Effectiveness of mindfulness-based interventions on mental health in natural menopause: a systematic review and meta-analysis

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Abstract

BACKGROUND: There are currently more than 750 million women worldwide aged 40-60 years, the age during which the majority undergo menopausal transition. This period is often marked by challenging symptoms that affect physical and mental health, productivity, and quality of life, sometimes becoming severe enough to compromise personal and professional relationships. A substantial proportion of women experience mental health symptoms such as anxiety, depression and cognitive complaints. Mindfulness-based interventions (MBIs) have shown promising results in alleviating menopausal symptoms and represent a safe, self-managing alternative or complement to pharmacological treatments. OBJECTIVES: To consolidate and review the current state of the literature on the effectiveness of MBIs for mental health symptoms, including anxiety, depression, and cognitive function in women undergoing natural menopause. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It included randomized and non-randomized controlled trials of MBIs in women undergoing natural menopause. The outcomes of interest were mental health, including anxiety, depression, and cognitive function. Databases searched included PubMed, Embase, PsycInfo, CINAHL, and Web of Science. Searches were performed up to October 2025. Reference lists and specialist journals were also hand searched. The methodological quality and risk of bias of the included studies were assessed using the Cochrane Risk of Bias 2.0 (RoB 2) and the Newcastle-Ottawa Scale (NOS). An exploratory random-effects meta-analysis was conducted where measurement consistency permitted. RESULTS: Ten studies (eight randomized controlled trials and two quasi-experimental designs), including a total of 1,270 participants, met the inclusion criteria. Six studies assessed psychosocial quality of life using the MENQOL Psychosocial Domain, enabling meta-analysis; a large pooled effect favoured MBIs (Hedges' g = -1.06, p < 0.001). Secondary outcomes of anxiety and depression, measured independently, showed smaller effects. No study assessed cognitive function using validated cognitive instruments. CONCLUSIONS: Preliminary evidence suggests mindfulness-based interventions may improve mental health symptoms during natural menopause. The discrepancy between composite psychosocial effects and standalone mood effects may reflect measurement differences between menopause-specific and generic instruments, or suggest that cognitive complaints contribute to the observed benefits. However, substantial methodological limitations temper confidence in these findings. Future research should prioritise validated cognitive assessment as an independent outcome, investigation of practice dose required to maintain benefits, and comparative effectiveness trials against established treatments.

Abstract as published, via PubMed.