INTRODUCTION:

Menopause is a part of every woman's life, they spend a significant part of their lives. It is the stage when menstrual period permanently stops, which usually occur between the age of 40 to 60 associated with hormonal, physical and psychological changes. These changes can occur gradually or abruptly. It can start as early as the age of 30 and last until as late as the age of 60, due to when the ovaries stop functioning or removed. Menopause is not an illness but a natural biological process, though the risk foruro- genital and heart disease andosteoporosis rises after menopause,that may impair personal or social interactions and diminish the overall quality of life.

The word “Yoga” means “yoke” or “unity” translated from Sanskrit and its emphasis on the mind-body connection, the interrelation between physical and mental fitness. Yoga is a non-invasive, non-pharmacological and effective treatment. This can be done by concentrating physical body through breathing and postures in order to build strength and flexibility. Yoga therapy increasingly popular nowadays because, it has great practical relevance to modern medicine.

According to the data supplied by the Indian Menopausal Society, in the year of 1990, it was estimated that 467 million menopausal women were existing in Tamil Nadu State and expected to increase up to 1200 million by the year 2030.

Most women in India over the age of 45 do not understand the changes taking place in their bodies and spend their valuable years of life battling problems and diseases associated with menopause.

The menopause treatments actually focus on relieving the symptoms and preventing chronic condition such as heart disease and osteoporosis. Women undergo Hormonal Replacement Therapy (HRT that, the low dose of estrogen and progestin, which helps in alleviating symptoms such as hot flashes and vaginal dryness, however has some serious side effects and increases risk of cancer and heart problems).Healthy life style practices such as yoga therapy, exercise, proper diet, avoid smoking and coffee, reduction of stress were also found be effective in making menopausal women to become bearable and can also facilitate in preventing chronic ailments that can occur in the postmenopausal period. A regular yoga practice can make a world of difference in a women's experience of menopause.

BENEFITS OF YOGA:

· Exercise increases the cardio respiratory function and reduces the metabolic risks associated with declining estrogen.

· It increases HDL, reduces LDL, triglycerides and fibrinogen.

· Exercise can help to minimize midlife weight gain.

· Reduce the risk of high blood pressure, heart attack and stroke

· It increases the bone mass, strengthen the bone mineral density and prevent osteoporosis.

· It also reduces low back pain

· It is proven to reduce stress and improve the mood stability

· It may help to reduce hot flashes.

· Reduces the dryness or itching in vagina

· Minimize the sexual problems

· Strengthen the pelvic floor muscles

Breathing exercise (Pranayama):

It refers to deep inhale and exhale, this can be done, in lying or sitting position by slow deep inhale while counting 1, 2, 3, 4 and 5 in the mind then holding the breath for a moment while counting 1, 2 and 3 in the mind, followed by a slow long exhalation while 1,2,3,4 and 5count in the mind until the end of the respiratory cycle. An individual can perform ten slow full breathing at a time with rest interval of 30seconds to one minute and then start up again. It can be done twice a day. Any yoga can be performed for one and half-hour after breakfast or prior to lunch or dinner but better to perform in early morning after emptying the bowel and bladder.

Pranayama means calming the mind and body by controlling the breathing and sympathetic nervous system, thus reducing hot flashes. Chest-expanding poses energize the body by improving respiration and circulation and thus encounter the depression and anxiety.

· Walking on the spot for at least 10 minutes in every 4 hours may be helpful for a person

· Foot circles involve raising the feet a short distance off the ground and making as many “air circles” as possible till the count of three. This should be done with one foot at a time if it is difficult to hold both feet off the ground simultaneously. Try clockwise circles followed by counter clockwise circles on consecutive repetitions. Do at least 20 repetitions. Rest the feet back on the ground till the count of three.

· Foot curls involves raising the feet a short distance off the ground and curling the feet into a tight ball. This should be held till the count of three and then relaxed. Both feet can be exercised together. Do it at least 20 times. Rest the feet back on the ground till the count of three after every repetitions. When sitting, do foot circles and curls at least every 30 minutes to an hour or more frequently if possible.

· Fingers Lift the arms to shoulder height. Keeping the arms straight open the hands wide. Flex the fingers, closing over the thumbs. Repeat 10 times.

· Wrists Flex and extend the wrists, repeating 10 times. Rotate your wrists clockwise and counterclockwise 10 times each. Now hold the hand in extension and move it from side to side at the wrist. Repeat 10 times.

Leg press:

The leg press allows to test the true strength of the lower back. A lot of weight can be moved with this exercise and that results in an increase of bone mineral density. Sitting or standing in a comfortable position place the hands at sides and flex the toes 10 times. Rotate the ankles in each direction 10 times, keeping heels on the floor.

Leg press

Foot curls

(Supta Baddha Konasana):

Supported Lying Down (Reclining) Bound Angle Pose Body needs to hold the reclined version of the pose comfortably and slide the arms up or rest them on the floor or extended above the head. Knees flexed inward, thighs and groins stretched. Can use belt also around hip and feet and remain for 10mts, 2 times in a day, which improves blood supply to the reproductive organs and free energy flow to pelvic area.

