we conducted a randomized controlled trial for women ( menstrual irregularities ) with psychological problems .
small paper chits written either case or control were placed in opaque , sequentially numbered envelopes prepared by a biostatistician who had no contact with participants .
the study was approved by the ethical committee at csmmu u.p ( erstwhile kgmu ) lucknow .
subjects with menstrual irregularities were diagnosed by senior consultant in the department of obstetrics and gynecology , c.s.m .
participants were aged between 18 and 45 years with current menstrual irregularities persisting for > 6 months .
interested individuals were initially screened for eligibility by senior consultant after oral informed consent was obtained and using inclusion and exclusion criteria . according to inclusion and exclusion criteria , eligible subjects were invited to take up yoga classes . at the first meeting , written informed consent was obtained and their socio economic history and menstrual history was recorded .
women more than 18 years of age having menstrual irregularities , ( pathological amenorrhea , dysmenorrhea , oligomenorrhea , polymenorrhea , hypomenorrhea , menorrhagia and metrorrhagia ) were included .
women having known gynecological neoplasm requiring surgery , pregnancy , pelvic inflammatory disease ( pid ) and uncooperative subjects were excluded .
the socio demographic data , details of personal history and menstrual history ( last menstrual period , duration of menstrual cycle , amount of bleeding and dysmenorrhea ) and pervious treatments such as physical therapy and yoga therapy were inquired and recorded .
a total of 150 subjects were included and were randomly assigned into two groups : 1 .
medroxy progesterone , norethistrone , ethinyl estrodiol , levonorgestrol , tranexemic acid , ethamsylate medicines were prescribed to the patients by the consultants as and where required . out of 150 subjects ,
10 subjects from intervention group and 14 subjects from control group were dropped out because they did not turn up for the second follow - up . out of 24 drop - out patients , 16 patients could not follow the time schedule and 8 patients did not feel better so they were not willing after 1 week .
a final assessment was done at the end of the treatment period ( 6 month ) with the test tool , scan rating scale .
the outcome was assessed using following measures : 
 proforma for socio demographic and personal history detailsschedule for clinical assessment in neuropsychiatry ( scan ) : the psychiatric interview was conducted with the scan ; version 2.1 based clinical interviews were conducted to assess somatoform symptoms of the subjects .
the scan based clinical interview was used to inquire about 76 physical symptoms in seven symptom groups . 
 
proforma for socio demographic and personal history details schedule for clinical assessment in neuropsychiatry ( scan ) : the psychiatric interview was conducted with the scan ; version 2.1 based clinical interviews were conducted to assess somatoform symptoms of the subjects .
the scan based clinical interview was used to inquire about 76 physical symptoms in seven symptom groups . in this study rating
was made on 0 ( zero ) and 1 ( one ) , 0 means absence of symptom and 1 means presence of symptom .
the yoga nidra intervention used was developed by swami satyananda saraswati , school of yoga , munger , bihar , india .
the final protocol ( yoga classes ) consisted of 35-minute /day , five days in week intervention with yoga nidra in the department of physiology csmmu , lucknow , u.p . ,
this was done to take into account the imbalances , if any , at the baseline characteristics of the subjects . independent sample 
t test ( parametric test ) was used to compare the differences in scores between the two groups ( yoga vs. non - yoga group ) .
we conducted a randomized controlled trial for women ( menstrual irregularities ) with psychological problems .
small paper chits written either case or control were placed in opaque , sequentially numbered envelopes prepared by a biostatistician who had no contact with participants .
the study was approved by the ethical committee at csmmu u.p ( erstwhile kgmu ) lucknow .
subjects with menstrual irregularities were diagnosed by senior consultant in the department of obstetrics and gynecology , c.s.m .
participants were aged between 18 and 45 years with current menstrual irregularities persisting for > 6 months .
interested individuals were initially screened for eligibility by senior consultant after oral informed consent was obtained and using inclusion and exclusion criteria . according to inclusion and exclusion criteria , eligible subjects were invited to take up yoga classes . at the first meeting , written informed consent was obtained and their socio economic history and menstrual history was recorded .
women more than 18 years of age having menstrual irregularities , ( pathological amenorrhea , dysmenorrhea , oligomenorrhea , polymenorrhea , hypomenorrhea , menorrhagia and metrorrhagia ) were included .
women having known gynecological neoplasm requiring surgery , pregnancy , pelvic inflammatory disease ( pid ) and uncooperative subjects were excluded .
the socio demographic data , details of personal history and menstrual history ( last menstrual period , duration of menstrual cycle , amount of bleeding and dysmenorrhea ) and pervious treatments such as physical therapy and yoga therapy were inquired and recorded .
