Original Article

Effect of yogic intervention on quality of life in university

girls with cyclical mastalgia
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

Garima Jaiswal, Ghanshyam Singh Thakur

Department of Naturopathy and Yoga, HNB Garhwal Central University, Srinagar, Uttarakhand, India
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023

Abstract Background: Cyclical mastalgia is a benign breast disease and common phenomena in the reproductive age of
women. It is the pain in the breast mainly felt in previous 5–7 days of the mensuration cycle. This affects the overall
quality of life (QOL) and is linked to fear, fatigue, and other psychological causes. Fear of breast cancer influences
the state of mind and badly affect emotional health and entire physical health. The present study was conducted
to determine the effect of yogic practice on QOL in girls with cyclical mastalgia.
Methods: Forty females having cyclical mastalgia (last 6 months) were recruited for the study and randomly assigned
into two groups (yoga group and control group) with the age range of 20 to 30 years (23.52 ± 2.28). The subjects of both
the groups were assessed for quality of life at the baseline and after completion of experimental period of sixty days.
Results: After completing 60 days yogic intervention, yoga group showed significant improvement after 2 months
of yoga practices and even after the 1-month follow-up in physical health (<0.01), sociological health (<0.05),
environmental health (<0.05), and overall QOL (<0.05) than the control group. Psychological health showed the
significant effect after 1 month of follow-up (>0.05).
Conclusion: The results of present study concludes that the quality of life of university girls suffering from cyclical
mastalgia can be improved after yoga practices.

Key Words: Yoga, quality of life, cyclical mastalgia

Address for correspondence:

Dr. Ghanshyam Singh Thakur, Department of Naturopathy and Yoga, HNB Garhwal Central University, Srinagar,
Uttarakhand, India.
E-mail: ghanshyam.thakur20@gmail.com
Submitted: 17-Feb-2021 Accepted: 06-Apr-2021 Published: 21-Jul-2021

INTRODUCTION Mokbel, 2004). While the etiology of mastalgia is not notable,

The word “breast pain” is frequently used to describe pain
discomfort in one or both breasts, and it ranges from moderate
pain to agonising pain (Smith, Pruthi, & Fitzpatrick, 2004). The
term “Breast Pain” was used by Cooper, in 1829. After that
different terminologies were used for describing breast pain
such as mastalgia, mastodynia, and fibrocystic-breast-disease or
syndrome. A typical condition with an occurrence of 41%–79%
is mastalgia or breast pain (Scurr, Hedger, Morris, & Brown,
2014). It can be divided into three categories: cyclical, extra-
mammary, and noncyclical (Arce-Salinas, Ramirez-Morales,
Alvarado-Miranda, & Lara-Medina, 2014; Gumm, Cunnick, &
Access this article online
Quick Response Code:
Website:
www.ym-kdham.in
cyclical breast pain is interrelated with the menstrual cycle,
with an onset during the late luteal period and menstrual phase
termination or decline and is triggered by natural hormonal
changes that activate ductal elements (estrogen), stroma
(progesterone) or ductal secretion (prolactin), and many more
psychological factors (Dogliotti, Orlandi, & Angeli, 1989). Pain
in the breast is mainly felt in previous 5–7 days of mensuration
cycle. An earlier study showed that pain interferes with all-health
domain of life (Niv & Kreitler, 2001). Previous study shows the
prevalence of high-risk factors, i.e., anxiety, stress, depression,
caffeine, and smoking leading to mastalgia in women and disturbs
This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work non-commercially, as long as
appropriate credit is given and the new creations are licensed under the identical terms.
For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com

DOI: How to cite this article: Jaiswal G, Thakur GS. Effect of yogic
10.4103/ym.ym_6_21 intervention on quality of life in university girls with cyclical mastalgia.
Yoga Mimamsa 2021;53:12-7.

