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A systematic review of exercise interventions on negative affect, pain, and fatigue in women with premenstrual syndrome

Authors: Li, X. and Ding, F. and Ma, X. and Wang, X. and Chen, J. and Chen, L.

Year: 2026 Journal: BMC Womens Health Vol/Issue: Vol. 26, No. 1 Pages: 75

Study Characteristics

Lifestyle Pillars
Physical Activity
Study Design
Meta-analysis/Sys Review

Abstract

Background

Premenstrual syndrome refers to a constellation of cyclical somatic, psychological, and behavioral changes that recur during the late luteal phase of the menstrual cycle. These recurring disturbances impair daily life and occupational performance, and their long-term accumulation may predispose individuals to more severe physical or psychological conditions.

Objective

We aimed to systematically evaluate the efficacy of exercise interventions for alleviating negative affect, pain, and fatigue in women diagnosed with premenstrual syndrome (PMS).

Design

A systematic review and meta-analysis was conducted.

Methods

Search of publications was conducted in Web of science, Embase, Pubmed, and The Cochrane Library. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan’s Q test and quantified using the I(2) index.

Results

Of the 20 articles selected, six applied running ; three, Pilate ; and eleven, yoga. The meta-analysis showed that exercise improved negative affect (P < 0.01), pain symptoms (P < 0.01), and fatigue symptoms (P < 0.01). Subgroup analyses revealed that running for 9–12 weeks at a frequency of three or more sessions per week appeared to be more effective in alleviating negative affect. Similarly, yoga practiced with the same duration and frequency (9–12 weeks and ≥ 3 sessions/week) appeared to be more effective in pain symptoms, while a program of 9–12 weeks appeared to be more effective for reducing fatigue.

Conclusion

Exercise has a ameliorative effect on negative affect, pain, and fatigue in women with PMS. Among the programs studied, running for 9–12 weeks at ≥ 3 sessions/week appeared to be more effective in negative affect, while yoga for 9–12 weeks at ≥ 3 sessions/week appeared to be more effective for pain relief, and yoga for 9–12 weeks appeared to be more effective for fatigue alleviation.

Prospero Registration

CRD420251088581.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-025-04242-9.