Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 49  |  Issue : 1  |  Page : 3-8

Psychophysiological responses across the menstrual cycle in low fit college women after yoga training


1 Principal, Bharati Vidyapeeth Deemed University College of Physical Education, Pune, Maharashtra, India
2 Scientific Research Department, Kaivalyadhama SMYM Samiti, Lonavla, Pune, Maharashtra, India
3 M. Phil Scholar, Scientific Research Department, Kaivalyadhama, Lonavla, Pune, Maharashtra, India

Date of Web Publication16-Jun-2017

Correspondence Address:
Tushar Kanti Bera
Bharati Vidyapeeth Deemed University, College of Physical Education, Pune - 411 043, Maharashtra
India
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DOI: 10.4103/ym.ym_7_17

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  Abstract 


Background: Women of reproductive age suffer from menses-associated health problems such as premenstrual symptoms, menstrual pain, and irregular menstrual cycles. Research has proved that premenstrual syndrome (PMS) is a psychophysiological and a stress-induced disorder and that stress is a cause of symptoms of PMS.
Objective: This controlled experiment was conducted with a view to examine the effect of full course of yoga training (suggested by Swami Kuvalayananda) on psychophysiological responses across menstrual cycle in low fit college women.
Methods: A total of 55 low fit college women, aged 20–30 years, with problems in menstrual cycle, volunteered in this study and were divided randomly into two groups, namely, yoga group (n1 = 27) and control group (n2 = 28). At the baseline and after completion of 12 weeks of yoga training, both the groups were assessed for menstrual status, pain tolerance, resting pulse rate, and blood pressure (systolic and diastolic) using standard tools. The yoga group practiced a set of full course of yoga for 1 h daily in the morning (6:30–7:30), 6 days in a week (except Sundays and holidays), for a total period of 12 weeks, whereas the control group did not participate in the said yoga program but were involved in some recreational activities and/or library reading during the tenure of experiment.
Results: The result of factorial ANOVA followed by Scheffe's post hoc test indicates that yoga training could bring down pulse rate (CD = 0.43, p < 0.05) and blood pressure (CD = 0.47, p < 0.01) at a normal range, whereas it could bring a statistically significant improvement in the symptoms of menstrual problems (CD = 0.45, p < 0.01) and pain tolerance ability (CD = 0.40, p < 0.01).
Conclusion: Yoga training could contribute to improvement in the psychophysiological responses across menstrual cycle among the low fit college women.

Keywords: College women, menstruation problems, yoga


How to cite this article:
Bera TK, Shete SU, Verma A, Sharma N. Psychophysiological responses across the menstrual cycle in low fit college women after yoga training. Yoga Mimamsa 2017;49:3-8

How to cite this URL:
Bera TK, Shete SU, Verma A, Sharma N. Psychophysiological responses across the menstrual cycle in low fit college women after yoga training. Yoga Mimamsa [serial online] 2017 [cited 2017 Jun 27];49:3-8. Available from: http://www.ym-kdham.in/text.asp?2017/49/1/3/208282




  Introduction Top


Menstruation is an important part of every woman's life cycle. A woman begins to go through a series of hormonal changes during the menstruation cycle that occurs once every month (Flug, Largo, & Prader, 1984). Although such a pattern of menstruation cycle is natural, unfortunately almost every woman is likely to experience menstruation problems such as premenstrual syndrome (PMS) and premenstrual dysphoric disorders by the way of induced anxiety, stress, and several mood swings at some point of time (Johnson, 2004). The onset of menstruation or menarche is a hallmark of female pubertal development. Menstrual disorders are a common presentation by late adolescence, 75% of girls experience some problems associated with menstruation (Lee, Chen, Lee, & Kaur, 2006).

In fact, the problems of menstruation are neglected in our society although menstrual dysfunction is a common problem in the population of the reproductive age group. There are several types of problems in menstrual cycle related to irregular periods that affect the frequency of menstruation such as polymenorrhea (frequent periods - with intervals of 21 days or less), oligomenorrhea (infrequent menstrual periods - interval between menstruation exceeds 35 days), and amenorrhea (absence of periods for more than 60 days in a woman of reproductive age: physiologically occurs during pregnancy and breastfeeding). Moreover, psychological factors such as stress, anxiety, and depression are prevalent during menstruation (Allsworth et al., 2007).

