Habitual Physical Activity and Structured Exercise in Premenstrual Syndrome: A Narrative Review of Observational and Interventional Evidence
DOI:
https://doi.org/10.12775/QS.2026.69.74554Keywords
premenstrual syndrome, habitual physical activity, structured exercise, aerobic exercise, yoga, progressive muscle relaxation, quality of life, women’s healthAbstract
Background: Premenstrual syndrome (PMS) is a cyclic condition with physical, affective and behavioural symptoms that may impair functioning and quality of life. Habitual physical activity and structured exercise are distinct exposures.
Aim: To distinguish these exposures, synthesise observational and interventional evidence, and assess clinical implications and methodological limitations.
Material and Methods: This structured narrative review searched PubMed and Scopus, with Google Scholar supplementary, for English-language publications from January 2011 to 1 June 2026. Both evidence streams were synthesised separately, considering design, PMS ascertainment, programme characteristics, outcomes and methodological limitations.
Results: Observational evidence was mixed, with inverse, null and possible non-linear associations. Measurement and ascertainment differences, confounding, reverse causality and uncertain temporality limited causal interpretation. Interventional findings were broadly favourable but heterogeneous across aerobic, mind-body and strengthening programmes. Global PMS outcomes were not interchangeable with pain, stress or biomarkers. Confidence was limited by selected samples, varied comparators, inconsistent reporting and limited follow-up.
Conclusion: Habitual physical activity and structured exercise are not interchangeable, and observational evidence does not support a prevention claim. Evidence did not support modality ranking or a precise prescription. Structured exercise may be an individualised adjunct but should not replace diagnosis or established care; severe, persistent, functionally impairing or atypical symptoms require clinical assessment. Future studies need standardised PMS confirmation, syndrome-wide outcomes and transparent programme, safety and follow-up reporting.
References
1. Liguori F, Saraiello E, Calella P. Premenstrual syndrome and premenstrual dysphoric disorder’s impact on quality of life, and the role of physical activity. Medicina (Kaunas). 2023;59(11):2044. doi:10.3390/medicina59112044
2. Maged AM, Abbassy AH, Sakr HRS, Elsawah H, Wagih H, Ogila AI, et al. Effect of swimming exercise on premenstrual syndrome. Arch Gynecol Obstet. 2018;297(4):951–959. doi:10.1007/s00404-018-4664-1
3. Chang HC, Cheng YC, Yang CH, Tzeng YL, Chen CH. Effects of yoga for coping with premenstrual symptoms in Taiwan—a cluster randomized study. Healthcare (Basel). 2023;11(8):1193. doi:10.3390/healthcare11081193
4. Chen Z, Imai K, Zhou X. The relationship between physical activity and premenstrual syndrome in senior high school students: a prospective study. Sci Rep. 2023;13:5881. doi:10.1038/s41598-023-32357-2
5. Kawabe R, Chen CY, Morino S, Mukaiyama K, Shinohara Y, Kato M, et al. The relationship between high physical activity and premenstrual syndrome in Japanese female college students. BMC Sports Sci Med Rehabil. 2022;14:175. doi:10.1186/s13102-022-00569-0
6. Kroll-Desrosiers AR, Ronnenberg AG, Zagarins SE, Houghton SC, Takashima-Uebelhoer BB, Bertone-Johnson ER. Recreational physical activity and premenstrual syndrome in young adult women: a cross-sectional study. PLoS One. 2017;12(1):e0169728. doi:10.1371/journal.pone.0169728
7. Shi Y, Shi M, Liu C, Sui L, Zhao Y, Fan X. Associations with physical activity, sedentary behavior, and premenstrual syndrome among Chinese female college students. BMC Womens Health. 2023;23:173. doi:10.1186/s12905-023-02262-x
8. Morino S, Egawa M, Hirata H, Nishimura F, Aoyama T, Konishi I. Association between premenstrual syndrome and daily physical activity levels. J Womens Health Issues Care. 2016;5(5):1000241. doi:10.4172/2325-9795.1000241
9. Yang H, Ma Y, Wang Y, Fu C, Liu W, Li W. Association between physical activity and risk of premenstrual syndrome among female college students: a systematic review and meta-analysis. BMC Womens Health. 2024;24:307. doi:10.1186/s12905-024-03147-3
10. Pearce E, Jolly K, Jones LL, Matthewman G, Zanganeh M, Daley A. Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJGP Open. 2020;4(3):bjgpopen20X101032. doi:10.3399/bjgpopen20X101032
