Effect of Three Yoga Poses (Cobra, Cat and Fish Poses) in Women with Primary Dysmenorrhea: A Randomized Clinical Trial

  • Zahra Rakhshaee
    Address correspondence to: Zahra Rakhshaee, MS, Department of Midwifery, Islamic Azad University, Rasht Brunch, 41335-3516, Rasht, Iran
    Department of Midwifery, Islamic Azad University, Rasht Branch, Rasht, Iran
    Search for articles by this author
Published:April 22, 2011DOI:



      We have evaluated the clinical efficacy of yoga for primary dysmenorrhea. Primary dysmenorrhea occurs in 50% of female adolescents and is a common problem in women of reproductive age. We have assessed whether three yoga poses (Cobra, Cat, and Fish Poses) are able to reduce severity and duration of primary dysmenorrhea.


      To determine the effectiveness of yoga in adolescents with primary dysmenorrhea, 92 girl students,18–22 years old, were randomly assigned to an experimental group (n = 50) and a control group (n = 42). The Visual Analog Scale for Pain was used to assess intensity of pain and the pain duration was calculated in terms of hours. Each group was evaluated for three menstrual cycles. At first cycle no method was presented; the participants only were asked to complete the questionnaire of menstrual characteristics during their menstrual. Then the participants were asked by the experimental group to do yoga poses at luteal phase, and also to complete the menstrual characteristics questionnaire in during of menstruation. The control group did not receive any intervention except to complete menstrual characteristics questionnaire in during of menstruation.


      There was a significant difference in the pain intensity and pain duration in the post-tests compared with the pretest in yoga group (P < 0.05). The results showed that compared with the Control group, there was a significant difference in the pain intensity and pain duration in the experimental group (P < 0.05).