There are some other conditions which are related to pain during menstruation such as dysmenorrhea (cramps or painful menstruation, involves menstrual periods that are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen); irregular periods that affect the quantity of menstruation, which are known as hypomenorrhea (a diminution of the flow or a shortening of the duration of menstruation); and menorrhagia (an abnormally heavy and/or prolonged menstrual period). Many females also complain of pain, anxiety, depression, fatigue, and vomiting during the menstrual cycle throughout their reproductive life (Solomon et al., 2002).

Several studies have indicated that women of reproductive age suffer from menses-associated health problems such as premenstrual symptoms, menstrual pain, and irregular menstrual cycles (Klein & Litt, 1981; Flug et al., 1984; Munster, Schmidt, & Helm, 1992). It has also been reported that about 40% of women experience mild premenstrual symptoms and another 40% have premenstrual symptoms severe enough for them to seek medical assistance (Dell, 2004). Further, in a population-based survey, 79% of 18-year-old girls were found to experience menstrual pain and 21% of 16-year-old girls had stayed at home due to menstrual pain (Teperi & Rimpela, 1989). In fact, irregular menstrual cycles have serious health problems such as type 2 diabetes mellitus and cardiovascular disease (Solomon et al., 2001), osteoporosis (Harlow & Ephross, 1995; Kaplan & Manuck, 2004), and infertility (Rowland et al., 2002). Research has proved that PMS is a psychophysiological and a stress-induced disorder and that stress is a cause of symptoms of PMS (Benson & Frankel, 1978; Cakir, Mungan, Karakas, Girisken, & Okten, 2007). Although ample of researches revealed that yoga plays a significant role in controlling almost all the aspects of psychophysiological ailments, the aim of this study was to observe the effect of yoga practices on selected psychophysiological variables in low fit college women with problems in menstrual cycle.


  Materials and Method Top


Study participants

This study was conducted at Rajasthan Mahila Teachers Training College, Udaipur, Rajasthan, India. Two hundred (n = 200) females, aged 20–30 years, were randomly surveyed for menstruation status using a rating scale (Bera, 2004). Out of the 200 females, 110 (55%) had menstruation problems of different kinds that were reconfirmed by a qualified medical doctor (gynecologist). Further, all the 110 females were tested for health-related physical fitness (American Alliance for Health, Physical Education, and Recreation, 1976) which revealed that 67 (60.8%) females had very low fitness scores. These 67 participants were reexamined by the medical officer, where five participants who had known ailments or on medication and two participants who did not sign the consent form, as discarded by the medical practitioner, were excluded from this study. Finally, sixty females who consented to participate were included for this controlled experiment. The entire sixty females (with problems in menstruation cycle) were randomly assigned into experimental and control groups with thirty females in each group considering Fisher's random table. Further, background information about the participants including age, education, weight, height, socioeconomic status, parents' occupation, life style, and family history were noted down. It was observed that, during the experimental period, attendance of three participants from experimental group was irregular and two from control group withdrew their participation from this study. Thus, finally 27 females remained in the experimental group and 28 in the control group.

Assessment tools

The variables considered in this study were menstruation status (symptoms of menstruation problem), pain tolerance, pulse rate, and blood pressure (systolic and diastolic). The symptoms of menstruation problems were evaluated by a standard rating scale (Bera, 2004) that bears sufficient reliability (r = 0.83, p < 0.01) and ensures content validity, and the score was recorded in points. The rating scale includes 27 questions regarding family information, physiological information, and menstruation profiles. A psychological questionnaire was also administered to evaluate pain tolerance in points (Bera, 2004a). This scale includes 45 questions representing 9 dimensions, namely, medicine and pain, self-management of pain, body weight and pain, sitting style and pain, standing style and pain, sleeping style and pain, self-acceptance and pain, social life and pain, and traveling and pain. This is a two-point scale, i.e., each question has two answers “Yes”/“No.” This scale bears sufficient reliability (r = 0.78, p < 0.01) and ensures content validity. Moreover, Omron's Digital Sphygmomanometer was used to measure physiological variables, i.e., pulse rate in beats/min. and blood pressure (systolic and diastolic) in mmHg.