a total of 150 subjects were included and were randomly assigned into two groups : 1 .
medroxy progesterone , norethistrone , ethinyl estrodiol , levonorgestrol , tranexemic acid , ethamsylate medicines were prescribed to the patients by the consultants as and where required . out of 150 subjects , 10 subjects from intervention group and 14 subjects from control group were dropped out because they did not turn up for the second follow - up .
out of 24 drop - out patients , 16 patients could not follow the time schedule and 8 patients did not feel better so they were not willing after 1 week .
a final assessment was done at the end of the treatment period ( 6 month ) with the test tool , scan rating scale .
the outcome was assessed using following measures : 
 proforma for socio demographic and personal history detailsschedule for clinical assessment in neuropsychiatry ( scan ) : the psychiatric interview was conducted with the scan ; version 2.1 based clinical interviews were conducted to assess somatoform symptoms of the subjects .
the scan based clinical interview was used to inquire about 76 physical symptoms in seven symptom groups . 
 
proforma for socio demographic and personal history details schedule for clinical assessment in neuropsychiatry ( scan ) : the psychiatric interview was conducted with the scan ; version 2.1 based clinical interviews were conducted to assess somatoform symptoms of the subjects .
the scan based clinical interview was used to inquire about 76 physical symptoms in seven symptom groups . in this study rating
was made on 0 ( zero ) and 1 ( one ) , 0 means absence of symptom and 1 means presence of symptom .
the yoga nidra intervention used was developed by swami satyananda saraswati , school of yoga , munger , bihar , india .
one yoga instructor was selected by an expert panel for this study . the final protocol ( yoga classes ) consisted of 35-minute /day , five days in week intervention with yoga nidra in the department of physiology csmmu , lucknow , u.p . ,
this was done to take into account the imbalances , if any , at the baseline characteristics of the subjects .
t test ( parametric test ) was used to compare the differences in scores between the two groups ( yoga vs. non - yoga group ) .
in the present study , intervention and control groups were compared by independent samplet test ( parametric test ) on all measures at socioeconomic demographic profile and baseline characteristics , there were no significant differences .
socio economic demographic profile is shows in table 1 and baseline characteristics of intervention and control groups are shows in table 2 .
independent samplet test was used to examine group differences on these measures was a cut - off of p<0.05 of the present study .
socio economic demographic profile baseline characteristic of intervention and control groups table 3 shows comparison of mean difference in score mean with sd of pre - treatment and post - treatment values of psychological variables .
we found significant changes in pain symptoms ( p<0.006 ) , gastrointestinal symptoms ( p<0.04 ) , cardiovascular symptoms ( p<0.02 ) and urogenital symptoms ( p<0.005 ) in intervention group after the 6 month of yogic intervention with comparison to control group .
although , the improvement on neurological , autonomic and skin and glands symptoms did not show a significant difference , yet in intervention group there was improvement in these parameters also when compared with the control group .
comparison of differences in pre- and post - treatment values of psychological variables in intervention and control groups tables 4 and 5 are showing changes in the baseline and post intervention in menstrual symptoms of intervention and control groups but more changes in intervention group as compassion to the control group .
changes in the menstrual symptoms of intervention group changes in the menstrual symptoms of control group
in the present study , two groups were well matched for age , socio economic status and there were no significant differences .
the results suggest that the aspects of somatoform symptoms measured in this study improved in intervention group .
those who were the participants of intervention group ( yoga nidra ) started feeling better and were relieved somatoform symptoms as then compared with the control group .
the current study , suggests that in patients with menstrual irregularities , yoga nidra not only has utility as a possible therapeutic strategy , but also may be a method for improving headache , giddiness , nervousness and irritability .
yoga nidra probably relieves pain by stimulating the pituitary gland to release its own potent pain - suppressing compounds .
research studies have uncovered the existence of endogenous morphine - like brain hormones , termed endorphins and encephalin .
these natural substances appear to be produced by the pituitary gland under conditions of extreme stress and prolonged , intractable pain and are secreted into the cerebrospinal fluid which surrounds and supports the entire central nervous system . through yoga nidra powerful stimulus
can be given to the pituitary gland to release these hormones so that need for external painkillers is not there . in the intervention group which practiced yoga nidra for 6 months
, there was significant decrease in their degree of pain symptoms ( according to the scan ) and observed a significant change during the treatment period .
the ability of yoga nidra to control pain was investigated in a study , in which the need for analgesic medication was eliminated , or markedly reduced , among the 54 participants in the study .