Supported Child's Pose below down (AdhoMukhaVirasana)

Downward Facing Dog Pose (Adho Mukha Svanasana)

Forward bending from standing position by placing the head forward touching the floor as much as possible with support of hands, with legs straight and remain in this pose for 1 to 10 counts. Repeat it for 2 to 3 times and preferably twice a day.

The hormonal fluctuations in the body irritate the blood vessels and nerve endings, causing the vessels to over dilate and producing a hot flushed feeling and night sweating for 1 to 5 minutes. If these yoga were regularly practiced, hot flushed feeling is minimized, calm the mind and relax the nerves.

Supported Legs-up-the-Wall Pose – The Great Rejuvenator (ViparitaKarani):

Lie down in supine position near to the wall and place the both legs on the wall with back straight with or with or with out pillows for 10mts, twice a day. Which improves blood supply to the reproductive organs and pelvic area, head and brain and also prevent or minimize the risk of varicose veins.

Sphincter Control Exercise:

This exercise to strengthen the sphincter muscles, which involves contracting and relaxing the anal sphincter muscle. To feel and locate the sphincter muscles around the anus, urethra and vagina to start tighten. Pretending to hold a bowel and bladder movement to prevent from passing faeces or urine.

This can be done in sitting, standing or lying in a comfortable position with the legs slightly apart. Now try and squeeze the muscles as long as can. Relax in between each squeeze. Try to hold for up to 10 seconds and does this up to 10 times, can be scheduled as many number of times.

Savasana (Corpse Pose):

Sava means a dead body in Sanskrit, this asana is preferable to perform at the end of the yoga, because it helps the body to get complete rest and bring peace to the mind.

· Lie down with the back (supine), do not use a pillow. Let the body take the most naturally comfortable position. Spread the legs and hand away from the body and palms of the hand facing upwards. Rotate the legs in and out few times and let them fall gently out to the sides.

· Slowly turn the head side to side few times, so that the spine is centering and relaxing.

· Now tighten the whole body (every part of the body from head to feet) for few seconds and slowly loosen the body. On performing this, there is a pleasant feeling of cool fresh blood flows to all parts of the body and nourishing it.

· Now concentrate on each limb of the body, starting from the toes and try to convince (autosuggestion) that toes are quite relaxed. Try to move the toes a little and imagine that they are so relaxed that they cannot even to move. Gradually shift the focus on upper limbs, then feet, heels, abdominal region, stomach, heart region, neck and finally head. In addition, try to convince (autosuggestion) that these parts are quite relaxed.

· Then relax and lie motionless and though-less, like a dead body. Hold the pose for several minutes. Make your mind still and concentrate on your breath or the body.

After doing the pose, slowly come out the pose with gentle movement, turn to the side and sit down. Which help to build energy and burn off excess anxiety and improves blood to the brain and encourages deep sleep, focused breathing, which can improve mental alertness, soothes the nerves, calms the mind and puts the body into a deep state of rest and quick body temperature changes (hot flushes).

General instructions:

· Avoid hot places and wear lighter clothes

· To avoid spicy foods

· Try to avoid stress in life, stress activation of both the sympathetic nervous system and cause constriction of the arterioles of the vascular systems, may induce hot flashes.

· Seek counseling on problems related to sex and vaginal dryness

· Do regular house hold activities and specific activities or exercise.

· Join a support group(improve social interaction).

· Can have 1,200 to1,500 mg of calcium every day and a low-fat diet

· Keeping the body weight in normal limit.

· Quitting smoking

· Drinking alcohol to be avoided

· Limiting caffeine, spicy and hot.

CONCLUSION:

The yoga therapy (Vitamin-Y) is a simple, cost effective and easy to practice and should practice twice a day at least. This practice is helpful today’s life style because high level of stress and goal oriented life. These yoga cause difficult like body pain and discomfort for few days for the beginners. But which will be habituated within 7 to 15 days. One can realize the effect within a couple of week. Yoga helps to minimize the post menopausal symptoms and need of drugs in future.

REFERENCES:

· ABC of Yoga 2003-2008, Maxlifestyle International, 11th October 2009, http://www.abc-of-yoga.com/yoga-and-health/yoga-lifestyle.asp .

· Swami Nishchalananda Saraswati, 2004, A Systematic Course in the Ancient Tantric Techniques of Yoga and Kriyayoga, Yoga Publications Trust, Ganga Darshan, Munger, Bihar, India.

· Booth-La Force, C, Thurston, R C and Taylor M R 2007, 'A pilot study of a Hatha yoga treatment for menopausal symptoms', Maturitas, vol. 57, issue 3, pp. 286-295.

· Grady, D 2006, 'Feasibility and acceptability of restorative yoga for treatment of hot flushes: A pilot trial', Maturitas, vol. 56, issue 2, pp. 198-204.

· Managing Menopause 2009, The Jean Hailes Foundation for women's health, viewed 6 October 2009,http://www.managingmenopause.org.au/

· www.managingmenopause.org.au –JeanHaillesFoundation www.menopause.org.au –AustralasianMenopauseSociety www.menopause.org – North American Menopause Society

Received on 04.08.2014 Modified on 17.08.2014

Int. J. Adv. Nur. Management 2(3): July-Sept.,2014; Page 166-170