Integrated Core Stability Exercises and Yoga Program on Premenstrual Syndrome

Premenstrual syndrome (PMS) is a common health problem that affects women during the reproductive age. It is a menstrual disorder characterized by a cluster of physical, psychological and behavioral symptoms that manifest cyclically during the luteal phase of the menstrual cycle and resolve rapidly within a few days of the onset of menstruation.

University students are the most vulnerable group to the severe form of PMS due to poor sleep quality, unorganized dietary habits, high caffeine consumption, and chronic academic stress.

Management of PMS usually includes both pharmacological and nonpharmacological modalities. Pharmacological interventions typically serve as the first line of defense for severe presentations. Physical exercise is one of the non-pharmacological interventions for management of PMS that is safe, highly effective and inexpensive. Regular physical activity stimulates the release of beta-endorphins (natural analgesics), reduces circulating cortisol levels, improves systemic blood flow and downregulates inflammatory processes

• exercises program (Behavioral): practice an integrated yoga and core stability exercises program for 60 minutes, 3 times/week, for 8 weeks.

Primary outcomes

• Reduction in premenstrual syndrome symptoms severity [after 4 weeks , (follow up) after 8 weeks]: Nursing students who practice in an integrated yoga and core stability exercises program experience reduction in premenstrual syndrome symptoms severity than nursing students who do not practice yoga and core stability exercises.

Sex: Female, ages: 15 Years to 25 Years

Inclusion Criteria:

* 1\. Aged 15- 25 years. 2. Have normal body mass index (20 - 29 kg/m2). 3. Have PMS symptoms that resolve within 4 days after the onset of menstruation and are present during ≥3 consecutive symptomatic cycles.

  4\. Have at least 6 months of regular cycles (21-35 days and 4-7 days of blood flow).

  5\. Have a smartphone with WhatsApp application.

Exclusion Criteria:

* 1\. Presence of diabetes, mental and physical illness, or diagnosed psychological disorder.

  2\. History of joint movement and muscle diseases, endometriosis, pregnancy or lactation period, smoking and alcohol use, polycystic ovary syndrome, or oral contraceptive and antidepressant use.

  3\. Participating in other exercise programs, being a licensed athlete, or use vitamin-mineral or herbal supplement.

  4\. Adolescent students who consume painkillers or herbal medicines during the intervention or perform other non-pharmacological interventions.