the remainders suffered from a verity of conditions characterized by long term or intermittent pain , including gastrointestinal pain , shoulder and neck pain and lower back pain . at follow - up after 6 weeks of yoga nidra therapy
, patients reported an average of 81 effective pain relief and yoga nidra have also been used successfully in the management of chronic arthritic pain .
these findings are consistent ; researchers reported that in a smaller sample of young adults , where positive effects of yoga were found on general well - being .
mind -- body methods such as yoga , with its reliance on deep relaxed abdominal breathing and attention to comfort , may disrupt chronic patterns of functional disability , anxiety and maladaptive coping , which subsequently could reduce overall levels of gastrointestinal symptoms in another study performed on adolescents , researchers observed that yoga group reported lower levels of functional disability , less use of emotion - focused avoidance and lower anxiety following the intervention than adolescents in the control group . when the pre- and post - intervention data for the two groups were combined , adolescents had significantly lower scores for gastrointestinal symptoms and emotion -- focused avoidance following the yoga intervention .
adolescents found the yoga to be helpful and indicated they would continue to use it to manage their ibs .
yoga nidra has emerged as an effective preventive , alleviative and curative technique in the management of degenerative and ischemic heart disease .
researchers have found that yoga nidra significantly lowered levels of serum cholesterol in cardiac patients .
other studies have reported yoga training is associated with a significant increase of cardiac vagal modulation . since this method is easy to apply with no side effects , it could be a suitable intervention in cardiac rehabilitation programs .
the practice of yoga nidra throughout urogenital problems helps to create the most favorable conditions for intrauterine growth and development .
yoga nidra has also been prescribed for the relief of pain associated with dysmenorrhea ( disturbance of the menstrual cycle ) and excessive levels of premenstrual tension .
authors concluded that yogic relaxation training should be prescribed more frequently as an adjunct or alternative to conventional drug therapy for menstrual dysfunction and pain .
very severe pain during menstruation and spent one to several days in bed each month as a result .
these women were given individual interviews and a series of relaxation sessions using a technique similar to yoga nidra .
results were most successful , with all subjects reporting a reduction in tension , pain and time in bed .
six months after stopping the relaxation therapy more than half reported that they were still having pain - free periods and they showed an improved attitude to menstruation in general .
yoga nidra can be used in stressful situations to become relaxed and for better management of stress .
they experienced that yoga program helped in decreasing backache , pain in arms and legs , headaches , nausea , irregular menstruation and dysmenorrhea .
they felt happy and satisfied . increased experience of altered states of consciousness ( asc ) during sudarshan kriya and related practice .
yoga nidra also increased the consciousness associated with deep relaxation which reduces the mental and physical problems .
the results indicate that somatoform symptoms in patients with menstrual disorder can be decreased by learning and applying a program based on yogic intervention ( yoga nidra ) .
instructions for yoga nidra were given in the following manner : 
 a)preparation : get ready for yoga nidra .
lie down on your back on the floor and adopt the pose called shavasana . in this position
the body should be straight from head to toe , the legs slightly apart and the arms a little away from the body , with the palms of the hands turned upwards . during yoga nidra there should be no physical movement ( patient closes her eyes and keeps them closed until is told to open ) ( pause ) .
take deep breath and as you breathe out , feel the cares and worries of the day flow out of you . in the practice which follows
, you are going to develop the feeling of relaxation in the body . during yoga nidra
, you are functioning on the levels of hearing and awareness , and the only important thing is to follow the voice of the instructor ( pause)b)relaxation : now brings about a feeling of inner relaxation in the whole body ; concentrate on the body and become aware of the importance of complete stillness ( pause ) . develop awareness of your body from the top of the head to the tips of the toes and mentally repeat the mantra o -- o -- o -- m -- m -- m . experience complete stillness and complete awareness of the whole body
again repeat o -- o -- o -- m -- m -- m ( pause)c)resolve : at this moment you should resolve yourself .
the resolve will have to be very simple ; it should be short , positive statement in simple language stated three times with awareness , feeling and emphasis . the resolve you make during yoga nidra
is bound to come true in your life ( pause)d)rotation of consciousness : we now begin rotation of consciousness , rotation of awareness by taking a trip through the different parts of the body ( pause ) as quickly as possible the awareness is to go from part to part .
repeat the part in your mind and simultaneously become aware of that part of the body . become aware of the right side , left side , back , front , and major parts ( pause)e)breathing : become aware of your breath . feel the flow of your breath in and out of your lungs ( pause ) counting breaths with navel , chest , throat and nostril awareness ; each 27 to 1f)image visualization : stop counting and leave your breaths ; we now come to visualization .
a number of different things will be named and you should try to develop a vision of them on all levels of feelings , awareness , emotions , imagination , as best you cane)resolve : now this is time to repeat your resolve .
