The Effect of Laughter Yoga and Premenstrual Symptoms

Premenstrual Syndrome (PMS) describes somatic, cognitive, emotional, and behavioral symptoms that occur in women during the luteal phase of the menstrual cycle and resolve with the onset of menstruation. These symptoms are common during the reproductive years. The emotional symptoms of PMS include depression, outbursts of anger, irritability, crying spells, anxiety, confusion, social withdrawal, poor concentration, insomnia, increased short sleep, and changes in sexual desire. Physical symptoms include thirst, appetite changes, breast tenderness, bloating and weight gain, headaches, swelling in the hands or feet, aches and pains, fatigue, skin problems, and gastrointestinal symptoms, which can occur in the days before and after menstruation. While the epidemiology, etiology, and pathophysiology of PMS, first described in the literature in 1931, have not yet been fully elucidated, factors that may contribute to its development include thyroid dysfunction, hormonal changes, neurotransmitters, hypoglycemia, fluid retention, genetic and psychological factors, diet, stress, and lifestyle. Epidemiological studies indicate that PMS affects approximately one-fifth of women. Therefore, while PMS is common in adolescence and young adulthood, it stands out as a significant problem during this period. Premenstrual symptoms negatively impact women's relationships with family, work, and friends, as well as their social activities. They can lead to losses in education and employment, decreased work productivity, increased error/accident rates, alcohol/substance abuse, and criminal behavior, and negative mother-child behavior. It's also known that mental disorders and physical illnesses worsen during the premenstrual period, and psychiatric hospitalizations increase. Furthermore, premenstrual symptoms negatively impact a woman's quality of life, making them an important issue to address early in a woman's life. Numerous treatment methods are used to reduce or eliminate PMS symptoms.

The goal of treatment for PMS is to reduce or eliminate symptoms, reduce negative impacts on activities and relationships, and minimize treatment side effects. A stepwise approach should be implemented in PMS treatment, encompassing non-pharmacological treatment, pharmacological treatment, and surgical treatment. It has been reported that 60% of women with PMS symptoms seek treatment for their symptoms, but only about half as often seek medical attention.

Recommended non-pharmacological treatments include lifestyle changes, education, dietary support, herbal treatment options, acupuncture, and cognitive behavioral therapy. Lifestyle changes include regular exercise, limiting caffeine, salt, and alcohol consumption, eliminating nicotine, and increasing complex carbohydrate intake. Exercise has been shown to reduce PMS symptoms. Shifting focus is particularly important. Cognitive therapy methods and physical activity have been found to reduce PMS symptoms. Alternative medicine methods, in particular, are widely used to reduce PMS symptoms.

Laughter yoga is one of the alternative medicine methods that has recently emerged and is used to maintain and improve health. Laughter is generally considered a visual expression of happiness or a feeling of joy. It also helps clarify one's intentions in social interactions and foster emotional connection in conversations. Laughter is contagious; when a person laughs, the person next to them is often moved and begins to laugh as well. Laughter has been described as a universal phenomenon that can be observed in the body and contributes to irreplaceable social functions. During the emergence of laughter, people establish relationships between objects and attribute specific meanings to them by comparing them with others. The combination of all these factors provides relief. People laugh not only at humor, but also when solving a puzzle, escaping a dangerous situation, winning a game, experiencing disappointment, feeling hopeless, encountering an old friend, feeling embarrassed, or angry. Laughter can occur in a variety of emotional states. Laughter yoga has been found to lower cortisol levels, stabilize blood pressure, and improve quality of life scores, especially after the fourth session. Laughter yoga has been found to have a positive impact on young people's overall health, improving physical well-being and symptoms of sleep disorders, reducing anxiety and depression scores, and improving social functioning. In this context, considering the uses and benefits of laughter yoga, it is thought that it may be effective in reducing PMS symptoms. There are numerous studies in the literature on premenstrual syndrome. However, few studies have investigated the effectiveness of alternative methods for reducing symptoms. No studies have examined the effectiveness of laughter yoga in reducing premenstrual syndrome. This study aims to determine the effects of laughter yoga on quality of life and premenstrual symptoms in young people experiencing premenstrual syndrome.

Inclusion criteria

• Volunteering to participate in the research
• Fully answering survey and scale forms
• Ability to read and understand Turkish
• Being between the ages of 18 and 25 years
• Having regular menstruation (between 21 and 35 days)

Exclusion criteria

• Unwilling to continue working
• Having any problem that prevents communication (such as hearing, speaking, and understanding abilities),
• Having a gynecological disease (abnormal uterine bleeding, uterine fibroids, ovarian cysts, hormonal treatment, etc.)
• Having a chronic or physical illness
• Having a mental illness
• Being under psychiatric treatment (Pharmacotherapy or psychotherapy)
• Taking medication for menopausal symptoms
• Using one of the pharmacological or non-pharmacological methods to reduce premenstrual symptoms (COCs, acupressure, homeopathy, etc.)