12 © 2021 Yoga Mīmāṃsā | Published by Wolters Kluwer - Medknow

 Jaiswal and Thakur: Yoga for quality of life in mastalgia
the quality of life (QOL) (Kanat et al., 2016). QOL differ by
gender and type of pain condition; there could be high chances
of prevalence of pain and poor QOL in female suffering from
cyclical mastalgia (Azizabadi Farahani & Assari, 2010). Several
earlier studies have reported that various modern treatments such
as Danazol and Bromocriptine improved QOL and pain but the
patient experienced complaints about menstrual irregularities,
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
weight gain, headache, and nausea (Durning & Sellwood, 1982;
Kontostolis, Stefanidis, Navrozoglou, & Lolis, 1997; Kumar
et al., 2010; Mansel & Dogliotti, 1990; Nappi, Affinito, Di Carlo,
Esposito, & Montemagno, 1992; Oksa, Luukkaala, & Mäenpää,
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023
2006). Many studies in relation to yoga and pain management
have shown promising results. However, there are no such studies
which claim the similar effects in mastalgia. The frequency of the
pain in mastalgia disturbs the QOL and it affects the day-to-day
activities. Therefore, the main objective of present study was to
see the impact of yoga practices on QOL in girls suffering from
cyclical mastalgia.
MATERIALS AND METHODS
Forty girls with age range between 20 and 30 years (23.52 ± 2.82)
consented to participate in this study. The subjects were selected
from girls’ hostel of H.N.B.G University, Uttarakhand. These
forty girls were having the symptoms of mastalgia according to
Cardiff breast torment graph. Participants who were engaged,
pregnant, taking prophylactic pills were excluded from the study.
Participants were randomly divided into experiment group (n=20)
and control group (n=20) by using online random sequence
generator. The study was approved by the Institutional Ethical
Committee (Ref. No./2019/04), and written informed consent
was also taken from the participants and superintendent of the
girl’s hostel.
Research design
The present study followed a randomized controlled design.
Forty participants were divided into two groups: experimental
and control groups; each group comprised of twenty participants.
The preassessment was done on the date of menstruation, so all
participants’ QOL was assessed individually. Post data were taken
after 60 days of intervention and follow up data was collected after
one month. Data were taken three times, i.e., pre, post and follow-
up. Yoga module was prepared by specialists and comprised of
Asanas, Pranayama, Meditation, and Kriya (cleansing practice)
[Table 1]. The experimental group participated in yoga protocol
for 90 min. everyday for sixty days. Whereas control group
participants continued with their daily schedule and not allowed
to participate in yoga training.
Assessment
Quality of life
Psychological imbalances reflect by QOL and its result from
augmented responses to incorrectly perceived environmental
situations. QOL was developed by WHO as “Quality of life
BREF” (WHOQOL-BREF), it is a valuable instrument to evaluate
the progressions over the period of treatment of an individual
Yoga Mīmāṃsā | Volume 53 | Issue 1 | January-June 2021
(The World Health Organization QOL (WHO-QoL-BREF,
2004). This tool has recently been standardized for the use in an
Indian population prior and has demonstrated interior reliability
(Cronbach’s α = 0.87), content validity (0.50–0.77), and predictive
validity (0.44–0.63) (Agnihotri, Awasthi, Chandra, Singh, &
Thakur, 2010; Meena et al., 2015). WHOQOL-BREF comprises
26 items with five domains. The questionnaire was having five
options and subjects were asked to give one response best suited
i.e., (1) not at all, (2) a little, (3) moderately, (4) very much, and
(5) extremely. Among these 26 items, question 1 surveyed forecast
about the general impression of QOL, question 2 was utilized to
evaluate the general view of well-being, and the remaining 24
items evaluated four domain of QOL i.e. physical health, social
health, and environmental health.
Data analysis
Statistical analysis was done using Statistical Package for
the Social Sciences software version 20.0 (SPSS-20.0) (IBM
Corporation., Armonk, N.Y., USA). Shapiro–Wilk test was used
to test the normality. Shapiro-Wilk test revealed that the data
was not normally distributed, hence, Man-Whitney test was
used to compare the difference between two groups. Within
group comparison (baseline, post test & follow-up) was done
by Friedman test followd by post hoc Bonferroni adjustment.
Wilcoxon sign-ranked test was performed to detect the statistical
significance of condition as compared to respective baseline
(before condition).
RESULTS
Forty females having cyclical mastalgia were recruited for the
study and randomly assigned into two groups (yoga group and
control group) with the age range of 20 to 30 years.
Between group comparison is presented in Table 2. Mann–
Whitney U-test indicate that the physical health score of yoga
group (Mdn = 23) did not significantly differ from the control
group (Mdn = 21.5), U = 140, p = 0.108, after 2-month. However,
after one month follow up there was significant difference in
physical health score between yoga and control group. (Mdn =
23.5) was significantly different than the control group (Mdn = 20),
U = 118.5, p < 0.026. In psychological health score of yoga group
(Mdn = 20) there was no significant difference between yoga and
control group after two months. (Mdn = 19), U = 138, p = 0.096.
However, significant difference was observed in yoga and control
group after one month follow-up. (Mdn = 20) was significantly
different than the control group (Mdn = 18), U = 121.5, p = 0.033.
Sociological health score of yoga group (Mdn = 10.5) In case of
sociological health there was no significant difference in yoga and
control group after two months. However, one month follow-up
showed significant difference. (Mdn = 9), U = 120.5, p = 0.030,
after 2-month scores. Further, again at 1-month follow-up scores
in the yoga group (Mdn = 10.5) was significantly different than the
control group (Mdn = 9), U = 110.5, p = 0.014 In environmental
health significant difference between yoga group (Mdn=28) and
control group (Mdn=23) U=108, p=0.012 was observed. Further,
13
 Jaiswal and Thakur: Yoga for quality of life in mastalgia