11. Gnanasambanthan S, Datta S. Premenstrual syndrome. Obstet Gynaecol Reprod Med. 2019;29(10):281–285. doi:10.1016/j.ogrm.2019.06.003
12. Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update. 2015;21(6):762–778. doi:10.1093/humupd/dmv039
13. Kamalifard M, Yavari A, Asghari-Jafarabadi M, Ghaffarilaleh G, Kasb-Khah A. The effect of yoga on women’s premenstrual syndrome: a randomized controlled clinical trial. Int J Womens Health Reprod Sci. 2017;5(3):205–211. doi:10.15296/ijwhr.2017.37
14. Abiç A, Dağ-Canatan S, Er-Korucu A, Aksoy-Can A. The effects of yoga and progressive muscle relaxation exercises on premenstrual syndrome: a randomized controlled trial. Women Health. 2024;64(3):261–273. doi:10.1080/03630242.2024.2314524
15. El-Lithy A, El-Mazny A, Sabbour A, El-Deeb A. Effect of aerobic exercise on premenstrual symptoms, haematological and hormonal parameters in young women. J Obstet Gynaecol. 2015;35(4):389–392. doi:10.3109/01443615.2014.960823
16. Dózsa-Juhász O, Makai A, Prémusz V, Ács P, Hock M. Investigation of premenstrual syndrome in connection with physical activity, perceived stress level, and mental status—a cross-sectional study. Front Public Health. 2023;11:1223787. doi:10.3389/fpubh.2023.1223787
17. Shavaisi F, Heydarpour S, Jalilian N, Jalali A, Rezaei M. The effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome: a single-blind, randomized controlled trial. BMC Womens Health. 2024;24:499. doi:10.1186/s12905-024-03333-3
18. ElDeeb AM, Atta HK, Osman DA. Effect of whole body vibration versus resistive exercise on premenstrual symptoms in adolescents with premenstrual syndrome. Bull Fac Phys Ther. 2020;25:1. doi:10.1186/s43161-020-00002-y
19. Samadi Z, Taghian F, Valiani M. The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iran J Nurs Midwifery Res. 2013;18(1):14–19. PMCID: PMC3748549; PMID: 23983722.
20. Mohebbi Dehnavi Z, Jafarnejad F, Sadeghi Goghary S. The effect of 8 weeks aerobic exercise on severity of physical symptoms of premenstrual syndrome: a clinical trial study. BMC Womens Health. 2018;18:80. doi:10.1186/s12905-018-0565-5
21. Vishnupriya R, Rajarajeswaram P. Effects of aerobic exercise at different intensities in pre menstrual syndrome. J Obstet Gynaecol India. 2011;61(6):675–682. doi:10.1007/s13224-011-0117-5
22. Vaghela N, Mishra D, Sheth M, Dani VB. To compare the effects of aerobic exercise and yoga on premenstrual syndrome. J Educ Health Promot. 2019;8:199. doi:10.4103/jehp.jehp_50_19
23. Simsek Kucukkelepce D, Unver H, Nacar G, Tashan ST. The effects of acupressure and yoga for coping with premenstrual syndromes on premenstrual symptoms and quality of life. Complement Ther Clin Pract. 2021;42:101282. doi:10.1016/j.ctcp.2020.101282
24. Çitil ET, Çitil Canbay F. Effect of progressive muscle relaxation exercises on symptoms of premenstrual syndrome: a single-blind randomized controlled trial. Arch Psychiatr Nurs. 2024;51:228–234. doi:10.1016/j.apnu.2024.07.005
25. Tsai SY. Effect of yoga exercise on premenstrual symptoms among female employees in Taiwan. Int J Environ Res Public Health. 2016;13(7):721. doi:10.3390/ijerph13070721
26. Çitil ET, Kaya N. Effect of Pilates exercises on premenstrual syndrome symptoms: a quasi-experimental study. Complement Ther Med. 2021;57:102623. doi:10.1016/j.ctim.2020.102623
27. Aykut Ş, Şevgin Ö. Effect of video-based exercise on premenstrual symptoms: a randomized controlled trial. Ginekol Pol. 2025;96(2):102–108. doi:10.5603/gpl.98199
28. Karim A, Rafique S, Muneeb HN, Saleem N. Comparative effects of resistive exercises and stretching on abdominal cramps in premenstrual syndrome. Pak J Rehabil. 2023;12(2):140–148. doi:10.36283/pjr.zu.12.2/018
29. Toğluk S, Gül S. The effects of progressive muscle relaxation exercises on premenstrual syndrome symptoms and violence tendencies in women: a randomized controlled trial. BMC Womens Health. 2025;25:176. doi:10.1186/s12905-025-03712-4
30. Nemes VA, Mikó-Baráth E, Briest C, Szabó D, Mintál T, Patczai B, et al. Effect of targeted yoga practice on PMS symptoms, body composition, and hip mobility: an eight-week pilot study. Sports (Basel). 2026;14(1):21. doi:10.3390/sports14010021
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Copyright (c) 2026 Oliwia Dziewięcka, Wojciech Ziębka, Julia Kaczmarek, Maria Dziewięcka, Michał Błażuk, Nela Poznańska, Julia Kujawa, Kinga Kościółek, Dominika Darasz, Dominik Zając
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