Physical activity and mental health outcomes during menopause: A randomized controlled trial


Background: Many women experience detriments in mental health during the menopausal transition. Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist.Purpose: This study examined the effects of a 4-month randomized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women (M age=49.9; SD=3.6).Methods and Results: Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month randomized controlled exercise trial with three arms: walking, yoga, control. The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect. Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes. Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness.Conclusions: Physical activity appears to enhance mood and menopause-related QOL during menopause, however, other aspects of mental health may be affected only as a result of reduction in menopausal symptoms. Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms.

This is a preview of subscription content, access via your institution.


  1. (1)

    U.S. Census Bureau: United States Census 2000. Retrieved March 13, 2007 from

  2. (2)

    U.S. Census Bureau:Facts & features: Women’s history month. Retrieved August 26, 2005 from

  3. (3)

    NIH State-of-the-Science Panel: National Institutes of Health State-of-the-Science Conference statement: Management of menopause-related symptoms.Annals of Internal Medicine. 2005,142:1003–1013.

    Google Scholar 

  4. (4)

    North American Menopause Society:Menopause Core Curriculum Study Guide. Cleveland, OH: NAMS, 2000.

    Google Scholar 

  5. (5)

    North American Menopause Society: Treatment of menopause-associated vasomotor symptoms: Position statement.Menopause. 2004,2:11–33.

    Google Scholar 

  6. (6)

    Bosworth HB, Bastian LA, Kuchibhatla MN, et al.: Depressive symptoms, menopausal status, and climacteric symptoms in women at midlife.Psychosomatic Medicine. 2001,63:603–608.

    PubMed  CAS  Google Scholar 

  7. (7)

    Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG: A prospective population-based study of menopausal symptoms.Obstetrics & Gynecology. 2000,96:351–358.

    Article  CAS  Google Scholar 

  8. (8)

    Greene JG: Constructing a standard climacteric scale.Maturitas. 1998,29:25–31.

    PubMed  Article  CAS  Google Scholar 

  9. (9)

    Dennerstein L, Lehert P, Guthrie J: The effects of the menopausal transition and biopsychosocial factors on well-being.Archives of Women’s Mental Health. 2002,5:15–22.

    PubMed  Article  CAS  Google Scholar 

  10. (10)

    Blumel JE, Castelo-Branco C, Binfa L, et al.: Quality of life after the menopause: A population study.Maturitas. 2000,34:17–23.

    PubMed  Article  CAS  Google Scholar 

  11. (11)

    Schneider HPG: The quality of life in the post-menopausal woman.Best Practice & Research Clinical Obstetrics & Gynaecology. 2002,16:395–409.

    Article  Google Scholar 

  12. (12)

    Freeman EW, Sammel MD, Lin H, Nelson DB: Associations of hormones and menopausal status with depressed mood in women with no history of depression.Archives of General Psychiatry. 2006,63:375–382.

    PubMed  Article  CAS  Google Scholar 

  13. (13)

    Joffe H, Hall JE, Soares CN, et al.: Vasomotor symptoms are associated with depression in perimenopausal women seeking primary care.Menopause. 2002,9:392–398.

    PubMed  Article  Google Scholar 

  14. (14)

    Blumenthal JA, Fredrikson M, Matthews KA, et al.: Stress reactivity and exercise training in premenopausal and postmenopausal women.Health Psychology. 1991,10:384–391.

    PubMed  Article  CAS  Google Scholar 

  15. (15)

    Slaven L, Lee C: Psychological effects of exercise in adult women: The impact of menopausal status.Psychology and Health. 1994,9:297–303.

    Article  Google Scholar 

  16. (16)

    Slaven L, Lee C: Mood and symptom reporting among middle-aged women—the relationship between menopausal status, hormone replacement therapy, and exercise participation.Health Psychology. 1997,16:203–208.

    PubMed  Article  CAS  Google Scholar 

  17. (17)

    Wilbur J, Miller A, Montgomery A: The influence of demographic characteristics, menopausal status, and symptoms on women’s attitudes toward men opause.Women & Health. 1995,23:19–39.

