Abstract
Background Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) affect substantial proportions of women of reproductive age, imposing significant burdens on quality of life, work productivity, and psychological wellbeing. Evidence suggests that physical activity may improve symptoms of these conditions.
Aim. To synthesise current evidence on physical activity and structured exercise as adjunctive interventions in the management of premenstrual disorders, examining mechanistic pathways, exercise modalities, and clinical implications.
Material and methods. A narrative review was conducted, focusing in particular on premenstrual syndrome and premenstrual dysphoric disorder, as well as the impact of physical activity on alleviating their symptoms. Randomized controlled trials, systematic reviews, and meta-analyses were prioritized and appraised qualitatively.
Results. Systematic reviews and meta-analyses demonstrate that physical activity, particularly aerobic exercise at moderate intensity, reduces both physical and psychological premenstrual symptoms. Identified mechanisms include modulation of ovarian hormone profiles, enhancement of endogenous opioid systems, regulation of neuroendocrine stress responses, fluid-electrolyte balance, and prostaglandin metabolism. Alternative modalities including Pilates and kinesio taping demonstrate comparable efficacy. Strength training performance fluctuates across menstrual cycle phases, with optimal performance during the late follicular phase.
Conclusions. Regular, preference-sensitive exercise provides a practical and sustainable method for managing PMS symptoms; however, it should not replace prospective diagnosis or appropriate treatment. Further research employing prospective symptom monitoring, standardized outcome measures, and mechanistic biomarkers is essential to refine personalized recommendations and identify optimal exercise prescriptions for individual women.