Table 1: List of yogic practice

Intervention Time
Opening mantra ‑ gayatri mantra 1 min
Yogic breathing 2 min
Pawan muktasana series ‑ 1 10 min
Surya namaskar 10 min
Posture (asana)
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

Standing poses (asana) 4 min

Aardhakaticakrāsana (Halfwaist wheel pose) 1 min
Pad hastasana 1 min
Ardhacakrāsana (Halfwheel pose) 1 min
Trikonāsana (Triangle pose) 1 min
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023

Sitting poses 5 min

Pashchimmotanasana 1 min
Gomukhāsana (Cow face pose) 1 min
Uśtrāsana (Camel pose) 1 min
Saśankāsana 1 min
Vakrāsana (Twisted pose) 1 min
Prone poses 3 min
Bhujangāsana (Cobra pose) 1 min
Dhanurāsana (Bow pose) 1 min
Salabhāsana (Locust pose) 1 min
Inverted poses 1 min
Sarvāngāsana (Shoulder stand) 1 min
Deep relaxation (yoga nidra) 20 min
Pranayama and kriya 12 min+15 min
Kapalbbhati 40 stroke×3
Nadishodhan 9 cycle
Bhastrika 20×3 round
Bhramari 9 rounds
Kriya Once in a week
Jalneti
Kunjal
Meditation 5 min
Chanting of a, u, m, and om (nādānu sandhāna) 03 round each 5 min
mantra
Shanti path 2 min
Total time 1 h 30 min

