Physical exercise and mind-body exercise in the menopausal transition: A systematic review and meta-analysis of effects on quality of life, symptoms, and psychological health

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Abstract

OBJECTIVES: The climacteric period is associated with endocrine changes and multisystem symptoms that may adversely affect health-related quality of life and psychological well-being. This systematic review and meta-analysis aimed to evaluate the effects of conventional and mind-body exercise interventions on menopausal symptomatology, health-related quality of life, anxiety, and depression in women during the climacteric period. METHODS: A systematic search and meta-analysis of randomized controlled trials were conducted according to the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420251148069). PubMed (MEDLINE), Scopus, and Web of Science were searched from January 2020 to September 2025. Risk of bias was assessed using the Cochrane RoB tool, certainty of evidence using the GRADE approach, and random-effects meta-analyses, prespecified subgroup analyses, and leave-one-out sensitivity analyses were performed. RESULTS: Twelve randomized controlled trials including 1,050 participants were included in the systematic review. Exercise was associated with significant improvements in menopausal symptomatology (Hedges' g = -2.10; 95% CI [-4.14, -0.06]), health-related quality of life (Hedges' g = 1.41; 95% CI [0.46, 2.36]), anxiety (MD = -1.20; 95% CI [-1.52, -0.88]), and depressive symptoms (MD = -1.17; 95% CI [-1.40, -0.94]) compared with control conditions. Exploratory subgroup analyses suggested that the effects of exercise may differ according to exercise modality. Sensitivity analyses supported the robustness of the pooled estimates. CONCLUSIONS: The available evidence suggests that physical exercise represents an effective non-pharmacological strategy for improving menopausal symptomatology, health-related quality of life, anxiety, and depressive symptoms in women during the climacteric period. These findings support its incorporation into routine clinical care and highlight the importance of individualised exercise prescription.

Abstract as published, via PubMed.