    Article  CAS  Google Scholar 

  18. (18)

    Gold EB, Sternfeld B, Kelsey JL, et al.: Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age.American Journal of Epidemiology. 2000,152:463–473.

    PubMed  Article  CAS  Google Scholar 

  19. (19)

    Ivarsson T, Spetz AC, Hammar M: Physical exercise and vasomotor symptoms in postmenopausal women.Maturitas. 1998,29:139–146.

    PubMed  Article  CAS  Google Scholar 

  20. (20)

    Sternfeld B, Quesenberry CP, Jr., Husson G: Habitual physical activity and menopausal symptoms: A case-control study.Journal of Women’s Health. 1999,8:115–123.

    PubMed  CAS  Article  Google Scholar 

  21. (21)

    Gold EB, Block G, Crawford S, et al.: Lifestyle and demographic factors in relation to vasomotor symptoms: Baseline results from the study of women’s health across the nation.American Journal of Epidemiology. 2004,159:1189–1199.

    PubMed  Article  Google Scholar 

  22. (22)

    Boraz MA, Simkin-Silverman LR, Wing RR, et al.: Hormone replacement therapy use and menopausal symptoms among women participating in a behavioral life-tyle intervention.Preventive Medicine. 2001,33:108–114.

    PubMed  CAS  Google Scholar 

  23. (23)

    Lindh-Astrand L, Nedstrand E, Wyon Y, Hammar M: Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy.Maturitas. 2004,48:97–105.

    PubMed  Article  CAS  Google Scholar 

  24. (24)

    Teoman N, Ozcan A, Acar B: The effect of exercise on physical fitness and quality of life in postmenopausal women.Maturitas. 2004,47:71–77.

    PubMed  Article  Google Scholar 

  25. (25)

    Ueda M: A 12-week structured education and exercise program improved climacteric symptoms in middle-aged women.Journal of Physiological Anthropology & Applied Human Science. 2004,23:143–148.

    Article  Google Scholar 

  26. (26)

    Wilbur J, Miller AM, McDevitt J, Wang E, Miller J: Menopausal status, moderate-intensity walking, and symptoms in midlife women.Research and Theory for Nursing Practice. 2005,19:163–180.

    PubMed  Google Scholar 

  27. (27)

    Aiello EJ, Yasui Y, Tworoger SS, et al.: Effect of a yearlong, moderate-intensity exercise intervention on the occurrence and severity of menopause symptoms in postmenopausal women.Menopause. 2004,11:382–388.

    PubMed  Article  Google Scholar 

  28. (28)

    Courneya KS, Mackey JR, Bell GJ, et al.: Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: Cardiopulmonary and quality of life outcomes.Journal of Clinical Oncology. 2003,21:1660–1668.

    PubMed  Article  Google Scholar 

  29. (29)

    Asikainen TM, Kukkonen-Harjula K, Miilunpalo S: Exercise for health for early postmenopausal women: A systematic review of randomised controlled trials.Sports Medicine. 2004,34:753–778.

    PubMed  Article  Google Scholar 

  30. (30)

    Asikainen TM, Miilunpalo S, Oja P, et al.: Randomised, controlled walking trials in postmenopausal women: The minimum dose to improve aerobic fitness?British Journal of Sports Medicine. 2002,36:189–194.

    PubMed  Article  Google Scholar 

  31. (31)

    Adams J: Exploring yoga to relieve menopausal symptoms.Holistic Nursing Practice. 2003,17:166–167.

    PubMed  Google Scholar 

  32. (32)

    Sander E: Menopause—the Yoga Way: Yoga can ease away uncomfortable symptoms—and change your whole attitude toward this profound life transition.Yoga Journal. 1996:61–71.

  33. (33)

    Eisenberg DM, Davis RB, Ettner SL, et al.: Trends in alternative medicine use in the United States, 1990–1997: Results of a follow-up national survey.Journal of the American Medical Association. 1998,280:1569–1575.

    PubMed  Article  CAS  Google Scholar 

  34. (34)

    Keenan NL, Mark S, Fugh-Berman A, et al.: Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies.Menopause. 2003,10:507–515.