Table 2: Mean standard deviation and median score of quality of life in yoga and control group
Yoga (n=20), mean±SD (median) Control (n=20), mean±SD (median)
Before After 2 months 1 month Before After 2 months 1 month
follow‑up follow‑up
Physical 22.60±2.98a (22) 22.70±2.87 (23) 23.20±3.22c (23.5) 20.75±2.88 (20) 21.05±2.87 (21.5) 20.70±3.54 (20)
health
Psychological 19.60±3.08a (20) 20.20±2.89 (20) 20.15±2.87a (20) 17.90±3.16 (17) 18.25±3.92 (19) 17.70±3.61 (18)
health
Sociological 10.35±1.87 (11) 10.45±1.19a (10.5) 10.65±1.57a (10.5) 9.25±2.61 (9) 9.50±1.96 (9) 9.35±1.63 (9)
health
Environmental 26.70±4.59a (28) 27.55±3.72a (28) 27.70±4.07c (28) 23.25±5.49 (22.5) 23.20±6.18 (23) 22.35±4.70 (22.5)
health
Overall QOL 79.70±9.80 80.90±7.70 81.70±8.55 (83.50)c 71.15±11.97 72.00±12.33 70.10±10.87
(81.00)a (80.50)a (68.50) (72.50) (69.00)
*p<0.05; **p<0.01; ***p<0.001 (Within group comparisons); ap<0.05; bp<0.01; cp<0.001 (between groups comparisons at before, after 2 months, and 1 month
follow‑up comparisons). QOL, quality of life; SD, standard deviation

after one month follow-up significant difference was seen between
yoga (Mdn=28) and control group (Mdn=22.5) U=77, p<0.001.
Overall, QOL showed significant changes between group
comparison. After 2 months, yoga group (Mdn = 80.5)
significantly differed than the control group (Mdn = 72.5), U =
108, p = 0.012, Also after 1 month follow-up score of yoga group
(Mdn = 83.50) significantly differed than the control group (Mdn
= 69), U = 86.5, p < 0.002.
However, within group comparison, Friedman test showed that
there was no significant difference in all the domains of QOL

