Yoga for menopausal symptoms-A systematic review and meta-analysis

Objectives: To systematically review and meta-analyze the effectiveness of yoga for menopausal symptoms. Methods: Medline (via PubMed), the Cochrane Central Register of Controlled Trials, and Scopus were screened through to February 21, 2017 for randomized controlled trials (RCTs) comparing the effects of yoga on menopausal symptoms to those of no treatment or active comparators. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Two authors independently assessed risk of bias using the Cochrane risk of bias tool. Results: Thirteen RCTs with 1306 participants were included. Compared with no treatment, yoga reduced total menopausal symptoms (SMD = -1.05; 95% CI -1.57 to -0.53), psychological (SMD = -0.75; 95% CI -1.17 to -0.34), somatic (SMD = -0.65; 95% CI -1.05 to -0.25), vasomotor (SMD = -0.76; 95% CI -1.27 to -0.25), and urogenital symptoms (SMD = -0.53; 95% CI -0.81 to -0.25). Compared with exercise controls, only an effect on vasomotor symptoms was found (SMD = -0.45; 95% CI -0.87 to -0.04). Effects were robust against selection bias, but not against detection and attrition bias. No serious adverse events were reported. Conclusion: Yoga seems to be effective and safe for reducing menopausal symptoms. Effects are comparable to those of other exercise interventions.