Three months of mindful yoga significantly lowered free testosterone levels in women with polycystic ovary syndrome (PCOS), according to the results of a study published in The Journal of the American Osteopathic Association.

Typical treatments for PCOS address individual symptoms or promote weight loss to improve reproductive parameters. A common comorbidity with PCOS is excessive weight, which may hinder some individuals from engaging in the strenuous physical activity often suggested to increase weight loss.

Studies have shown that yoga can improve insulin sensitivity and lipid profiles in women with PCOS, but some previous studies had unrealistic practice parameters and did not study women with hyperandrogenism.

To investigate whether a moderate yoga practice could decrease serum testosterone levels in women with PCOS, researchers recruited 31 premenopausal women aged 22 to 43 years (mean age, 31.2 years) with a body mass index of 20 to 48 kg/m2 and a confirmed diagnosis of PCOS. Women who smoked, used hormone-based medications in the 3 months before the start of the study, used insulin-sensitizing agents, had been diagnosed with another endocrine disorder, were pregnant or breastfed in the 6 months before the beginning of the study, were diagnosed with a major psychiatric disorder, or used antipsychotic medication were excluded. None of the participants had practiced yoga or received osteopathic manipulative treatment or acupuncture within the 6 months before the start of the study. Individuals who did not complete measurements at any time point were excluded.

Participants were randomly assigned to the mindful yoga intervention group (n=20) or the control group (n=11). Women in the mindful yoga intervention group participated in a 3-hour mindfulness training workshop as well as 1-hour group classes 3 times each week for 3 months with the same instructor from February to May 2017. The sessions focused on body awareness, breathing techniques, restorative yoga, and meditation. Participants in the control group were asked not to change any aspects of their daily routine. Assessments of androgen profile measurements, cardiometabolic parameters, and anxiety and depression were completed before and after the 3-month period.

A significant decrease in free testosterone was observed in participants in the mindful yoga group (P =.0413). Scores for anxiety and depression also significantly improved in participants in the yoga intervention group (P =.0365 and P <.0001, respectively). Though not significant, levels of dehydroepiandrosterone (DHEA) also trended lower in the mindful yoga group.

To determine whether improvements in free testosterone levels would last after the end of the trial, individuals in the mindful yoga group who did not continue to practice yoga after the trial were reassessed 3 months after the end of the study. Free testosterone levels remained similar to those at the end of the trial.

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This study showed that thrice-weekly yoga practice significantly improved free testosterone levels in women with PCOS and also improved DHEA, anxiety, and depression levels, suggesting that mindful yoga may be a holistic, effective therapy that is potentially more accessible and realistic to implement than aerobic exercise.

A limitation to this study was its small sample size. Future studies should examine different types of yoga and isolated mindfulness in PCOS and whether mindful yoga has particular benefits for individuals of a specific age or body mass index.

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Reference

Patel V, Menezes H, Menezes C, Bouwer S, Bostick-Smith CA, Speelman DL. Regular mindful yoga practice as a method to improve androgen levels in women with polycystic ovary syndrome: a randomized, controlled trial. J Am Osteopath Assoc. 2020;120(5):323-335.