Study design and protocol

This was a randomized controlled trial to find the efficacy of yoga training for the management of menstrual problems, pain, pulse rate, and blood pressure. After collection of the baseline data on the symptoms of menstruation problems and pain tolerance ability, resting pulse rate, and blood pressure (systolic and diastolic) during menstrual cycle, the participants of the experimental group underwent a full-course yoga training program (Kuvalayananda, 1924) daily 1 h in the morning (6:30–7:30), 6 days a week (except Sundays and holidays), for a total period of 12 weeks, whereas the control group, during this period, did not participate in the said yoga program but were involved in some recreational activities and/or library reading.

Total duration of the experiment was 12 weeks. During this period, the participants of the experimental group practiced a set of yoga in the form of asanas (Sarvangasana, Matsyasana, Halasana, Bhujangasana, Shalabhasana, Dhanurasana, Ardha-Matsyendrasana, Paschimottanasana, Shavasana), bandha (Uddiyana), mudra (Yoga mudra), kriyas (Nauli and Kapalabhati), and pranayamas (Ujjayi and Bhastrika). Each session of yoga practices was started and concluded with low-pitch Om chanting. It is important to note that Shirshasana and Mayurasana were excluded from the training intervention because the participants were unable to perform them properly.

Since this experiment was a part of M. Phil (Master of Philosophy) research of Scientific Research Department of Kaivalyadhama, SMYM. Samiti, Lonavla (India), conducted at Rajasthan (India), the ethical clearance was issued by the then Institutional Ethics Committee of Kaivalyadhama (Lonavla, India). However, after 12 weeks of yoga training intervention, all the variables were posttested.

The data were analyzed employing descriptive statistics, and effects of yoga training were evaluated by 2× 5 factorial ANOVA followed by Scheffe's post hoc test.


  Result and Discussion Top


This experiment considered five psychophysiological variables (viz., menstrual problems and pain tolerance ability, pulse rate, systolic and diastolic blood pressure) on the basis of earlier reports (Lee et al., 2003; Abplanalp, Livingston, Rose, & Sanwisch, 1977).

The result on the symptoms of menstruation problems (points) of the low fit college women indicates that the mean scores (standard deviation [SD]) of yoga group (pre: 1 and post: 2) and control group (pre: 3 and post: 4) were 32.67 (5.64), 26.55 (6.87), 31.80 (6.29) and 30.36 (4.64), respectively, which showed that the baseline data on menstruation problems of the participants were much higher [Table 1]. Appearance of high-intensity suffering from menstrual problems may be due to uncontrolled activities of cortisol and growth hormones that might have led to psychophysiological stress during the menstrual cycle (Abplanalp et al., 1977). However, result of Scheffe's post hoc test revealed that the yoga training could significantly reduce the symptoms of menstruation cycle (CD =0.56, p < 0.01), whereas the participants of control group could not reduce these symptoms (CD =0.11, p > 0.05). The result, in turn, infers that yoga group showed significant superiority over the controlled one in reducing the symptoms of menstruation cycle (CD =0.45, p < 0.01) [Table 2]. The result obtained from this investigation seems to be logical because relaxation component of yoga perhaps contributed to alleviate PMS symptoms (Goodale, Domar, & Benson, 1990). Moreover, yoga perhaps controlled stress syndrome and levels of cortisol as well as dehydroepiandrosterone sulfate (DHEAS) and melatonin, which might have helped to minimize PMS of the college women and inspired them to live a quality life with enhanced favorable mood (Carlson, Speca, Patel, & Goodey, 2004). Thus, considering this mechanism, the selected yoga practices might have reversed the symptoms of menstruation cycle of low fit college women [Figure 1]. This suggests that yoga has a significant role in controlling the symptoms of menstruation problems during menstruation cycle.
Table 1: Mean (standard deviation) of psychophysiological responses of low fit women having menstruation problems

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Table 2: Impact of yoga on psychological responses (pain tolerance and menstruation problems) of low fit women across menstruation cycle

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Figure 1: Yoga for resolving menstrual problems

