Exercise Modalities for the Management of Menopausal Symptoms: A Structured Narrative Review

Abstract

Background: Menopause is associated with vasomotor, psychological, somatic, and urogenital symptoms that can markedly reduce quality of life. Although hormone therapy is the most effective treatment for vasomotor symptoms, many women seek safe, non-pharmacological alternatives. Exercise is increasingly recommended; however, the benefits of specific exercise modalities remain unclear. Aim: To compare the effects of different exercise modalities on menopausal symptoms and menopause-related quality of life in postmenopausal women. Materials and methods: A structured narrative review of randomized controlled trials published in English between January 2015 and March 2026 was conducted using PubMed. Studies evaluating structured exercise interventions in naturally postmenopausal women were included and synthesized according to exercise modality. Results: Nine randomized controlled trials involving 589 postmenopausal women were included. Resistance training showed the most consistent improvements in vasomotor symptoms and sleep quality, while multicomponent exercise provided broader benefits across vasomotor, psychological, and somatic domains. Pilates improved symptom severity, quality of life, and sexual function. Yoga and Qigong enhanced psychological well-being, sleep, and menopause-specific quality of life, whereas dance-based exercise improved anxiety, depression, perceived stress, and mood. Conclusions: Structured exercise is a safe and effective non-pharmacological strategy for managing menopausal symptoms. As different exercise modalities provide complementary benefits, exercise prescription should be individualized according to symptom profile, functional capacity, and personal preferences. Further comparative randomized trials are warranted.