Journal of Ayurveda and Integrated Medical Sciences

Introduction

Menopause is a natural phenomenon occurs at the age of 45-55 years. Various hormonal changes take place in the body during this phase of life; which results in development of several signs and symptoms that may disturb the routine activities. During reproductive years, women are protected by female hormones, i.e., estrogen and progesterone. With menopause, women enter an estrogen deficient phase in their lives, which accelerates the ageing process resulting into greater vulnerability to psychosomatic problems. These diminished hormonal levels lead to the various symptoms seen in menopausal age which includes vasomotor symptoms like hot flushes, night sweats, headache, insomnia, dizziness, etc.^[1]

Psychological symptoms include poor memory and concentration, insomnia, fatigue, mood swings, anxiety, depression, irritability, sleep apnea, restless leg, loss of self-esteem.^[2][3] Up to 70% of women experience psychogenic symptoms associated with perimenopause and menopause. So, menopausal health demands even higher priority in Indian scenario.^[4]

The eight limbs of Yoga (Ashtang Yoga) - Yama, Niyam, Aasana, Pranayama, Pratyahar, Dharana, Dhyana, Samadhi. Pranayama being the most relaxing technique which help in relaxing the body as well as mind. Pranayamasand are considered a form of meditation in itself, as well as a preparation for deep meditation. They promote physical well-being and self-awareness, improve lung and cognitive capacities, reduce blood pressure, anxiety, and other psychosomatic patterns, probably by increasing the parasympathetic tone.^[5]

Although Pranayama therapy is a useful as a adjuvant therapy for menopausal women. Current evidence indicates that women will get benefits from Pranayama during menopausal transition in term of improved psychological wellbeing, sleep patterns & emotional modulation by enhancing the quality of life.^[6] While Yoga offers numerous benefits, and many studies have explored its effects related to menopause,^[7] there is limited research focusing on individual Pranayama techniques, particularly in relation to psychological aspects of menopause. Bhramari Pranayama, known for its health benefits, lacks sufficient scientific evidence supporting its effects.

Surya Bhedana Kumbhaka, Ujjayi Kumbhaka, Siktari Kumbhaka, Sitali Kumbhaka, Bhastrika Kumbhaka, Bhramari Kumbhaka, Murccha Kumbhaka, Plavini Kumbhaka, highlighting the importance of air retention.^[10]

Bhramari Pranayama^[11]

वेगाद्घोषं पूरकं भृङ्गनादं भृङ्गीनादं रेचकं मंदमंदम् । योगीन्द्राणामेवमभ्यास योगाच्चित्ते जाता काचिदानंदलीला ।।(ह.यो.प्र.२/६८)

Sound is produced like the large black bee (Bhramara) during Prāṇāyāma, the name called it as a Bhramari.

Method

1. Sit in Padmāsana, Siddhāsana, Vajrāsana or Sukhāsana with the back erect.
2. Perform Jalandhara Bandha.
3. Close the eyes & look inwards.
4. Exhale completely.
5. Take slow, deep, steady breath through both nostrils. Fill the lung
6. With hold the breath with Mula Bandha.
7. Exhale slowly with humming round like a black bee.
8. Repeat the cycle five to ten minutes.

Benefits^[12]

1. Beneficial in insomnia.
2. Relieves stress, tensions, anger, anxiety, & blood pressure
3. Improves the voice & throat ailments.