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Since the symptoms of pain during the phases of menstruation cycle are generally evident in most of the women, especially who suffer from menstruation problems, they need to improve pain tolerance ability instead of using modern medicine frequently. The result of this investigation indicates that pain tolerance ability (points) of low fit college women (with menstruation problems) in yoga group (pre: 1 and post: 2) and control group (pre: 3 and post: 4) were 41.89 (9.72), 49.70 (10.33), 44.37 (8.31), and 47.87 (7.29), respectively [Table 1], which indicates that the baseline data on pain tolerance ability of the low fit women were very poor. In fact, earlier research also evidenced the similar baseline data on poor tolerance ability of the women with disturbed menstrual cycle (McCracken, 1998). The result of Scheffe's post hoc test revealed that the yoga training could significantly improve the symptoms of pain tolerance ability (CD = 0.52, p < 0.01), whereas the participants of control group could not improve the same (CD = 0.09, p > 0.05). The result further infers that yoga group showed significant superiority over the control group in improving the symptoms of pain tolerance ability (CD = 0.40, p < 0.01) [Table 2]. Thus, the yoga practices might have helped the college women to accept as well as adjust the pain that appears due to menstrual problems, which perhaps improved the pain tolerance ability among low fit college women (Rakhshaee, 2011; McCracken, 1998; Hayes et al., 1999; Benson & Frankel, 1978) [Figure 2]. Moreover, yoga might have worked as an alternative therapy and perhaps improved the mental health status (Peeke & Frishett, 2002) of the college women. This, in fact, suggests that yoga has a significant role in reducing the pain symptoms and/or improving pain tolerance ability among the college women during different phases of menstruation cycle.
Figure 2: Yoga for increasing pain tolerance ability during menstruation problems

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In case of pulse rate (beats/min), the result revealed that the mean scores (SD) in this variable of the low fit college women (who suffer from menstruation problems) in yoga group (pre: 1 and post: 2) and control group (pre: 3 and post: 4) were 81.89 (9.39), 74.88 (9.24), 83.43 (10.56), and 83.84 (10.43), respectively, which indicate that the baseline data on resting pulse rate of the participants with menstruation problem were higher [Table 1]. Appearance of such result in baseline data is found similar to several earlier studies, which indicate that women of reproductive age suffer from menses-associated hormonal as well as physiological changes and experience its associated health problems such as premenstrual symptoms, menstrual pain, and irregular menstrual cycles (Klein & Litt, 1981; Flug et al., 1984; Munster, Schmidt, & Helm, 1992). Thus, the baseline data as appeared in this investigation seem to be logical. The result of factorial ANOVA followed by Scheffe's post hoc test further revealed that the yoga training could significantly bring down the resting pulse rate level within the normal range (CD = 0.68, p < 0.01), whereas the participants of controlled group could not reduce it statistically (CD = 0.15, p > 0.05) [Table 3]. The result further infers that yoga group showed significant superiority over the control group in reducing pulse rate to the normal range (CD = 0.43, p < 0.05) [Figure 3]. Thus, the selected yoga practices might have worked as progressive stretching as well as relaxation (Goodale et al., 1990; Benson & Frankel, 1978; Lee et al., 2003), which could effectively reverse the pulse rate to the normal range in the low fit college women having menstruation problems. This, in fact, suggests that yoga helps in maintaining normal pulse rate level during menstruation period.
Table 3: Impact of yoga training in physiological responses (pulse rate, systolic and diastolic blood pressure) of low fit women across menstruation cycle

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Figure 3: Yoga for pulse rate reduction during menstruation

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Result on systolic blood pressure (mmHg) of the low fit college women (with menstruation problems) indicates that the mean scores (SD) of yoga group (pre: 1 and post: 2) and control group (pre: 3 and post: 4) were 122.74 (21.38), 118.48 (19.29), 120.50 (19.22), and 121.34 (20.17), respectively, which infer that the baseline data on resting systolic blood pressure of the participants with menstruation problem were higher [Table 1]. The result of Scheffe's post hoc test revealed that the yoga training could significantly bring down the resting systolic blood pressure level to the normal range (CD = 0.61, p < 0.01), whereas the participants of controlled group could not reduce the same (CD = 0.09, p > 0.05). The results further deduce that yoga group showed significant superiority over the control group in lowering systolic blood pressure within the normal range (CD = 0.47, p < 0.01) [Table 3]. Thus, the progressive as well as relaxation aspects and diaphragmatic as well as abdominal breathing of yoga practices might have influenced the parasympathetic activities (Anand, 1991; Lee et al., 2003) that perhaps worked effectively to reverse the systolic blood pressure to the normal range of low fit college women having menstruation problems [Figure 4]. This, in fact, suggests that yoga significantly maintains normal range of systolic blood pressure during menstruation period.
Figure 4: Yoga for maintaining normal systolic blood pressure during menstruation