14 Yoga Mīmāṃsā | Volume 53 | Issue 1 | January-June 2021

 Jaiswal and Thakur: Yoga for quality of life in mastalgia
[Table 2]. Post hoc test using a Wilcoxon signed-ranked test with
a Bonferroni-adjusted alpha level of 0.017 (0.05/3) showed no
statistically significant difference in before, after 2 months and
1-month follow-up in all domains. Yoga intervention showed
nonsignificant increase trend in the QOL domains, whereas control
group showed a nonsignificant decrease trend in QOL scores.
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
DISCUSSION
The result of this randomized control trial of 2 months yoga
intervention could improve QOL’s domain; physical health,
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023
psychological health, social health, and environmental health
in girls suffering from mastalgia. In the present research,
participants were girls suffering from mastalgia. Previous study
shows the prevalence of high-risk factor, i.e., anxiety, stress,
depression, caffeine, and smoking associated with mastalgia
in women and disturbs QOL (Kanat et al., 2016). The research
has demonstrated that severe mastalgia in women’s daily lives
can be attributed to a rise in fear of breast cancer (Leinster,
Whitehouse, & Walsh, 1987), it may lead to a disturbance of the
QOL. In a large-scale analysis, cyclic mastalgia has been shown
to affect domain of QOL such as sleep status by 10%, 6%, and
13%, physical activity by 36%, and sexual activity by 48% (Ader
& Browne, 1997). In this perspective Indian traditional yoga
practices were found beneficial in improving QOL in various
patients who are dealing with pain (Cramer, Rabsilber, Lauche,
Kümmel, & Dobos, 2015; Russell, Daniels, Smoot, & Allen,
2019). It is evident from past randomized controlled trial with
six month follow-up that QOL and depression scores improved
Figure 1: The graphical representation of change in physical health
score. Line graph for physical health mean shift from the baseline,
intervention at the end of 2 months, and follow-up after 1month
between the yoga group (n = 20) and control group (n = 20)
Figure 2: The graphical representation of change in psychological
health score. Line graph for psychological health mean shift from
the baseline, intervention at the end of 2 months, and follow-up
after 1 month
Yoga Mīmāṃsā | Volume 53 | Issue 1 | January-June 2021
with yoga among nursing students with mastalgia (Raghunath,
Raghuram, Ravi, Ram, & Ram, 2016).
The first domain of QOL is physical health, and it deals with
feature such as mobility, fatigue, pain, sleep, and work capacity,
etc. The results revealed that after practicing yoga for 2 months
physical health of the girls with mastalgia was significantly
improved (<0.05) as compared to the control group which shows
efficacy of yoga in physical health’s domain [Figure 1]. Similar
positive effect was observed in psychological health domain
[Figure 2] of QOL which deals with issues related to emotions,
self-esteem, faith, perception, understanding, and memory.
Yoga is defined as “mastery over the changes of the mind”
(Patanjali) (Swami Prabhavananda, 2002), which is the goal of
the integrated yoga programme. Multiple studies have shown
the impact of yoga on the reduction of anxiety, (Tang, Holzel,
& Posner, 2015) depression, and stress (Carmody & Baer, 2008)
with better mental well-being as shown by improved perceptual
skills (Telles, Nagarathna, & Nagendra, 1995). This study also
shows the significant improvement (p < 0.05) in social health
domain [Table 2] which implies the improvement [Figure 3] in
personal relationships, social support, and sexual activity. There
seems to be an element of yoga practise related to the culture that
can be helpful to one’s social and spiritual health. Yoga could be
useful for emotionally isolated groups, such as those who are
elderly, bereaved, and lonely, as well as those who are having
relationship crisis (Kishida, Mogle, & Elavsky, 2019; Ross,
Bevans, Friedmann, Williams, & Thomas, 2014). The last domain
of QOL is environmental health which also improved (p < 0.05)
Figure 3: The graphical representation of change in sociological
health score. Line graph for sociological health mean shift from the
baseline, intervention at the end of 2 months, and follow-up after 1
month
Figure 4: The graphical representation of change in environmental
health score. Line graph for environmental health mean shift from
the baseline, intervention at the end of 2 months, and follow-up after
1 month
15
