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Background <p>Depression in peri- and post-menopausal women burdens families and health systems. Physical activity is recognized as a complementary therapy for menopausal depressive symptoms, but prior studies lack direct comparisons of intervention types. This network meta-analysis fills this gap by evaluating multiple physical activity modalities via direct and indirect comparisons, establishing an evidence-based hierarchy to guide clinical decisions and provide actionable guidance for managing depression in these women.</p> Methods <p>A systematic search across four databases (PubMed, Cochrane Library, Embase, Web of Science) identified randomized controlled trials (RCTs ) on physical activity for depression in peri- and post-menopausal women. Search timeframe: database inception to April 2025. Two independent researchers selected studies, extracted data, and assessed quality via the Cochrane Risk of Bias Tool. We conducted frequentist network meta-analyses (Stata/SE 15.1) integrated direct and indirect evidence. Surface Under the Cumulative Ranking Curve (SUCRA) ranked interventions by efficacy probabilistically, with higher values indicating superior outcomes.</p> Results <p>Twenty-three RCTs were ultimately included in the meta-analytical synthesis. The results demonstrated superior therapeutic efficacy of aerobic exercise in alleviating depressive symptoms among peri-and post-menopausal women (SUCRA = 78.7%), closely followed by multi mode motion (SUCRA = 78.1%). Stretching exercise and mind-body exercises also achieved clinically meaningful improvements, with respective SUCRA values of 72.6% and 45.4%.</p> Conclusion <p>Our findings show aerobic exercise, multimodal motion, and stretching best reduce depressive symptoms in peri- and post-menopausal women. Clinicians should prioritize aerobic exercise; multi modal motion programs (combining aerobic and stretching) may boost adherence for those seeking variety. Despite physical activity’s proven antidepressant effects, key challenges include developing theory-based strategies to support long-term adherence, especially amid menopausal physiological changes that hinder consistent exercise.</p> Trial registration <p>This study has been registered on PROSPERO (CRD420251026378).</p>

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Effects of different physical activity interventions on depressive symptoms in menopausal women: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月24日

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  • Hongyu Wang,
  • Shuang Li,
  • Xiaolin Zhang,
  • Ying Zhu,
  • Qianqian Huang,
  • Ke-Lei Guo,
  • Dong Li

摘要

Background

Depression in peri- and post-menopausal women burdens families and health systems. Physical activity is recognized as a complementary therapy for menopausal depressive symptoms, but prior studies lack direct comparisons of intervention types. This network meta-analysis fills this gap by evaluating multiple physical activity modalities via direct and indirect comparisons, establishing an evidence-based hierarchy to guide clinical decisions and provide actionable guidance for managing depression in these women.

Methods

A systematic search across four databases (PubMed, Cochrane Library, Embase, Web of Science) identified randomized controlled trials (RCTs ) on physical activity for depression in peri- and post-menopausal women. Search timeframe: database inception to April 2025. Two independent researchers selected studies, extracted data, and assessed quality via the Cochrane Risk of Bias Tool. We conducted frequentist network meta-analyses (Stata/SE 15.1) integrated direct and indirect evidence. Surface Under the Cumulative Ranking Curve (SUCRA) ranked interventions by efficacy probabilistically, with higher values indicating superior outcomes.

Results

Twenty-three RCTs were ultimately included in the meta-analytical synthesis. The results demonstrated superior therapeutic efficacy of aerobic exercise in alleviating depressive symptoms among peri-and post-menopausal women (SUCRA = 78.7%), closely followed by multi mode motion (SUCRA = 78.1%). Stretching exercise and mind-body exercises also achieved clinically meaningful improvements, with respective SUCRA values of 72.6% and 45.4%.

Conclusion

Our findings show aerobic exercise, multimodal motion, and stretching best reduce depressive symptoms in peri- and post-menopausal women. Clinicians should prioritize aerobic exercise; multi modal motion programs (combining aerobic and stretching) may boost adherence for those seeking variety. Despite physical activity’s proven antidepressant effects, key challenges include developing theory-based strategies to support long-term adherence, especially amid menopausal physiological changes that hinder consistent exercise.

Trial registration

This study has been registered on PROSPERO (CRD420251026378).