.1093/advances/nmaa181
Black DS, Slavich GM. Mindfulness meditation and the immune system: A systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1):13-24. DOI: https://doi.org/10.1111/nyas.12998
Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-55. DOI: https://doi.org/10.1093/humrep/dew218
Chadchan SB, Popli P, Maurya VV, Kommagani R. The role of gut microbiota in the regulation of reproductive function in women with PCOS. Cell Mol Gastroenterol Hepatol. 2022;13(5):1381-1395. https://doi.org/10.1016/j.jcmgh.2021.12.010 DOI: https://doi.org/10.1016/j.jcmgh.2021.12.010
Choudhary N, Nagendra HR. The effects of a yoga intervention on symptoms of polycystic ovary syndrome: A pilot study. Int J Yoga. 2013;6(2):103-9.
Clemente-Suárez VJ, Redondo-Flórez L, Rubio-Zarapuz A, Martín-Rodríguez A, Tornero-Aguilera JF. Microbiota implications in endocrine-related diseases: From development to novel therapeutic approaches. Biomedicines. 2024;12(1):221. DOI: https://doi.org/10.3390/biomedicines12010221
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017;1(1):CD010802. DOI: https://doi.org/10.1002/14651858.CD010802.pub2
Cryan JF, O'Riordan KJ, Cowan CSM, Sandhu KV, Bastiaanssen TFS, Boehme M, et al. The microbiota-gut-brain axis. Physiol Rev. 2019;99(4):1877-2013. DOI: https://doi.org/10.1152/physrev.00018.2018
Delamater C, Santoro N. Management of the perimenopause. Endocrinol Metab Clin North Am. 2018;47(3):469-86. DOI: https://doi.org/10.1097/GRF.0000000000000389
Deng H, Chen Y, Xing J, Zhang N, Xu L. Systematic low-grade chronic inflammation and intrinsic mechanisms in polycystic ovary syndrome. Front Immunol. 2024;15:1470283. DOI: https://doi.org/10.3389/fimmu.2024.1470283
Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications. Endocr Rev. 2012;33(6):981-1030. DOI: https://doi.org/10.1210/er.2011-1034
Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev. 2015;36(5):487-525. DOI: https://doi.org/10.1210/er.2015-1018
Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38(9):1165-74. DOI: https://doi.org/10.2337/diabetes.38.9.1165
Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: A systematic review and metaanalysis. Fertil Steril. 2011;95(3):1048-58. DOI: https://doi.org/10.1016/j.fertnstert.2010.11.036
Estevão C. The role of yoga in inflammatory markers. Brain Behav Immun Health. 2022;20:100421. DOI: https://doi.org/10.1016/j.bbih.2022.100421
Gautam R, Maan P, Jyoti A, Kumar A, Malhotra N, Arora T. The role of lifestyle interventions in PCOS management: A systematic review. Nutrients. 2025;17(2):310. DOI: https://doi.org/10.3390/nu17020310
Giampaolino P, Foreste V, Di Spiezio Sardo A, Mercorio A, Serretiello E, Dell'Aversana S, et al. Microbiome and PCOS: State-of-art and future aspects. J Clin Med. 2021;10(5):1042. DOI: https://doi.org/10.3390/ijms22042048
González F. Inflammation in polycystic ovary syndrome: Underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012;77(4):300-5. DOI: https://doi.org/10.1016/j.steroids.2011.12.003
Greenwood EA, Huddleston HG. Polycystic ovary syndrome in the menopausal transition. Semin Reprod Med. 2021;39(3-4):101-7.
Hairul Hisham M, Zainuddin AA, Aris T, Awang H, Zahid AZM. Impact of lifestyle intervention on gut microbiota and metabolic parameters in women with polycystic ovary syndrome: A randomized controlled trial. Nutrients. 2024;16(2):234.
Hitch TCA, Day C, Taylor JC, Clark IM, Tapp H, Vayssier-Taussat M, et al. Microbiome and host immunity in PCOS: Current insights and future perspectives. Trends Microbiol. 2022;30(1):60-75.