 Jaiswal and Thakur: Yoga for quality of life in mastalgia
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
Figure 5: The graphical representation of change in overall QOL
score. Line graph for overall QOL mean shift from the baseline,
intervention at the end of 2 months, and follow-up after 1 month
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023
after the 2 months of yoga practices [Figure 4]. Environmental
dimensions are one of the major influences of QOL (Streimikiene,
2015). This study also measured overall QOL [Table 2] and result
revealed that yoga can significantly (p < 0.05) improve [Figure
5] Overall QOL after the 2 months of practicing and after the
1-month follow-up (p < 0.05). Mastalgia has been reported as a
condition that impacts individual’s QOL (Ali, 2017). This study
can be useful for girls who are having low QOL during the breast
pain (Salgado, Mardini, & Chen, 2005). After practicing of yoga,
girls experienced less frequency of breast pain. The limitation
of present study is that it included small sample size and shorter
duration. In fact, long term studies are needed to substantiate the
findings of present study.
However, future study on the larger population is required to
confirm the beneficial effects of yoga. Since this study was
limited to measure the QOL in girls suffering from mastagia, the
other related factors of breast pain such as breast pain chart and
biochemical factors will be required to clarify the role of yoga in
the prevention of breast pain in girls during the menstruation cycle.
CONCLUSION
Mastalgia is very common complaint in females. Mastalgia in
young women is associated with anxiety and depression which
hampers QOL. Yoga intervention has showed significant change
in QOL as compared to control group in females suffering from
mastalgia.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
Ader, D. N., & Browne, M. W. (1997). Prevalence and impact of cyclic
mastalgia in a United States clinic-based sample. American Journal
of Obstetrics and Gynecology, 177 (1), 126-132. doi: 10.1016/S0002-
9378(97)70450-2.
Agnihotri, K., Awasthi, S., Chandra, H., Singh, U., & Thakur, S. (2010).
Validation of WHO QOL-BREF instrument in Indian adolescents. Indian
Journal of Pediatrics, 77 (4), 381-386. doi: 10.1007/s12098-010-0041-1.
16
Ali, A. (2017). Mastalgia : psychological intervention and its impact on
quality research article mastalgia : psychological intervention and its
impact on quality of life. International Journal of Current Research,
9(3), 47985-47987.
Arce-Salinas, C., Ramirez-Morales, R., Alvarado-Miranda, A., &
Lara-Medina, F. (2014). Mastalgia. In Benign Disease of the Breast:
Diagnosis and Treatment (pp. 167-176). Mexico Nova Science Publishers,
Inc. doi: 10.3810/pgm.1997.11.369.
Azizabadi Farahani, M., & Assari, S. (2010). Relationship between pain
and quality of life. In Handbook of Disease Burdens and Quality of Life
Measures (pp. 3933-3953). New York: Springer. doi: 10.1007/978-0-
387-78665-0_229.
Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice
and levels of mindfulness, medical and psychological symptoms and
well-being in a mindfulness-based stress reduction program. Journal of
Behavioral Medicine, 31 (1), 23-33. doi: 10.1007/s10865-007-9130-7.
Cooper, A., Fripp, G. D., & Bristol Medical Library Society,. (1829).
Illustrations of the diseases of the breast. Medical Heritage Library,
London.
Cramer, H., Rabsilber, S., Lauche, R., Kümmel, S., & Dobos, G. (2015). Yoga
and meditation for menopausal symptoms in breast cancer survivors - A
randomized controlled trial. Cancer, 121 (13), 2175-2184. doi: 10.1002/
cncr.29330.
Dogliotti, L., Orlandi, F., & Angeli, A. (1989). The endocrine basis of benign
breast disorders. World Journal of Surgery, 13 (6), 674-679. doi: 10.1007/
BF01658413.
Durning, P., & Sellwood, R. A. (1982). Bromocriptine in severe cyclical
breast pain. British Journal of Surgery, 69(5), 248–249. doi: 10.1002/
bjs.1800690505.
Gumm, R., Cunnick, G. H., & Mokbel, K. (2004). Evidence for the management
of mastalgia, 20 (5), 681-684. doi: 10.1185/030079904125003377.
Kanat, B. H., Atmaca, M., Girgin, M., Ilhan, Y. S., Bozdağ, A., & Özkan, Z.,
… Emir, S. (2016). Effects of mastalgia in young women on quality of
life, depression, and anxiety levels. Indian Journal of Surgery, 78 (2),
96-99. doi: 10.1007/s12262-015-1325-5.
Kishida, M., Mogle, J., & Elavsky, S. (2019). The daily influences of yoga
on relational outcomes off of the mat. International Journal of Yoga, 12
(2), 103. doi: 10.4103/ijoy.ijoy_46_18.