repeat the same resolve that you made at the beginning of the practice , do not change it , repeat the resolve three times with full awareness and feeling ( pause)f)finish : relax all efforts , draw your mind outside and become aware of your breath ( pause ) , become aware of the natural breath , awareness of the whole body and awareness of breathing ( pause ) .
your body is lying totally relaxed on the floor you are breathing quietly and slowly .
develop awareness of your body from the top of the head to the tips of the toes and say mentally in your mind o -- o -- o -- m -- m -- m ( pause ) .
when you are sure that you are wide awake , sit up slowly and open your eyes .
lie down on your back on the floor and adopt the pose called shavasana . in this position
the body should be straight from head to toe , the legs slightly apart and the arms a little away from the body , with the palms of the hands turned upwards . during yoga nidra there should be no physical movement ( patient closes her eyes and keeps them closed until is told to open ) ( pause ) .
take deep breath and as you breathe out , feel the cares and worries of the day flow out of you . in the practice which follows
, you are going to develop the feeling of relaxation in the body . during yoga nidra
, you are functioning on the levels of hearing and awareness , and the only important thing is to follow the voice of the instructor ( pause ) relaxation : now brings about a feeling of inner relaxation in the whole body ; concentrate on the body and become aware of the importance of complete stillness ( pause ) .
develop awareness of your body from the top of the head to the tips of the toes and mentally repeat the mantra o -- o -- o -- m -- m -- m .
experience complete stillness and complete awareness of the whole body again repeat o -- o -- o -- m -- m -- m ( pause ) resolve : at this moment you should resolve yourself .
the resolve will have to be very simple ; it should be short , positive statement in simple language stated three times with awareness , feeling and emphasis . the resolve you make during yoga nidra
is bound to come true in your life ( pause ) rotation of consciousness : we now begin rotation of consciousness , rotation of awareness by taking a trip through the different parts of the body ( pause ) as quickly as possible the awareness is to go from part to part . repeat the part in your mind and simultaneously become aware of that part of the body .
become aware of the right side , left side , back , front , and major parts ( pause ) breathing : become aware of your breath . feel the flow of your breath in and out of your lungs ( pause ) counting breaths with navel , chest , throat and nostril awareness ; each 27 to 1 image visualization : stop counting and leave your breaths ; we now come to visualization .
a number of different things will be named and you should try to develop a vision of them on all levels of feelings , awareness , emotions , imagination , as best you can resolve : now this is time to repeat your resolve .
repeat the same resolve that you made at the beginning of the practice , do not change it , repeat the resolve three times with full awareness and feeling ( pause ) finish : relax all efforts , draw your mind outside and become aware of your breath ( pause ) , become aware of the natural breath , awareness of the whole body and awareness of breathing ( pause ) .
your body is lying totally relaxed on the floor you are breathing quietly and slowly .
develop awareness of your body from the top of the head to the tips of the toes and say mentally in your mind o -- o -- o -- m -- m -- m ( pause ) .
please take your time , do not hurry . start moving your body . when you are sure that you are wide awake , sit up slowly and open your eyes .
 background : yoga nidra is a successful therapy for both recent and long - standing psychological disturbances of all kinds especially depression and high anxiety level and neurotic patterns.objective:the purpose of the present work , therefore , was to conduct a preliminary randomized study of yoga nidra as a treatment in the patients of menstrual disorders with somatoform symptoms.materials and methods : patients were recruited from department of obstetrics and gynecology , csm medical university ( erstwhile kgmu ) lucknow , uttar pradesh , india . 
 one hundred and fifty female patients with menstrual disorders were randomly divided in to two groups 1- intervention group : 75 subjects ( yoga nidra intervention and medication ) 2- control group : 75 subjects ( without yoga nidra intervention only medication ) . 
 schedule for clinical assessment in neuropsychiatry tool was used.results:there was significant improvement in pain symptoms ( p<0.006 ) , gastrointestinal symptoms ( p<0.04 ) , cardiovascular symptoms ( p<0.02 ) and urogenital symptoms ( p<0.005 ) after 6 months of yoga nidra therapy in intervention group in comparison to control group.conclusion:yoga nidra appears to be a promising intervention for psychosomatic problems . 
 it is cost - effective and easy to implement . 
 the results indicate that somatoform symptoms in patients with menstrual disorder can be decreased by learning and applying a program based on yogic intervention ( yoga nidra ) . 
MATERIALS AND METHODS
Study design and setting
Study participants
Inclusion criteria
Exclusion criteria
Data collection
Yoga Nidra intervention
Data analysis
RESULTS
DISCUSSION
CONCLUSIONS
APPENDIX-1