Introduction: Primary dysmenorrhea refers to cyclic menstrual pain without an identifiable underlying pathology. This common condition is characterized by cramping during menstruation, often accompanied by symptoms like low backache, nausea, vomiting, headache, or diarrhea. Prostaglandins play a role in dysmenorrhea by stimulating myometrial contractions and causing ischemia. Despite its prevalence, dysmenorrhea can significantly impact physical and mental well-being.

Empiric therapy, including NSAIDs, oral contraceptives, and other medications, is commonly used for management. Non-pharmacological approaches such as exercise, acupuncture, and yoga have also been studied. Yoga, with its holistic approach, may not only alleviate menstrual pain but also improve overall health.

The study aims to assess the effect of yoga on menstrual distress among adolescent girls suffering from primary dysmenorrhea. Additionally, it aims to address knowledge gaps related to menstrual and reproductive health in this population.

Aim: Alleviate menstrual distress and improve overall menstrual health in adolescent girls.

Primary Objective: Evaluate the impact of yoga intervention using the Menstrual Distress Questionnaire (MDQ).

Materials and Methods:

Study Design: Randomized Controlled Trial

Study Site: Government high school in Ranchi

Study Population: Adolescent girls (class 8th to 10th) with primary dysmenorrhea from government and private high schools.

Inclusion criteria:

1. Adolescent girls of class 8^th to 10^th already attained menarche and willing to participate in the study
2. Menstrual pain grading of 3 to 8 on VAS 
3. Having menstrual cycle of 24-38 days with regularity by which no. of days varies ≤ 7-9 days
4. Menstrual bleeding phase of ≤ 8 days
5. Volume of bleed <100 points on Pictorial Blood Assessment Chart (PBAC)

Exclusion criteria:

1. Any pre diagnosed Gynecological condition leading to Secondary dysmenorrhea
2. Already performing Yogic asanas
3. Taking regular medications for Menstrual cramps
4. Any Musculo skeletal disability restricting the intervention.

 Sample size:

Sample Size calculation: From the previous study 

Alpha=0.05 / Z_{(1-α/2) = 1.96}

Power=0.80/Z _{(1-β) = 0.84}

Delta=0.91(μ₂-μ₁)

SD  (σ) = 2.67

Equating the values into the formula: [{Z_(1-α/2)+Z_(1-β)} × (2σ)²] / (μ₂-μ₁)²

 Sample Size in number:125 per group / 250 total

Method of Sample collection: Out of all the schools of the Ranchi city government  1 school will be selected by Simple Random sampling. Well-informed assent will be taken from the pupils, parents and head of the school prior to the study. Participants for the study will be selected as per eligibility criteria, Random allocation will be done using Block Randomization for fixed block sizes into participant population/ Intervention group and non- participant / control group, base line data by pre tested questionnaire will be collected from both the groups. Yoga as an intervention will be given to the intervention group for 3 months period 5 times in a week for a duration of 30-40 mins daily depending on the phase of menstrual cycle the participants are in (according to pre designed verified yoga protocol) preferably at the same time of the day.

Yoga given during menstrual bleeding phase

• Yoga will be instructed by a certified instructor and 
• a detailed booklet of all the asanas to be performed will be distributed to each participant. Participants will be instructed in the presence of school teachers/ PTs, accuracy of yoga being done will be checked fortnightly by the instructor. Investigator will be monitoring the intervention 2 to 3 times a week to check the regularity.
• End point data with the same questionnaire will be collected after the end of 4^th month of intervention at all the phases individually.
• Rescue treatment for the participants will be provided if the pain or other complications arise during the course of intervention and the particular participant will be excluded from analysis.

   Data collection and Statistical analysis:

Both pre-intervention and post-intervention data will be collected. Baseline characteristics of both the group will be compared, drop out, lost to follow-up will be assessed.  Per protocol, analysis will be done. All necessary tests of significance will be applied to prove the findings statistically significant.

Data entry and record will be maintained in Excel sheets using MS Excel and data analysis will be done by IBM SPSS software version 20.0