Exercise boosts psychological wellbeing for menopausal women

Engaging in physical activity during menopause can improve depression, mood and overall quality of life, a new study led by UCL researchers has found.

Published in Menopause Journal, the review of more than 1,000 women studied the effects of physical activity on psychological wellbeing and quality of life during perimenopause and early post menopause.

Menopause is when a woman's periods stop due to lower hormone levels. This usually happens between the ages of 45 and 55. It is estimated that there are currently around 13 million perimenopausal or menopausal women in the UK. 

Many women experience psychological symptoms during menopause, including depression, low mood, anxiety, stress, and difficulties with thinking and memory. These can have a significant impact on their quality of life, with an estimated one in ten women leaving work due to menopause symptoms. 

The study found physical activity, such as walking, dance and yoga, may help improve some of these psychological symptoms and overall quality of life during this period. 

As part of a systematic review and meta-analysis, researchers assessed 12 randomized controlled trials involving more than 1,000 women to determine how different types of physical activity impacted psychological symptoms during menopause. 

Types of physical activity were broken into two categories: aerobic-based exercise (ABIs), which included walking, Zumba, aerobic exercise, dance and Taekwondo, and mind-body activities (MBAs), which were made up of yoga, tai chi, Pilates and stretching. 

ABIs showed the strongest effects for reducing depressive symptoms and improving overall quality of life, with increased endorphin release linked to mood enhancement. This may be particularly relevant during perimenopause, when oestrogen fluctuations increase vulnerability to mood instability. 

ABIs also tended to involve fewer sessions, suggesting they may be easier to fit into for midlife women facing time and energy constraints. In one trial, women were instructed to walk three times per week for 30 minutes, and in another they attended three one-hour long Zumba classes per week. Across the 12 randomized trials, participants were required to attend multiple sessions per week, depending on the kind of physical exercise.

In contrast, those who participated in MBAs saw strong improvements in psychological quality of life. These kinds of exercises incorporate mindfulness, breathwork and body awareness, which may enhance emotional regulation. In one trial, women attended two weekly 75 minute yoga sessions, while another trial saw participants attend daily one hour yoga classes. 

The researchers hope their findings will highlight how physical activity offers a low-cost and widely available intervention option for women experiencing psychological symptoms during menopause, compared to other intervention methods such as hormone therapy and cognitive behavioral therapy. 

The team also believe that the social aspect of physical activity, such as participating in group fitness classes, may have added to improved mood and quality of life. 

Physical activity is an effective, accessible, non-pharmacological strategy to support psychological well-being and quality of life during midlife menopause. 

The majority of the interventions also used group-based formats, likely to foster social connection and peer support, both being factors associated with improved quality of life during menopause." 

Professor Aimee Spector, Senior Author and Director of the UCL Menopause Mind Lab, UCL Division of Psychology and Language Sciences

Improvements in depression, mood and quality of life were particularly evident among women in early post menopause (the stage of life that begins 12 consecutive months after a woman's final menstrual period), while physical activity was also associated with improvements in depressive symptoms during perimenopause. 

Lead author and NHS Clinical Psychologist Simone Saidel, who was a researcher at UCL when this review was conducted, said: "Treatment options for menopause are limited, with many women being unable to or choosing not to take hormone therapy. There are also significant health inequalities in terms of HRT access, and ethnic variations in attitudes towards it. 

"This study plays an important role in expanding the options available for symptom management, whereby clinicians may recommend it as an early intervention or an adjunct to medical or psychological treatments." 

Further research is needed to establish which forms of physical activity are most beneficial and how they can best be incorporated into support and care for women experiencing menopause. 

Data was included from seven countries (Brazil, China, Tunisia, India, Iran, Korea and USA) to complete this review.

Study limitations 

The researchers note that the evidence base remains limited, with substantial variation between studies and many of the studies judged to be at high risk of bias, highlighting the need for further high-quality trials.