Physical activity for psychological and physical well-being in menstruating individuals: an integrative review.

Abstract

Background: Physical and psychological symptoms vary across the menstrual cycle and may influence well-being and engagement in physical activity. While physical activity may alleviate menstrual pain, fatigue, and mood disturbances, evidence regarding beneficial types, intensities, and timing remains fragmented. This integrative review aimed to synthesise evidence on how physical activity contributes to psychological and physical well-being in menstruating individuals and to identify practically relevant recommendations.

Methods: An integrative review was conducted using a PIO-based search strategy. CINAHL, PubMed/MEDLINE, and the Cochrane Library were searched for peer-reviewed studies published in English or German between 2010 and 2025, supplemented by backward and forward citation tracking. Qualitative, quantitative, and mixed-methods studies examining physical activity in relation to psychological and/or physical well-being across the menstrual cycle were eligible. Three reviewers independently screened records using predefined criteria. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results: Fifty-five studies comprising 13,856 participants were included, with randomised controlled trials being most common (n = 31; 56.4%). Three domains emerged: menstrual pain and somatic symptoms; premenstrual and emotional symptoms; and quality of life, sleep, and daily functioning. Physical activity was predominantly associated with reductions in symptom burden and improvements in well-being. Evidence was most consistent for reductions in menstrual pain and somatic symptoms, particularly following mind-body approaches. Aerobic and other exercise modalities also showed beneficial but more heterogeneous findings. Improvements in premenstrual and emotional symptoms were frequently reported, whereas evidence for quality of life, sleep, and daily functioning was more limited. Heterogeneity in exercise modalities, intervention characteristics, and outcome assessment limited direct comparisons.

Conclusions: Physical activity may improve psychological and physical well-being in menstruating individuals, with the most consistent evidence for menstrual pain and somatic symptoms; findings for premenstrual, emotional, and quality-of-life outcomes were less consistent. Mind-body approaches such as yoga and Pilates showed particularly promising results. Rather than supporting a uniform cycle-based prescription, the findings point towards an individualised and symptom-responsive approach that also takes underlying conditions into account. More standardised and methodologically robust research is needed to establish specific recommendations and better understand experiences of physical activity across the menstrual cycle.