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The mean scores (SD) in diastolic blood pressure (mmHg) of the low fit college women (with menstruation problems) in yoga group (pre: 1 and post: 2) and control group (pre: 3 and post: 4) were 77.07 (16.32), 75.71 (9.96), 77.20 (13.86), and 83.74 (19.35), respectively [Table 1], which indicate that the baseline data on diastolic blood pressure of the participants (with menstruation problems) remained at normal range. The result of Scheffe's post hoc test revealed no change in diastolic blood pressure in both yoga group (CD = 0.09, p > 0.05) and control group (CD = 0.15, p > 0.05). Further, intergroup comparison (yoga vs. control) also revealed similar trend of result, i.e., no difference in maintaining diastolic blood pressure (CD = 0.14, p > 0.05) [Table 3]. Thus, the selected yoga practices had no control over the diastolic blood pressure among low fit college women having menstruation problems [Figure 5]. The mechanism of such nonsignificant change in diastolic blood pressure is not clearly evident in the earlier research literature. Although both the groups showed normal range in diastolic blood pressure in baseline and posttest, appearance of such result, in turn, suggests that yoga had no significant effects for controlling diastolic blood pressure among the college women during menstruation period.
Figure 5: Yoga for maintaining normal diastolic blood pressure during menstruation

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To summarize, many of the college women during menstruation cycle face intensive and intolerable menstrual pain and associated health disorder with aggression in behavioral pattern, stress, and anxiety (Teperi & Rimpela, 1989; Lee et al., 2003). This indicates that PMS during menstrual cycle jeopardize the behavioral states and parasympathetic activities in females of reproductive age. However, the present experiment concludes that selected yoga practices are found to be useful to regulate psychophysiological responses of the college women during different phases of menstrual cycle and recommends yoga as a fruitful means for the college women who suffer from PMS.

Acknowledgment

This project was done as a part of M. Phil. (Physical Education) degree course in the authorized research center (Kaivalyadhama SMYM Samiti, Lonavla, India, an institution of higher learning recognized by the Ministry of HRD, Government of India) of the then University of Pune, Pune (India). Authors are thankful to the Swami Maheshananda, Director of Research (Kaivalyadhama), Shri O. P. Tiwari, Secretary (Kaivalyadhama), and Shri Subodh Tiwari, Chief Executive Officer, (Kaivalyadhama). Last but not the least, everyone whosoever has contributed, directly or indirectly, to the successful completion of this project, are thanked earnestly.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Abplanalp, M. D., Livingston, L., Rose, R. M., & Sanwisch, D. (1977). Cortisol and growth hormone responses to psychological stress during the menstrual cycle. Psychosomatic Medicine, 39, 158-176.  Back to cited text no. 1
    
2.
Allsworth, J. E., Clarke, J., Peipert, J. F., Hebert, M. R., Cooper, A., & Boardman, L. A. (2007). The influence of stress on the menstrual cycle among newly incarcerated women. Womens Health Issues, 17 ( 4), 202-209.  Back to cited text no. 2
    
3.
American Alliance for Health, Physical Education, and Recreation. (1976). Youth Fitness Test Manual. Washington, DC: The Alliance.  Back to cited text no. 3
    
4.
Anand, B. K. (1991). Yoga and medical sciences. Indian Journal of Physiology and Pharmacology, 35 ( 2), 84-87.  Back to cited text no. 4
    
5.
Benson, H., & Frankel, F. H. (1978). Treatment of anxiety: A comparison of the usefulness of self-hypnosis and a meditational relaxation technique. An overview. Psychotherapy and Psychosomatics, 30, 229-242.  Back to cited text no. 5
    
6.
Bera, T. K. (2004). Rating scale for menstrual profiles. Lonavla (India): Scientific Research Department, Kaivalyadhama SMYM Samiti.  Back to cited text no. 6
    
7.
Bera, T. K. (2004a). Pain tolerance scale. Lonavla (India): Scientific Research Department, Kaivalyadhama SMYM Samiti.  Back to cited text no. 7
    
8.
Cakir, M., Mungan, I., Karakas, T., Girisken, I., & Okten, A. (2007). Menstrual pattern and common menstrual disorders among university students in Turkey. Pediatrics International, 49 ( 6), 938-942.  Back to cited text no. 8
    
9.
Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulphate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29, 448-478.  Back to cited text no. 9
    