Menopause

Menopause means permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity. It is the point of time when last and final menstruation occurs. The clinical diagnosis is confirmed following stoppage of menstruation (amenorrhea) for twelve consecutive months without any other pathology. As such, a woman is declared to have attained menopause only retrospectively Serum follicle-stimulating hormone (FSH) level is found elevated around the period of menopause (45-55 years).^[13]

Causes

Menopause is a natural process that occurs as the ovaries ages and produce less reproductive hormones.^[14] The body begins to undergo several changes in response to lower levels of :

The acoustic vibrations from the humming sound serve as a beneficial stimulus for the brain, soothing the brain and nerves, leading to significant positive effects.^[18]

The Bhramari is one type of Pranayama. Its simplicity of slow breathing and that it could be easily practiced by everyone irrespective of their age or gender makes it notifiable. In Bhramari Pranayama, the practitioner will sit in any comfortable posture and inhale and exhale through nostrils slowly and deeply. While exhaling, will have to produce sound (humming sound) like bumble bee strictly through nasal airways, keeping oral cavity closed by the lips, ears closed by fingers,^[19] the self induced humming sound in this practice resembles Mantra repetition technique. Bhramari Pranayama changes the normal breathing rhythm, with prolonged exhalation and short inhalation, which produces significant impact in physiological system.^[20]

Practice of Bhramari Pranayama for 5-10 min continuously induce subjective feelings of mind refreshment and blissfulness and sometimes the subjects are believed to go to even meditative state.^[21] So Bhramari Pranayama technique is not only a breathing practice but also a form of meditation. As compared with other Pranayama, it does not have any kind of breath holding or alternate nostril involvement with counting. Added to above, the humming sound which is produced during the breathing gives more attraction and interest to the subjects for practicing the Pranayama. In this, it's very convenient to control and check the correctness by the sound of humming which is produced by the Pranayama practitioners. It has been reported that the practice of Bhramari Pranayama is effective for Treating hormonal imbalance conditions and other disorders like anxiety and depression, and extremely beneficial in gynaecological diseases.

Bhramari Pranayama directly impacts the hypothalamus, pituitary, and pineal glands, helping to restore balance to the body's endocrine system. The vibrations from Bhramari Pranayama stimulate the hypothalamus, which plays a key role in maintaining homeostasis. This, in turn, helps regulate the pituitary gland, the master gland that controls the secretion of sex hormones, growth hormones, thyroid hormones, and adrenal hormones.

12. Rao M, Pranayama, Bramari Pranayama, editor, Textbook of Swasthavritta, 1st edition,varanasi: Chaukhamba Orientalia; 2021,ISBN 978-81-949809-4-0, page no.284.
13. Dutta D, Menopause, Definations, Konar H, editor, Textbook of Gynecology, 7^th edition,New Delhi: Jaypee; 2016, page no.46.
14. https://search.app/FckyRGVLhweKqSqp7
15. Dutta D, Menopause, Symptoms, Konar H, editor, Textbook of Gynecology, 7^th edition,New Delhi: Jaypee; 2016, page no.48.
16. Dutta D, Mnopause, Treatment, Konar H, editor, Textbook of Gynecology, 7^th edition,New Delhi: Jaypee; 2016, page no.49-50.
17. Kuppusamy M, Kamaldeen D, Pitani R, Amaldas J, Shanmugam P. Effects ofBhramari Pranayamaon health - A systematic review. J Tradit Complement Med. 2017 Mar 18;8(1):11-16. doi: 10.1016/j.jtcme.2017.02.003. PMID: 29321984; PMCID: PMC5755957.
18. Kumar A, venkatesh S, Effect of Short-Term Practice of Bhramari Pranayama on Sleep Quality and Perceived Stress in School Student, International Journal of Physiology, January -March 2021;9(1): 2
19. Saraswati S.S. 2009. Asana Pranayama Mudra Bandha.
20. Jerath R., Edry J.W., Barnes V.A., Jerath V. Physiology of long pranayamic breathing: neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Med Hypotheses. 2006;67(3):566–571. doi: 10.1016/j.mehy.2006.02.042.
21. Rajkishor P., Fumitoshi M., Bakardjia H., Vialatte F., Cichocki A. Paper Presented at: SCIS & ISIS. 2006. EEG changes after Bhramari Pranayama
22. Upadhye J, Health benefits of Bhramari Pranayama, International Journal of Physiology, Nutrition and Physical Education, 2019;4(2): 1 ISSN 2456-0057, Accepted: 15-06-2019