Effects of Yoga Interventions on Health Outcomes in Women With Gynecological Cancers: A Systematic Review of Randomised Controlled Trials

TL;DR

This review finds that yoga may improve mental health and quality of life in women with gynecological cancers, but more research is needed.

Contribution

The study provides a systematic review of yoga's effects specifically in women with gynecological cancers, highlighting meditative and restorative forms.

Findings

Meditative yoga reduced anxiety, depression, and stress in multiple trials.

Restorative yoga showed better adherence compared to vigorous forms.

Yoga improved quality of life, fatigue, and cognitive function, though with low to moderate evidence.

Abstract

Gynaecological cancers have a profound impact on women's health, with survivors often experiencing a diminished quality of life (QoL) owing to treatment-related symptoms such as fatigue, psychological distress, and cognitive impairment. Yoga, as a mind-body intervention, may offer supportive benefits, although evidence specific to this population remains limited. This systematic review synthesised randomised controlled trials (RCTs) that evaluated the effects of yoga on health outcomes in women with gynaecological cancers. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases (PubMed, Scopus, Web of Science, Cochrane, and Google Scholar) were searched from inception to June 2025. Eligible RCTs included those involving adult women with gynaecological cancers, yoga interventions lasting ≥4 weeks, and outcomes such as QoL, psychological well-being, fatigue, and cognition. Risk of bias was assessed using RoB 2 (Cochrane, London, United Kingdom) (some concerns overall), and a narrative synthesis was conducted owing to heterogeneity. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the certainty of the primary outcomes. Six RCTs comprising 320 participants were included. Meditative yoga (for example, yoga nidra and pranayama) reduced anxiety and depression (P = 0.00001-0.026; narrative standardized mean difference (SMD) -0.56 (95%CI -1.01 to -0.11) for depression, GRADE: moderate) and stress (P<0.0001) in four trials. QoL improved in three trials (P=0.039-<0.05; narrative SMD ~0.3 (95% CI 0.12-0.48), GRADE: low), fatigue in two (P=0.039-<0.05; narrative SMD -1.17 (95%CI -2.16 to -0.18), GRADE: low), and cognitive function in one pilot (P=0.0007 for fluid cognition; Cohen's d=0.6, GRADE: very low). Restorative yoga showed higher adherence than vigorous forms. No adverse events were observed. Preliminary evidence suggests that yoga may enhance psychological well-being, QoL, fatigue, and cognition, which is consistent with broader oncology reviews. Larger, standardised RCTs are necessary to confirm the efficacy of this treatment and inform its integration into supportive care.

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