STUDY SUMMARY: Yoga of Awareness Program for Menopausal Symptoms in Breast Cancer Survivors

Source: Support Care Cancer. February 2009. [Epub ahead of print]
Authors: Carson JW, Carson KM, Porter LS, Keefe FJ, & Seewaldt VL.
Contact: James Carson, Department of Anesthesiology and Peri-operative Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHS, Portland, OR, 97239. carsonja@ohsu.edu.

Researchers were interested in whether yoga could benefit breast cancer survivors currently experiencing menopause-related hot flashes. 37 female breast cancer surviors (mean age 54.4 ± 7.5, mean time since diagnosis 4.9 ± 2.4 years) were randomly assigned to either an 8-week Yoga of Awareness program (weekly 2-hour group classes, with 5-10 students) or to a wait-list control group (which would receive the yoga program after the initial study period).

The Yoga of Awareness classes 40 min of gentle stretching poses, 10 min of breathing techniques, 25 min of meditation, and 45 min of group study and discussion of various topics (for example, the yoga philosophy idea of non-judgment acceptance, and how this could be applied to the experience of hot flashes). Classes were co-taught by a certified yoga teacher who holds a master’s degree in health behavior and education and a clinical health psychologist. Classes followed two types of posture sequences. The first was a mat-based sequence including warm-ups, child’s pose, table, a downward-facing dog flow, half moon, a warrior 1 flow, extended side angle, modified locust, supine squats, supine big toe, supine sage twist with bolster, and corpse pose. The second was a chair-based sequence including warm-ups, cat/cow, a spine twist flow, sun salutation, standing wide angle fold, standing wide angle fold with twist, prayer flow, seated wide angle fold, head to knee, pigeon, forward fold, modified sage twist, seal of yoga, and corpse pose. Participants were encouraged apply yoga ideas to everyday life and to practice yoga at home. They were given simple homework assignments, CDs, and illustrated guides to help them do so. On average, participants attended of six of the eight classes.

Researchers measured menopausal symptoms and minutes of yoga practice through daily telephone diaries. Participants completed two weeks of daily self-reports at three time points: before the intervention period, during the last two weeks of the intervention, and three months after the intervention. At the end of the intervention, the yoga group showed a significant reduction in both number and severity of hot flashes, whereas the control group showed no change. They also reported being less bothered by the hot flashes when they did occur, which reflects the yoga program’s emphasis on non-judgmental awareness and acceptance. The yoga group showed significant improvements (compared to the control group) in daily joint pain, fatigue, sleep disturbance, and energy. These improvements were maintained at the 3-month follow-up, and the yoga group showed additional improvements in mood, relaxation, and acceptance. Many of these improvements were positively related to number of minutes spent practicing yoga each day.

This study provides encouraging evidence that yoga benefits cancer survivors and women going through menopause. Of particular note is the program’s emphasis on developing a yogic attitude toward physical symptoms and stressful life events, which received as much time as asana practice. This type of yoga program is a good model for the type of interventions many in the yoga community would like to see in both research and healthcare practice.

This research summary was orginally prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.