{"paper_id":"1860b109-5c07-4a87-9295-81756e1acf0b","body_text":"~ 1563 ~ \nInternational Journal of Clinical Obstetrics and Gynaecology 2025; 9(6): 1563-1571 \n \nISSN (P): 2522-6614 \nISSN (E): 2522-6622 \nIndexing: Embase \nImpact Factor (RJIF): 6.71 \n© Gynaecology Journal \nwww.gynaecologyjournal.com \n2025; 9(6): 1563-1571 \nReceived: 06-09-2025 \nAccepted: 09-10-2025 \n \nDr. Patel Mit Alpeshkumar \nDepartment of Obstetrics and \nGynaecology, Heritage Institute of \nMedical Sciences, Varanasi, Uttar \nPradesh, India \n \nDr. Madhu Jain \nProfessor and Head, Department \nof Obstetrics and Gynaecology, \nHeritage Institute of Medical \nSciences, Varanasi, Uttar Pradesh, \nIndia \n \nDr. Km Archana \nPG Resident, Department of \nObstetrics and Gynaecology, \nHeritage Institute of Medical \nSciences, Varanasi, Uttar Pradesh, \nIndia \n \nDr. Sushmita Singh \nPG Resident, Department of \nObstetrics and Gynaecology, \nHeritage Institute of Medical \nSciences, Varanasi, Uttar Pradesh, \nIndia \n \nDr. Medha Deep \nPG Resident, Department of \nObstetrics and Gynaecology, \nHeritage Institute of Medical \nSciences, Varanasi, Uttar Pradesh, \nIndia \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nDr. Patel Mit Alpeshkumar \nDepartment of Obstetrics and \nGynaecology, Heritage Institute of \nMedical Sciences, Varanasi, Uttar \nPradesh, India \n \nYoga and endometriosis: Exploring mind-body synergy \nin reducing stress and enhancing life quality: A \ncomparative interventional study \n \nPatel Mit Alpeshkumar , Madhu Jain , Km Archana , Sushmita Singh  and \nMedha Deep \n \nDOI: https://www.doi.org/10.33545/gynae.2025.v9.i6k.1830  \n \nAbstract \nIntroduction: Endometriosis is a persistent inflammatory condition that undermines women’s physical and \nemotional well-being, often manifesting as chronic pain, psychological stress, and impaired quality of life \n(QoL). These symptoms can interfere with daily functioning and mental health. Yoga, a  holistic practice \nincorporating posture training, breath regulation, and mindfulness, has been reported to alleviate stress, \nreduce pain, and enhance psychological balance. However, its targeted role in managing endometriosis -\nrelated outcomes remains insufficiently explored. \nAims and Objectives \nAim: To assess the role of yoga as a supportive intervention in women with endometriosis \nObjectives \n1. To assess and compare stress levels in women with endometriosis who undergo a yoga intervention \nand those receiving standard care without yoga. \n2. To evaluate and compare the quality of life of women with endometriosis in the yoga intervention \ngroup versus the standard care group. \n \nMethodology: Seventy patients with confirmed endometriosis were screened; sixty fulfilling the inclusion \ncriteria were enrolled after consent. Participants were randomized equally into two groups: Group A (yoga \nwith routine care) and Group B (standard care only). Tools applied included the Numeric Pain Rating Scale \n(NPRS) and Endometriosis Health Profile-30 (EHP-30), administered at baseline, 3 months, and 6 months. \nThe yoga regimen comprised selected asanas, pranayama, and guided relaxation. \nStatistical Analysis: Data were processed using SPSS v24. Mean differences between groups were \nanalyzed across time points, with significance determined at p<0.05. \nResults: Yoga, combined with standard medical care, significantly improves outcomes in women with \nendometriosis, with a 40% reduction in pain intensity and a 35% improvement in quality of life.  \nConclusion: Yoga significantly reduces pain and stress while enhancing life quality, offering a safe, cost -\neffective, and holistic adjunct to conventional treatment for endometriosis. \n \nKeywords: Endometriosis, yoga, pain, stress, quality of life, holistic therapy \n \nIntroduction  \nEndometriosis is a complex, estrogen -dependent inflammatory disorder marked by the ectopic \ngrowth of endometrial tissue outside the uterus. This condition not only causes cyclical pain, \ndysmenorrhea, dyspareunia, and infertility, but a lso profoundly influences women’s overall \nwell-being. Beyond reproductive health, it has far -reaching effects on physical, psychological, \nand social domains of life. Many women with endometriosis report persistent pain and \nemotional strain, leading to a me asurable decline in quality of life (QoL). With millions of \nwomen affected globally during their reproductive years, the disorder remains a major public \nhealth concern, often under recognized and underdiagnosed because of its diverse clinical \nmanifestations and lack of awareness [1]. \nThe burden of endometriosis is not confined to pelvic symptoms. Women frequently experience \nheightened stress, depression, and anxiety, which can interfere with relationships, workplace \nefficiency, and routine functioning  [7]. A vicious cycle emerges, where pain aggravates \npsychological distress and, conversely, stress amplifies the perception of pain. Advances in \nresearch reveal that mechanisms such as chronic inflammation and neuroangiogenesis contribute  \n\n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1564 ~ \nto the persistence of symptoms and progressive nature of the \ndisease [8]. These insights highlight the need for management \nstrategies that not only control physical pain but also address the \npsychosocial challenges of the disorder. \nConventional treatments, including hormonal  therapies, \nanalgesics, and surgery, play an important role in symptom \ncontrol and disease management. However, recurrence rates \nremain high, and many women continue to struggle with side \neffects and incomplete relief. Standard care frequently overlooks \nthe psychological dimensions, leaving women with an unmet \nneed for more comprehensive approaches [3]. In this context, \ncomplementary and integrative therapies are gaining recognition \nas valuable adjuncts to traditional management. \nYoga, a holistic practice r ooted in physical postures, controlled \nbreathing, and mindfulness, is increasingly explored for its role \nin improving health outcomes. Studies demonstrate its ability to \nreduce stress, enhance relaxation, and improve resilience  [4]. For \nwomen with endometr iosis, yoga offers both physical and \nemotional advantages, such as reduced pelvic pain, improved \nmood, and greater self -awareness [5]. Importantly, yoga provides \na safe, low-cost, and adaptable intervention that can be sustained \nlong-term, in contrast to i nvasive or pharmacological therapies  \n[6]. \nQualitative evidence suggests that women practicing yoga for \nendometriosis-related pain experience empowerment, improved \ncoping skills, and enhanced emotional balance. These benefits, \noften absent in conventional c are, contribute meaningfully to \nself-management and a sense of control over the illness  [5, 9 ]. \nActive coping strategies are particularly vital in chronic \nconditions, as they can directly influence treatment outcomes \nand perceived well-being. Systematic reviews also highlight that \nintegrative approaches, including yoga, contribute to meaningful \nimprovements in pain management and life satisfaction in \nwomen with symptomatic endometriosis [10]. \nConsidering the interplay of pain, emotional stress, and impaired  \nquality of life, there is an urgent need for integrated care models. \nYoga, with its ability to target both physical symptoms and \npsychological well -being, stands out as a highly promising \nadjunct. Although pilot studies and systematic reviews provide \nencouraging evidence, comparative interventional studies remain \nlimited [2]. \nWith this background, the present study aims to assess the role \nof yoga as a supportive intervention in women with \nendometriosis. By combining yoga practices with routine \nmedical care , the study evaluates improvements in pain, stress \nreduction, and quality of life. Through this holistic perspective, \nthe research seeks to generate evidence that can guide the \nintegration of yoga into mainstream gynecological practice, \nthereby offering women a more comprehensive, sustainable, and \nempowering approach to managing endometriosis. \n \nLiterature Review \nEndometriosis exerts a significant influence