    PubMed  Article  Google Scholar 

  35. (35)

    Soules MR, Sherman S, Parrott E, et al.: Executive summary: Stages of reproductive aging workshop (STRAW).Fertility and Sterility. 2001,76:874–878.

    PubMed  Article  CAS  Google Scholar 

  36. (36)

    Kessler RC, Greenberg DF:Linear Panel Analysis. New York: Academic, 1981.

    Google Scholar 

  37. (37)

    Kohl HW, Blair RS, Paffenbarger J, Macera CA, Kronenfeld JJ: A mail survey of physical activity habits as related to measured physical fitness.American Journal of Epidemiology. 1988,127:1228–1239.

    PubMed  CAS  Google Scholar 

  38. (38)

    American College of Sports Medicine:ACSM’s Guidelines for Exercise Testing and Prescription (6th Ed.). Baltimore: Lippincott Williams & Wilkins, 2000.

    Google Scholar 

  39. (39)

    Kammann R, Flett R: Affectometer 2: A scale to measure current level of general happiness.Australian Journal of Psychology. 1983,35:259–265.

    Article  Google Scholar 

  40. (40)

    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression.Archives of General Psychiatry. 1961,4:561–571.

    PubMed  CAS  Google Scholar 

  41. (41)

    Utian W, Janata JW, Kingsberg SA, Schluchter M, Hamilton JC: The Utian Quality of Life (UQOL) Scale: Development and validation of an instrument to quantify quality of life through and beyond menopause.Menopause. 2002,9:402–410.

    PubMed  Article  Google Scholar 

  42. (42)

    Diener E, Emmons R, Larsen R, Griffin S: The satisfaction with life scale.Journal of Personality Assessment. 1985,49:71–75.

    PubMed  Article  CAS  Google Scholar 

  43. (43)

    Borg GA:Borg’s Perceived Exertion and Pain Scales Book. Champaign, IL: Human Kinetics, 1998.

    Google Scholar 

  44. (44)

    Kingsland K, Kingsland V:Complete Hatha Yoga. New York: Arco, 1983.

    Google Scholar 

  45. (45)

    Iyengar BKS:Yoga: The Path to Holistic Health. London: Dorling Kindersley, 2001.

    Google Scholar 

  46. (46)

    Biddle SJH: Emotion, mood, and physical activity. In Biddle SJH, Fox KR, Boutcher SH (eds),Physical Activity and Psychological Well-Being. New York: Routledge, 2000, 63–87.

    Google Scholar 

  47. (47)

    Lee SW, Mancuso CA, Charlson ME: Expectations and outcomes associated with new practice of energy-yoga: Qualitative study.Journal of Clinical Epidemiology. 2003,56:922.

    Article  Google Scholar 

  48. (48)

    Elavsky S, McAuley E: Physical activity, symptoms, esteem, and life satisfaction during menopause.Maturitas. 2005,52:374–385.

    PubMed  Article  Google Scholar 

  49. (49)

    Hammar M, Brynhildsen J, Wyon Y, Nedstrand E, Notelovitz M: The effects of physical activity on menopausal symptoms and metabolic changes around menopause.Menopause. 1995,2:201–209.

    Google Scholar 

  50. (50)

    Thurston RC, Joffe H, Soares CN, Harlow BL: Physical activity and risk of vasomotor symptoms in women with and without a history of depression: Results from the harvard study of moods and cycles.Menopause. 2006,13:553–560.

    PubMed  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Steriani Elavsky Ph.D..

Additional information

This material is based on work conducted at the University of Illinois and was supported by the National Institute of Mental Health under Award No. MH073255-01, National Institute on Aging under Award No. AG12113, American College of Sports Medicine, Life Fitness Academy, and Paul D. Doolen Scholarship for the Study of Aging.

About this article

Cite this article

Elavsky, S., McAuley, E. Physical activity and mental health outcomes during menopause: A randomized controlled trial. ann. behav. med. 33, 132–142 (2007).

Download citation


  • Physical Activity
  • Depressive Symptom
  • Life Satisfaction
  • Positive Affect
  • Behavioral Medicine