Kontostolis, E., Stefanidis, K., Navrozoglou, I., & Lolis, D. (1997).
Comparison of tamoxifen with danazol for treatment of cyclical
mastalgia. Gynecological Endocrinology, 11 (6), 393-397. doi:
10.3109/09513599709152566.
Kumar, S., Rai, R., Das, V., Kumar, S., Dwivedi, V., & Agrawal, G. G. (2010).
Visual analogue scale for assessing breast nodularity in non-discrete
lumpy breasts: The Lucknow - Cardiff breast nodularity scale. Breast,
19 (3), 238-242. doi: 10.1016/j.breast.2010.02.002.
Leinster, S. J., Whitehouse, G. H., & Walsh, P. V. (1987). Cyclical mastalgia:
Clinical and mammographic observations in a screened population.
British Journal of Surgery, 74 (3), 220-222. doi: 10.1002/bjs.1800740324.
Mansel, R. E., & Dogliotti, L. (1990). European multicentre trial of
bromocriptine in cyclical mastalgia. The Lancet, 335 (8683), 190-193.
doi: 10.1016/0140-6736(90)90278-D.
Meena, U. K., Sen, R. K., Behera, P., Tripathy, S. K., Aggrawal, S., & Rajoli,
S. R. (2015). WHOQOL-BREF Hindi questionnaire: Quality of life
assessment in acetabular fracture patients. Indian Journal of Orthopaedics,
49 (3), 323-328. doi: 10.4103/0019-5413.156206.
Nappi, C., Affinito, P., Di Carlo, C., Esposito, G., & Montemagno, U. (1992).
Double-blind controlled trial of progesterone vaginal cream treatment
for cyclical mastodynia in women with benign breast disease. Journal of
Endocrinological Investigation: Official Journal of the Italian Scociety of
Endocrinology, 15 (11), 801-806. doi: 10.1007/BF03348808.
Niv, D., & Kreitler, S. (2001). Pain and Quality of Life. Pain Practice, 1 (2),
150-161. doi: 10.1046/j.1533-2500.2001.01016.x.
Oksa, S., Luukkaala, T., & Mäenpää, J. (2006). Toremifene for premenstrual
Yoga Mīmāṃsā | Volume 53 | Issue 1 | January-June 2021
 Jaiswal and Thakur: Yoga for quality of life in mastalgia
mastalgia: A randomised, placebo-controlled crossover study. BJOG: An
International Journal of Obstetrics and Gynaecology, 113 (6), 713-718.
doi: 10.1111/j.1471-0528.2006.00943.x.
Raghunath, S., Raghuram, N., Ravi, S., Ram, N., & Ram, A. (2016). Effect of
yoga therapy on quality of life and depression in premenopausal nursing
students with mastalgia: A randomized controlled trial with 6-month
follow-up. Journal of Health Research and Reviews, 3 (2), 48. doi:
10.4103/2394-2010.184229.
Downloaded from http://journals.lww.com/yomi by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
Ross, A., Bevans, M., Friedmann, E., Williams, L., & Thomas, S. (2014). “I
Am a Nice Person When I Do Yoga!!!”: A Qualitative Analysis of How
Yoga Affects Relationships. Journal of Holistic Nursing, 32 (2), 67-77.
doi: 10.1177/0898010113508466.
Russell, N., Daniels, B., Smoot, B., & Allen, D. D. (2019). Effects of yoga on
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 10/28/2023
quality of life and pain in women with chronic pelvic pain: Systematic
review and meta-analysis. Journal of Women’s Health Physical Therapy,
43 (3), 144-154. doi: 10.1097/JWH.0000000000000135.
Salgado, C. J., Mardini, S., & Chen, H. C. (2005). Mastodynia refractory to
medical therapy: Is there a role for mastectomy and breast reconstruction?
Plastic and Reconstructive Surgery, 116 (4), 978-983. doi: 10.1097/01.
prs.0000178073.63595.a2.
Scurr, J., Hedger, W., Morris, P., & Brown, N. (2014). The prevalence, severity,
Yoga Mīmāṃsā | Volume 53 | Issue 1 | January-June 2021
and impact of breast pain in the general population. The Breast Journal,
20 (5), 508-513. doi: 10.1111/tbj.12305.
Smith, R. L., Pruthi, S., & Fitzpatrick, L. A. (2004). Evaluation and
management of breast pain. Mayo Clinic Proceedings, 79 (3), 353-372.
doi: 10.4065/79.3.353.
Streimikiene, D. (2015). Environmental indicators for the assessment of
quality of life. Intellectual Economics, 9 (1), 67-79. doi: 10.1016/j.
intele.2015.10.001.
Swami Prabhavananda. (2002). Patanjali Yoga Sutras. Sri Ramakrishna
Math Chennai. Retrieved from https://istore.chennaimath.org/products/
patanjali-yoga-sutras/1309294000102321918.
Tang, Y. Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of
mindfulness meditation. Nature reviews. Neuroscience, 16(4), 213–25.
https://doi.org/10.1038/nrn3916.
Telles, S., Nagarathna, R., & Nagendra, H. R. (1995). Improvement in
visual perception following yoga training. - PsycNET. Journal of Indian
Psychology,13 (1), 30-32. doi: psycnet.apa.org/record/1996-93336-001.
World Health Organization. (‎2004)‎. The World Health Organization quality
of life (‎WHOQOL)‎ - BREF, 2012 revision. World Health Organization.
https://apps.who.int/iris/handle/10665/77773.
17