not only on physical \nhealth but also on intimate relationships and overall life \nsatisfaction. Pluchino N, Wenger JM, Petignat P, et al. reported \nthat sexual function is notably affected in women with \nendometriosis, and these challenges often extend to their \npartners, reflecting the  broad psychosocial impact of the disease  \n[11]. Such findings underline the necessity of treatment \napproaches that focus on improving both physical symptoms and \ninterpersonal well-being. \nFrom an epidemiological perspective, several risk factors have \nbeen identified that may contribute to the development and \nprogression of endometr iosis. McLeod BS, Retzloff MG  \nhighlighted the complex interaction between genetic, hormonal, \nand environmental factors in shaping disease susceptibility, \nunderscoring the importance of comprehensive prevention and \nmanagement strategies [12]. \nThe role of yo ga in addressing chronic pelvic pain has been \nencouraging. Saxena R, Gupta M, Shankar N, Jain S, Saxena A \ndemonstrated that yogic interventions significantly improve pain \nscores and quality of life, providing strong support for its \nintegration as a complem entary therapy in women’s health care  \n[13]. \nQuality of life assessments remain central to evaluating \ntreatment effectiveness. Bourdel N, Chauvet P, Billone V, et al. \nsystematically reviewed various QoL measures and confirmed \ntheir relevance in monitoring o utcomes for endometriosis \npatients, thereby highlighting the value of holistic evaluation  [14]. \nSimilarly, the professional and social consequences of \nendometriosis have been documented. Sperschneider ML, \nHengartner MP, Kohl -Schwartz A, et al . revealed tha t the \ncondition can disrupt work life and career progression , adding \nanother dimension to its burden [15]. \nLarge-scale surveys reinforce these observations. De Graaff AA, \nD’Hooghe TM, Dunselman GAJ, et al . r eported that \nendometriosis significantly affects physical, psychological, and \nsocial well -being across diverse populations, validating the \nglobal relevance of this challenge [16]. \nComplementary and alternative therapies are gaining attention. \nZheng W, Cao L, Xu Z, Ma Y, Liang X reviewed anti -\nangiogenic c omplementary medicines and described their \npotential role in reducing disease activity through novel \nmechanisms [17]. In addition, lifestyle -based approaches such as \nself-care have shown promise. Armour M, Sinclair J, Chalmers \nKJ, Smith CA observed that wo men practicing self-management \ntechniques reported improvements  in coping and daily \nfunctioning, supporting the empowerment of patients in \nmanaging their condition [18]. \nCollectively, these studies highlight the profound burden of \nendometriosis on multiple  aspects of life and emphasize the \npositive potential of integrative, holistic approaches such as \nyoga to improve pain, psychosocial health, and overall quality of \nlife. \n \nAims & Objectives \nAim \nTo assess the role of yoga as a supportive intervention in wome n \nwith endometriosis \n \nObjectives \n1. To assess and compare stress levels in women with \nendometriosis who undergo a yoga intervention and those \nreceiving standard care without yoga. \n2. To evaluate and compare the quality of life of women with \nendometriosis in the yoga intervention group versus the \nstandard care group. \n \nMethodology \n Study Design: Comparative interventional study \n Study Type:  Prospective quasi -experimental study (non -\nrandomized) \n \nPopulation: Women aged 18 -45 years with clinically and \nradiologically con firmed endometriosis attending the \nDepartment of Obstetrics and Gynecology, Heritage Institute of \nMedical Sciences, Varanasi. \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1565 ~ \nSample Size: 60 patients (from 70 screened; 10 excluded as per \neligibility criteria). \n \nInclusion Criteria \n Women aged 18 -45 years w ith confirmed diagnosis of \nendometriosis \n Patients willing to participate and provide informed consent \n \nExclusion Criteria \n Women with major psychiatric illness or chronic systemic \ndisorders \n Women diagnosed with chronic pelvic pain arising from \ncauses other than endometriosis \n Patients already practicing yoga/meditation regularly \n Pregnancy or lactation \n Refusal to participate \n \nData Collection Methods \nDemographic and clinical data (age, BMI, menstrual history, \nduration of symptoms, treatment history) were record ed at \nbaseline. Patients were randomly allocated into two groups \n(n=30 each): \n Group A: Yoga intervention group + standard medical care \n Group B:  Control group receiving standard medical care \nalone \n \nProcedure \nGroup A patients underwent structured yoga sessio ns twice \nweekly for 6 months, supervised by a certified yoga instructor. \nThe regimen included Bhramari pranayama, Vajrasana, \nPawanmuktasana, Marjariasana, Shalabhasana, Ardha \nMatsyendrasana, Ustrasana, Yoga nidra, Baddha konasana, \nSupta baddha konasana, Su pta matsyendrasana, Viparita karani, \nMalasana, Balasana, and Ananda balasana. Each session lasted \n60 minutes. Group B patients continued with their routine \nmedical care. \n \n \n \nBhramari Pranayama \n \n \n \nVajrasana \n \n \nPawanmuktasana \n \n \n \nMarjariasana \n \n \n \nShalabhasana \n \n \n \nArdha Matsyendrasana \n \n \n \nUstrasana \n\n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1566 ~ \n \n \nYoga nidra \n \n \n \nBaddha konasana (Butterfly) \n \n \n \nSupta baddha konasana \n \n \n \nSupta matsyendrasana \n \n \nMalasana \n \n \n \nViparita karani \n \n \n \nBalasana \n \n \n \nAnanda balasana \n\n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1567 ~ \nOutcomes were assessed using \n Pain: Numeric Pain Rating Scale (NPRS) \n Quality of Life:  Endometriosis Health Profile-30 (EHP-30) \nAssessments were done at baseline, 3 months, and 6 \nmonths. \n \nData Analysis \nAll data were  analyzed using SPSS version 24. Continuous \nvariables were expressed as mean ± SD and compared using an \nindependent t-test or repeated measures ANOVA. Categorical \ndata were analyzed using Chi -square test. A p-value <0.05 was \nconsidered statistically significant. \n \nObservations & Results \nDemographic and Clinical Characteristics  \n \nTable 1: Demographic and Clinical Characteristics \n \nCharacteristic Yoga Group (n=30) Control Group (n=30) P-Value \nAge (Mean ± SD) 32.4 ± 4.5 33.1 ± 4.8 0.42 \nHeight (Mean ± SD) 1.62 ± 0.08 m 1.63 ± 0.09 m 0.65 \nWeight (Mean ± SD) 60 ± 8 kg 62 ± 7 kg 0.54 \nBMI (Mean ± SD) 22.5 ± 1.2 23.0 ± 1.4 0.39 \nMarital Status (Single/Married) 12/8 13/7 0.21 \nEmployment Status (Employed/Unemployed) 18/2 16/4 0.32 \n \nStatistical Tests Used \nChi-square test >0.05 = Non-significant \nInterpretation \nThe demographic and clinical profiles of the two groups were \nwell balanced, with no statistically significant differences \nobserved in age, height, weight, or BMI, ensuring comparability \nat baseline. Marital an d employment status were also similar \nbetween groups, with chi -square analysis confirming \nhomogeneity. This strengthens the validity of subsequent \noutcome comparisons, as differences in results can be attributed \nto the intervention rather than baseline var iability. The close \nalignment of characteristics across both groups highlights the \nrobustness of randomization and enhances reliability of the study \nfindings. \n \n \n \nFig 1: Comparison of Demographic and Clinical Characteristics \n \nGraph Interpretation \nThe gra phical representation of demographic parameters shows \nnear-identical distributions between yoga and control groups, \nwith overlapping ranges for age, height, weight, and BMI. \nSimilarly, marital and employment status proportions were \nevenly matched.  \nThis in dicates successful randomization and group \ncomparability, ensuring a fair evaluation of the yoga \nintervention’s impact. The baseline uniformity provides a strong \nfoundation for interpreting improvements in pain, stress, and \nquality of life outcomes with co nfidence in internal study \nvalidity. \n \nTable 2: Pain Intensity Scores (NPRS) \n \nTime point Yoga Group Control Group P-Value \nBaseline 6.8 6.5 0.683 \nPost-Intervention (3 months) 5 6.3 0.004 \nPost-Intervention (6 months) 4.1 6 0.001 \nChange -2.7(40%) -0.5(7.7%)  Total Mean 5.3 6.2666  Statistical Tests Used: Chi-square test >0.05 = Non-significant. \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1568 ~ \nInterpretation \nThe demographic and baseline clinical parameters of the yoga \nand control groups demonstrated no statistically significant \ndifferences (Chi -square test, p>0.05). Both groups were \ncomparable with respect to age, body mass index, height, \nweight, marital status, and employment distribution. This \nuniformity at baseline highlights successful randomization and \neliminates the likelihood of confounding due t o demographic \nimbalance. Such similarity between groups provides a reliable \nfoundation for attributing subsequent changes in pain and quality \nof life specifically to the yoga intervention rather than pre -\nexisting differences. \n \n \n \nFig 2: Pain Intensity Scores over Time \n \nGraph Interpretation \nThe graphical representation of demographic variables shows \nparallel distributions between yoga and control groups, \nreflecting non -significant baseline differences (p>0.05). This \nconfirms effective randomization and ens ures both groups were \nwell-matched. The balanced baseline characteristics allow for \nfair and unbiased comparison of intervention outcomes. The \nsimilarity reinforces the validity of the study, establishing \nconfidence that any observed improvements in pain r eduction \nand quality of life are likely attributable to yoga intervention \neffects rather than demographic variations \n \nTable 3: Quality Of Life (QoL) Improvement Table \n \nGroup Baseline QoL (%) Post-Intervention QoL  \n(3 months) (%) \nPost-Intervention QoL  \n(6 months) (%) Improvement (%) p-value  \n(3 month) \np-value  \n(6 month) \nYoga Intervention 85 70 55 35 0.001 <0.001 Control 90 80 62 15 \nTotal Mean 56 67.5 76     \nInterpretation: The analysis of quality of life outcomes \nrevealed a marked improvement in the yoga intervention group, \nwhere scores declined by 35% over six months, compared to \nonly 15% improvement in the control group. Statistical analysis \nconfirmed significant differences at both 3 months ( p=0.001) \nand 6 months (p<0.001), reinforcing the positive impact of yoga. \nThese findings indicate that regular yoga practice, combined \nwith routine care, substantially enhances overall well -being, \noffering better emotional balance, stress management, and life \nsatisfaction compared to standard medical management alone. \n \n \n \nFig 3: QoL Scores over Time \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1569 ~ \nGraph Interpretation \nThe graphical trend highlights a steady, significant improvement \nin QoL among women practicing yoga, with a sharper \ndownward trajectory in scores compared to the flatter curve of \ncontrols. This sustained progress over six months reflects the \neffectiveness of yoga in enhancing daily functioning and \nemotional health. The visual contrast between groups \nemphasizes yoga’s superior role in improving well -being, \nvalidating its use as a complementary, ho listic therapy in \nendometriosis care. \n \nTable 4: Pain Intensity & QoL outcomes \n \nOutcome Yoga group Control group \n   6 mo Baseline 3 mo 6 mo \nPain Intensity 6.8 5 4.1(40%) 6.5 6.3 6(7.7%) \nQuality of Life (QoL) 85 70 55(35%) 90 80 62(15%) \nP-value 0.683 0.004 0.001 0.53 0.001 0.001 \nStatistical Tests Used: Chi-square test >0.05 = Non-significant. \n \nInterpretation \nThe comparative analysis revealed that women in the yoga group \nexperienced a marked reduction in pain intensity, with NPRS \nscores decreasing by 40 % over six months, compared to only \n7.7% in the control group. Similarly, quality of life improved \nsubstantially, with a 35% decline in EHP -30 scores versus 15% \nin controls. Statistical significance (p<0.05) was observed at 3 \nand 6 months, confirming the t herapeutic benefit of yoga. These \nfindings underscore yoga’s role as a powerful adjunct in \nendometriosis care. \n \n \n \nFig 4: Pain Intensity (NPRS) and Quality of Life (QoL) Over Time \n \nGraph Interpretation \nThe graphical trend highlights a continuous decline in pain \nscores and improvement in quality of life among the yoga group, \ncontrasting with minimal change in controls. Sharp divergence \nbetween the two curves from baseline to six months illustrates \nthe sustained benefit of yoga. The visual pattern reinforce s \nstatistical results, demonstrating that yoga provides superior \nlong-term relief and enhances life quality, making it an effective \nand integrative strategy for endometriosis management \n \n6. Discussion \nThe present study demonstrates that yoga, when combined  with \nstandard medical care, provides significant improvements in \npain reduction, stress management, and quality of life among \nwomen with endometriosis. A 40% reduction in pain intensity \nand a 35% improvement in QoL were observed in the yoga \ngroup compared  to minimal change in controls, reflecting the \nstrong therapeutic potential of mind -body interventions. These \nfindings are consistent with earlier research on yoga and \ncomplementary therapies, which confirm their role in alleviating \nsymptoms and improving daily functioning in women with \nchronic pelvic disorders. \nEvidence from global literature supports these observations. \nGonçalves AV, Barros NF, Bahamondes L  reported that hatha \nyoga effectively reduced pain in women with endometriosis, \nenhancing their abil ity to cope with symptoms and improving \nemotional well-being [19]. Similarly, Tripoli TM, Sato H, Sartori \nMG, De Araujo FF, Girão MJBC, Schor E  highlighted that \nendometriosis not only affects physical health but also sexual \nsatisfaction and overall quality  of life, stressing the importance \nof holistic management strategies [20]. \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 1570 ~ \nYoga as a therapeutic intervention has also been widely \nevaluated. A bibliometric analysis by Jeter PE, Slutsky J, Singh \nN, Khalsa SBS  emphasized the growing scientific interest in \nyoga, demonstrating its versatility in addressing both physical \nand psychological health challenges [21]. Furthermore, Sherman \nKJ proposed structured guidelines for developing yoga -based \nclinical trials, underscoring  the importance of rigorous \nmethodology in validating its therapeutic applications [22]. \nIn the context of chronic pelvic pain, Russell N, Daniels B, \nSmoot B, Allend DD  found that yoga significantly improved \nquality of life and pain outcomes, aligning well with the current \nstudy’s findings [23]. Additionally, lifestyle -focused approaches \nhold promise. A nationwide survey by Armour M, Sinclair J, \nChalmers KJ, Smith CA  showed that self -management \nstrategies, including yoga and complementary practices, were \nwidely adopted by women with endometriosis , contributing to \nenhanced coping mechanisms and functional improvements [24]. \nTaken together, these findings reinforce yoga as a safe, low -cost, \nand effective adjunct to conventional therapies. By addressing \nboth physical and psychosocial dimensions, yoga  empowers \nwomen with endometriosis, improves long -term well-being, and \nsupports integrative care models. \n \nImplications for Clinical Practice \nThe results of this study carry important clinical implications, \ndemonstrating that yoga can be a valuable adjunct to \nconventional medical care for women with endometriosis. The \nsignificant reduction in pain intensity and marked improvement \nin quality of life among participants practicing yoga highlight its \npotential as an integrative, patient -centered approach. Unlike  \npharmacological therapies, yoga is non -invasive, cost -effective, \nand free from adverse effects, making it a highly acceptable \noption for long-term management.  \nFor clinicians, recommending structured yoga sessions can help \naddress the multidimensional cha llenges of endometriosis by \nalleviating physical pain, reducing psychological stress, and \nenhancing emotional well -being. Incorporating yoga into \ntreatment plans may also encourage greater patient engagement \nand self-management, empowering women to take an  active role \nin their care. At a public health level, introducing yoga -based \ninterventions in both tertiary and community healthcare settings \ncould contribute to improved overall outcomes, reduced \nsymptom burden, and enhanced qual ity of life for affected \nwomen. \n \nLimitations \nThe present study, though demonstrating significant benefits of \nyoga in reducing pain and enhancing quality of life, has certain \nlimitations. The relatively small sample size and single -center \nsetting may restrict generalizability of res ults. The short follow -\nup duration of six months also limits assessment of long -term \noutcomes. Despite these constraints, the consistent improvement \nobserved in the yoga group provides strong preliminary \nevidence. Larger multicentric studies with extended follow-up \nare recommended to validate and expand upon these \nencouraging findings.  \n \nConclusion  \nThe present study demonstrates that yoga, when integrated with \nstandard medical care, offers a highly effective and holistic \napproach for the management of endo metriosis. Women in the \nyoga group experienced a 40% reduction in pain intensity and a \n35% improvement in quality of life, which were significantly \ngreater than the changes observed in the control group. These \nfindings highlight yoga’s ability to address b oth the physical and \npsychosocial dimensions of endometriosis, providing sustained \nrelief and enhanced well -being. Unlike pharmacological and \nsurgical therapies, yoga is safe, non -invasive, and cost-effective, \nmaking it a practical option for long -term man agement. By \nincorporating asanas, pranayama, and relaxation techniques, \nyoga improves stress regulation, promotes resilience, and \nempowers women with self -management skills. The consistency \nof benefits across different measures underscores its potential as  \na complementary therapy. Therefore, yoga should be considered \nan important adjunct in the comprehensive care of women with \nendometriosis, offering improved outcomes, better coping \nstrategies, and an enhanced quality of life. \n \nAcknowledgment  \nThe authors e xpress their sincere gratitude to the Department of \nObstetrics and Gynecology, Heritage Institute of Medical \nSciences, Varanasi, for providing continuous guidance, facilities, \nand encouragement throughout the study. Special thanks are \nextended to the yoga instructors for their dedicated support in \nconducting the intervention sessions and to the patients who \nwillingly participated, making this research possible. Their \ncooperation and commitment were invaluable in achieving the \nstudy objectives and generating meaningful clinical insights. \n \nConflict of Interest \nNot available  \n \nFinancial Support  \nNot available \n \nReferences  \n1. Ravins I, Joseph G, Tene L. The effect of practicing \n“endometriosis yoga” on stress and quality of life for \nwomen with endometriosis: AB design pilot study. \nAlternative Therapies in Health and Medicine . \n2023;29(3):8-14. \n2. Mikocka-Walus A, Druitt M, O'Shea M, Skvarc D, Watts \nJJ, Esterman A, et al . Yoga, cognitive -behavioural therapy \nversus education to improve quality o f life and reduce \nhealthcare costs in people with endometriosis: a randomised \ncontrolled trial. BMJ Open. 2021;11(8):e046603. \n3. Maulenkul T, Kuandyk A, Makhadiyeva D, Dautova A, \nTerzic M, Oshibayeva A, et al. Understanding the impact of \nendometriosis on wome n’s life: an integrative review of \nsystematic reviews. BMC Women’s Health. 2024;24:524. \n4. 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International \nJournal of Clinical Obstetrics and Gynaecology 2025; 9(6): 1563-1571.  \n \n \nCreative Commons (CC) License \nThis is an open access journal, and articles are distributed under the terms \nof the Creative Commons Attribution -Non Commercial-Share Alike 4.0 \nInternational (CC BY -NC-SA 4.0) License, which allows others to remix, \ntweak, and build upon the work non -commercially, as long as appropriate \ncredit is given and the new creations are licensed under the identical terms.","source_license":"CC0","license_restricted":false}