Kiecolt-Glaser JK, Bennett JM, Andridge R, Peng J, Shapiro CL, Malarkey WB, et al. Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: A randomized controlled trial. J Clin Oncol. 2014;32(10):1040-9. DOI: https://doi.org/10.1200/JCO.2013.51.8860
Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565-92. DOI: https://doi.org/10.1210/jc.2013-2350
Li C, Cheng D, Ren H, Zhang T. Unraveling the gut microbiota's role in PCOS: A new frontier in metabolic health. Front Endocrinol. 2025;16:1529703. DOI: https://doi.org/10.3389/fendo.2025.1529703
McEwen BS. Stress, adaptation, and disease: Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840(1):33-44. DOI: https://doi.org/10.1111/j.1749-6632.1998.tb09546.x
Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;(7):CD007506. DOI: https://doi.org/10.1002/14651858.CD007506.pub3
Morgan N, Irwin MR, Chung M, Wang C. The effects of mind-body therapies on the immune system: Meta-analysis. PLoS One. 2014;9(7):e100903. DOI: https://doi.org/10.1371/journal.pone.0100903
Nidhi R, Padmalatha V, Nagarathna R, Ram A. Effect of a yoga program on glucose metabolism and blood lipid levels in adolescent girls with polycystic ovary syndrome. Int J Gynaecol Obstet. 2012;118(1):37-41. DOI: https://doi.org/10.1016/j.ijgo.2012.01.027
Pal L, Zhang H, Williams J, Santoro NF, Diamond MP, Schlaff WD, et al. Deep yogic breathing increases parasympathetic activity: A randomized trial among women with stress urinary incontinence. Female Pelvic Med Reconstr Surg. 2018;24(2):156-60.
Pedroza Matute E, Iyavoo A. Integrative microbiome-based lifestyle intervention improves endocrine and metabolic profiles in women with PCOS. Front Endocrinol. 2023;14:1124562.
Qi X, Yun C, Sun L, Xia J, Wu Q, Wang Y, et al. Gut microbiota-bile acid-interleukin-22 axis orchestrates polycystic ovary syndrome. Nat Med. 2019;25(8):1225-33. DOI: https://doi.org/10.1038/s41591-019-0509-0
Ramamoorthi R, Gahreman D, Skinner T, Moss S. The effect of yoga practice on glycemic control and other health parameters in women with polycystic ovarian syndrome: A systematic review and meta-analysis. PLoS One. 2019;14(10):e0221950. DOI: https://doi.org/10.1371/journal.pone.0221067
Rani A, Sharma D, Dangi A, Das TK. Gut microbiota and its modulation via yoga and Ayurveda: A novel therapeutic strategy for management of polycystic ovary syndrome. J Ayurveda Integr Med. 2021;12(2):312-20.
Repaci A, Gambineri A, Pasquali R. The role of low-grade inflammation in the polycystic ovary syndrome. Mol Cell Endocrinol. 2011;335(1):30-41. DOI: https://doi.org/10.1016/j.mce.2010.08.002
Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev. 2016;37(5):467-520. DOI: https://doi.org/10.1210/er.2015-1104
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. DOI: https://doi.org/10.1016/j.fertnstert.2003.10.004
Senthilkumar H, Arumugam M. Gut microbiota: A hidden player in polycystic ovary syndrome. J Transl Med. 2025;23(1):443. DOI: https://doi.org/10.1186/s12967-025-06315-7
Shete SU, Verma A, Kulkarni DD, Bhogal RS. Effect of yoga training on inflammatory cytokines and C-reactive protein in employees of small-scale industries. J Educ Health Promot. 2017;6:76. DOI: https://doi.org/10.4103/jehp.jehp_65_17
Sivasankari R, Usha B. Reshaping the gut microbiota through lifestyle interventions in women with PCOS: A review. Indian J Microbiol. 2022;62(3):351-63. DOI: https://doi.org/10.1007/s12088-022-01019-8
Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364-379. DOI: https://doi.org/10.1111/cen.13795
Verma A, Upadhyay V, Saxena V. Effect of yoga therapy on health outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis. Am J Lifestyle Med. 2021;17(1):73-92. DOI: https://doi.org/10.1177/15598276211029221
Downloads
Published
How to Cite
Issue
Section
