Introduction: During the climacteric phase, women face an increased risk of metabolic syndrome (MetS) due to hormonal changes that contribute to abdominal obesity, impaired glucose metabolism, and dyslipidemia. This period is also characterized by symptoms such as hot flashes, night sweats, mood disturbances, sleep difficulties, and genitourinary complaints, which can reduce quality of life and exacerbate metabolic risk. Together, these challenges highlight the need for integrative, non-pharmacological strategies. This study evaluated the long-term effects of a structured yoga program on menopausal symptoms in climacteric women with MetS over 6, 12, and 24 months.
Methods: A total of 102 sedentary women aged 45–60 years with diagnosed MetS were allocated to a Shivam Yoga intervention or control group. The intervention group participated in guided yoga sessions twice weekly. Climacteric symptoms were assessed at baseline and at 6, 12, and 24 months using the Kupperman Index (KI), with scores ≤19 classified as mild, 20–34 as moderate, and >34 as severe. Changes in total and individual symptom scores were evaluated through within- and between-group comparisons.
Results: At all time points, the Yoga group showed significantly lower median KI scores than the Control group (p < 0.05), indicating reduced symptom severity and frequency. The proportion of participants with moderate or severe symptoms was also significantly lower in the Yoga group at 6 months (p < 0.001) and 12 months (p = 0.036). Among individual symptoms, nervousness showed the most pronounced improvement: scores were significantly lower than controls at 6 (−32.3%; p = 0.006), 12 (−39.8%; p = 0.003), and 24 months (−39.1%; p = 0.020), with sustained reductions from baseline. At 6 months, further improvements in insomnia (−23.6%; p = 0.034), depressive symptoms (−29.0%; p = 0.070), and palpitations (−23.2%; p = 0.019) were noted. Benefits persisted or intensified at later time points, with the Yoga group reporting significantly fewer palpitations (−32.2%; p = 0.043) and arthralgia/myalgia (−46.0%; p = 0.007) at 24 months.
Conclusion: Regular practice of Shivam Yoga over 24 months was associated with sustained improvements in climacteric symptoms, particularly nervousness, palpitations, and musculoskeletal discomfort, in women with MetS. These findings support yoga as a promising complementary approach for long-term symptom management during the menopausal transition and post-menopause.
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