10.
Dell, D. L. (2004). Premenstrual syndrome, premenstrual dysphoric disorder, and premenstrual exacerbation of another disorder. Clinical Obstetrics and Gynecology, 47, 568-575.  Back to cited text no. 10
    
11.
Flug, D., Largo, R. H., & Prader, A. (1984). Menstrual patterns in adolescent Swiss girls: A longitudinal study. Annals of Human Biology, 11, 495-508.  Back to cited text no. 11
    
12.
Goodale, I. L., Domar, A. D., & Benson, H. (1990). Alleviation of premenstrual syndrome symptoms with the relaxation response. Obstetrics and Gynecology, 75 ( 4), 649-655.  Back to cited text no. 12
    
13.
Harlow, S. D., & Ephross, S. A. (1995). Epidemiology of menstruation & its relevance to women's health. Epidemiologic Reviews, 17, 265-286.  Back to cited text no. 13
    
14.
Hayes, S. C., Bissett, R. C., Korn, Z., Zettle, R., Rosenfarb, I., & Cooper, I., … Grundt, A. (1999). The impact of acceptance versus control rationales on pain tolerance. The Psychological Record, 49, 33-47.  Back to cited text no. 14
    
15.
Johnson, S. R. (2004). Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: A clinical primer for practitioners. Obstetrics and Gynecology, 104, 845-859.  Back to cited text no. 15
    
16.
Kaplan, J. R., & Manuck, S. B. (2004). Ovarian dysfunction, stress, and disease: A primate continuum. ILAR J, 45, 89-115.  Back to cited text no. 16
    
17.
Klein, J. R., & Litt, I. F. (1981). Epidemiology of adolescent dysmenorrhea. Pediatrics, 68, 661-664.  Back to cited text no. 17
    
18.
Kuvalayananda, S. (1924). Asanas. Lonavla (India): Kaivalyadhama Ashram.  Back to cited text no. 18
    
19.
Lee, J. S., Lee, M. S., Lee, J. Y., Cornelissen, G., Otsuka, K., & Halberg, F. (2003). Effects of diaphragmatic breathing on ambulatory blood pressure and heart rate. Biomedicine & Pharmacotherapy, 57, 87-91.  Back to cited text no. 19
    
20.
Lee, L. K., Chen, P. C., Lee, K. K., & Kaur, J. (2006). Menstruation among adolescent girls in Malaysia: A cross-sectional school survey. Singapore Medical Journal, 47 ( 10), 874.  Back to cited text no. 20
    
21.
McCracken, L. (1998). Learning to live with pain: Acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74, 21-27.  Back to cited text no. 21
    
22.
Munster, K., Schmidt, L., & Helm, P. (1992). Length and variation in the menstrual cycle – A cross-sectional study from a Danish county. British Journal of Obstetrics and Gynaecology, 99, 422-429.  Back to cited text no. 22
    
23.
Peeke, P. M., & Frishett, S. (2002). The role of complementary and alternative therapies in women's mental health. Primary Care, 29 ( 1), 183-197.  Back to cited text no. 23
    
24.
Rakhshaee, Z. (2011). Effect of three yoga poses (Cobra, Cat and Fish Poses) in women with primary dysmenorrhea: A randomized clinical trial. Journal of Pediatric and Adolescent Gynecology, 24 ( 4), 192-196.  Back to cited text no. 24
    
25.
Rowland, A. S., Baird, D. D., Long, S., Wegienka, G., Harlow, S. D., & Alavanja, M., … Sandler, D. P. (2002). Influence of medical conditions and lifestyle factors on the menstrual cycle. Epidemiology, 13, 668-674.  Back to cited text no. 25
    
26.
Solomon, C. G., Hu, F. B., Dunaif, A., Rich-Edwards, J. E., Stampfer, M. J., & Willett, W. C., … Manson, J. E. (2002). Menstrual cycle irregularity and risk for future cardiovascular disease. The Journal of Clinical Endocrinology and Metabolism, 87, 2013-2017.  Back to cited text no. 26
    
27.
Solomon, C. G., Hu, F. B., Dunaif, A., Rich-Edwards, J., Willett, W. C., & Hunter, D. J., … Manson, J. E. (2001). Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. The Journal of the American Medical Association, 286, 2421-2426.  Back to cited text no. 27
    
28.
Teperi, J., & Rimpela, M. (1989). Menstrual pain, health and behaviour in girls. Social Science & Medicine, 29, 163-169.  Back to cited text no. 28
    


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