      Yoga reduced the severity and duration of primary dysmenorrhea. The findings suggest that yoga poses are safe and simple treatment for primary dysmenorrhea.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Maxson W.S.
        • Rosenwaks Z.
        Dysmenorrhea and premenstrual syndrome.
        in: Copeland L.J. Textbook of Gynecology. WB Saunders, Philadelphia2000: 513-514
        • Banikarim C.
        • Chacko M.R.
        • Kelder S.H.
        Prevalence and impact of dysmenorrheal on Hispanic adolescent adolescents.
        Arch Pediatr Adolesc Med. 2000; 154: 1226
        • Harel Z.
        A contemporary approach to dysmenorrhea in adolescents.
        Paediatr Drugs. 2002; 4: 797
        • Slap G.B.
        Menstrual disorders in adolescence.
        Best Pract Res Clin Obstet Gynaecol. 2003; 17: 75
        • Weissman A.M.
        • Hartz A.J.
        • Hansen M.D.
        • et al.
        The natural history of primary dysmenorrhea: a longitudinal study.
        BJOG. 2004; 111: 345
        • Coco A.S.
        Primary dysmenorrhea.
        Am Fam Physician. 1999; 60: 489
        • Bieglmayer C.
        • Hofer G.
        • Kainz C.
        • et al.
        Concentrations of various arachidonic acid metabolites in menstrual fluid are associated with menstrual pain and are influenced by hormonal contraceptives.
        Gynecol Endocrinol. 1995; 9: 307
        • Pickles V.R.
        Prostaglandins and dysmenorrhea. Historical survey.
        Acta Obstet Gynecol Scand Suppl. 1979; 87: 7
        • Burton W.N.
        • Morrison A.
        • Wertheimer A.I.
        Pharmaceuticals and worker productivity loss: A critical review of the literature.
        J Occup Environ Med. 2003; 45: 601
        • Majoribanks J.
        • Proctor M.L.
        • Farquhar C.
        Nonsteroidal anti-inflammatory drugs for primary dysmenorrhea.
        Cochrane Database Syst Rev. 2003; (CD001751)
        • Hendrix S.L.
        • Alexander N.J.
        Primary dysmenorrheal treatment with a desogestrel-containing low-dose oral contraceptive.
        Contraception. 2002; 66: 393
        • Proctor M.L.
        • Farquhar C.
        Clin Evid. 2002; 7: 1639
        • Proctor M.L.
        • Smith C.A.
        • Farquhar C.M.
        • et al.
        Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhea.
        Cochrane Database Syst Rev. 2002; 1 (CD002123)
        • Taylor D.
        • Miaskowski C.
        • Kohn J.
        A randomized clinical trial of the effectiveness of an acupressure device for managing symptoms of dysmenorrhea.
        J Altern Complement Med. 2002; 8: 357
        • Proctor M.L.
        • Hing W.
        • Johnson T.C.
        • et al.
        Spinal manipulation for primary and secondary dysmenorrhoea.
        Cochrane Database Syst Rev. 2004; 3 (CD002119)
        • Proctor M.L.
        • Murphy P.A.
        • Pattison H.M.
        • et al.
        Behavioural interventions for primary and secondary dysmenorrhea.
        Cochrane Database Syst Rev. 2007; 3 (CD002248)
        • Amodei N.
        • Nelson R.O.
        • Jarrett R.B.
        • et al.
        Psychological treatments of dysmenorrhea: differential effectiveness for spasmodics and congestives.
        J Behav Ther Exp Psychiatr. 1987; 18: 95
        • Ben-Menachem M.
        Treatment of dysmenorrhea: a relaxation therapy program.
        Int J Gynaecol Obstet. 1980; 17: 340
        • Quillen M.A.
        • Denney D.R.
        Self-control of dysmenorrheic symptoms through pain management training.
        J Behav Ther Exp Psychiatry. 1982; 13: 123
        • Kotani N.
        • Oyama T.
        • Sakai I.
        • et al.
        Analgesic effect of a herbal medicine for treatment of primary dysmenorrheal–a double-blind study.
        Am J Chin Med. 1997; 25: 205
        • Proctor M.L.
        • Murphy P.A.
        Herbal and dietary therapies for primary and secondary dysmenorrhoea.
        Cochrane Database Syst Rev. 2001; 3 (CD002124)
        • French L.
        Am Fam Physician. 2005; 71: 285
        • Harel Z.
        Dysmenorrhea in adolescents and young adults: etiology and management.
        J Pediatr Adolesc Gynecol. 2006; 19: 363
        • Tonini G.
        [Dysmenorrhea, endometriosis and premenstrual syndrome].
        Minerva Pediatrica. 2002; 54: 525
        • Carlson K.J.
        • Eisenstat S.A.
        • Ziporyn T.D.
        The Harvard Guide to Women’s Health.
        Harvard University Press, Cambridge1996
        • Manocha R.
        • Marks G.B.
        • Kenchington P.
        • et al.
        Sahaja yoga in the management of moderate to severe asthma: a randomized controlled trial.
        Thorax. 2002; 57: 110
        • Raub J.A.
        Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: A Literature Review.
        J Altern Complementar Med. 2002; 8: 797
        • Kronenberg F.
        • Fugh-Berman A.
        Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials.
        Ann Int Med. 2002; 137: 805
        • Oken B.S.
        • Kishiyama S.
        • Zajdel D.
        • et al.
        Randomized controlled trial of yoga and exercise in multiple sclerosis.
        Neurology. 2004; 62: 2058
        • Vyas R.
        • Dikshit N.
        Effect of meditation on respiratory system, cardiovascular system and lipid profile.
        Indian J Physiol Pharmacol. 2002; 46: 487
        • Andersch B.
        • Milsom I.
        Epidemiologic study of young women with dysmenorrhea.
        Am J Obstet Gynecol. 1982; 144: 655
        • Chen H.M.
        • Chen C.H.
        Effects of acupressure at the Sanyinjiao point on primary dysmenorrhea.
        J Adv Nurs. 2004; 48: 380
        • Engebretson J.
        Culture and complementary therapies.
        Complement Ther Nurs Midwifery. 2002; 8: 177