Hot flashes and night sweats are often the first things people associate with menopause. But for many women, the years leading up to menopause bring an entirely different set of challenges.
Difficulty sleeping, unexpected mood changes, aching joints and feelings of anxiety can all become part of everyday life. These symptoms can begin years before periods stop completely, sometimes catching women by surprise.
Now, a major international study suggests that one of the simplest ways to support well-being during this transition may be something many people already do: regular physical activity.
According to new research announced by The Menopause Society, women who exercised more frequently tended to experience fewer and less severe perimenopause symptoms.
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The findings were released on October 20, 2026, as part of the society's annual meeting in San Diego, California.
Researchers examined more than 1,800 women worldwide
The study analyzed information from more than 1,800 women living in 87 countries across six continents. All participants were users of Flo, a popular app designed to help women track their menstrual cycles and reproductive health.
The women completed an online questionnaire about how often they exercised and whether they experienced common perimenopause symptoms. Their activity levels ranged from no regular physical activity to exercising more than five days per week.
Researchers then compared those answers with symptoms in three different categories: psychological, physical and urogenital.
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Psychological symptoms included anxiety, low mood and irritability. Physical symptoms covered problems such as hot flashes, sleep disturbances and joint discomfort, while urogenital symptoms included vaginal dryness and bladder-related difficulties.
To assess how severely these problems affected participants, the researchers used a standardized questionnaire called the Menopause Rating Scale.
The researchers also examined factors that could influence the results, including age, body mass index, smoking, existing medical conditions and access to healthcare.
The overall pattern was encouraging. Women who reported more frequent physical activity generally had lower menopause symptom scores, although the study could not establish whether exercise itself was responsible for the differences.
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The biggest difference involved anxiety and mood changes
One of the most interesting discoveries was that the strongest connection appeared in psychological symptoms rather than the hot flashes most people associate with menopause.
Women who were physically active more frequently tended to report fewer problems with anxiety, irritability and low mood.
Dr. Liudmila Zhaunova, Director of Science at Flo Health and the study's presenting author, highlighted this finding.
"Something that stood out to us was that the benefits of physical activity seemed to be strongest for psychological symptoms like low mood irritability and anxiety," she said.
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"These symptoms can really impact daily life, and regular movement may be an accessible way to help."
These findings are particularly relevant because emotional changes during perimenopause are not always immediately recognized as part of the menopause transition.
Women may experience increased irritability, difficulty concentrating or changes in their emotional well-being without realizing that hormonal changes could be contributing.
As previously reported by Welltica, some signs of perimenopause are less obvious than hot flashes and can easily be mistaken for ordinary stress or other health problems.
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The new research suggests that maintaining an active lifestyle may be associated with better emotional well-being during this period, although it does not prove that exercise directly treats anxiety or depression.
The benefits were not limited to mental well-being
Although psychological symptoms showed the clearest association, the findings also suggested a connection between physical activity and other menopause-related complaints.
Women who exercised more frequently generally reported lower scores for physical symptoms, including sleep problems and discomfort associated with the menopause transition.
The researchers also identified a relationship with urogenital symptoms, a category covering problems such as vaginal dryness and urinary difficulties.
However, the study did not establish that physical activity improves every symptom individually. The researchers examined broader symptom categories, so the results should not be interpreted as evidence that exercise can directly treat vaginal dryness or prevent hot flashes.
There are also several possible explanations for the pattern.
Physical activity is known to support sleep quality, cardiovascular health and psychological well-being. It also helps maintain muscle strength and bone health, which become increasingly important as estrogen levels change during menopause.
These broader health benefits may help explain why physically active women reported feeling better overall.
Earlier studies found improvements of nearly 16 percent
The new findings are consistent with earlier research suggesting that exercise may help reduce certain perimenopause symptoms.
A systematic review published in the medical journal Cureus in March 2025 examined four randomized clinical trials involving different exercise programs.
The activities included aerobic exercise, such as brisk walking, alongside resistance training and programs combining both types of movement.
The researchers reported an overall reduction of approximately 15.7 percent in menopause symptom scores from the beginning of the exercise programs.
Some of the most noticeable improvements involved irritability and paresthesia, a condition that can cause tingling, prickling or unusual sensations in the skin.
Participants also experienced improvements in several physical symptoms, including fatigue, headaches and muscle discomfort.
However, the review found that exercise did not produce a significant improvement in depression, and the evidence for reducing hot flashes remained inconsistent.
This is an important distinction. While physical activity can support mental and physical health, scientists have not established that it can reliably treat every symptom associated with menopause.
How much exercise could make a difference?
The international Flo study found that women who exercised most frequently generally reported the lowest symptom scores.
Participants could select activity levels ranging up to more than five days per week, but the research did not establish an exact amount of exercise needed to improve symptoms.
It also did not determine whether walking, cycling, swimming or strength training was the most effective activity.
However, existing health recommendations offer a useful starting point.
The World Health Organization recommends that adults complete at least 150 minutes of moderate-intensity physical activity each week, alongside muscle-strengthening activities on two or more days.
That could mean taking a brisk 30-minute walk five times per week, cycling regularly or combining several shorter sessions throughout the week.
Strength training is also particularly relevant during menopause because declining estrogen levels can contribute to changes in muscle and bone health.
According to the NHS, regular physical activity, particularly weight-bearing and strength exercises, can help protect bone health while supporting general well-being during menopause.
For women who are not currently active, starting with short walks or other manageable activities may be more realistic than immediately attempting an intensive exercise routine.
The goal is to find something enjoyable and sustainable rather than treating exercise as another source of pressure.
Exercise may help, but it is not a replacement for treatment
Despite the encouraging findings, the researchers emphasized that the study has important limitations.
Participants reported their own activity levels and symptoms, meaning the results depended on personal recollection and assessment. The women were also recruited through a menstrual tracking app, so they may not represent the wider population.
Most importantly, the study was observational.
That means researchers identified a connection between physical activity and fewer symptoms, but they cannot determine whether exercise caused the improvement.
It is equally possible that women experiencing more severe symptoms find it harder to exercise regularly. Poor sleep, joint pain and fatigue can all make physical activity more challenging, creating a relationship that works in both directions.
The study was also presented at a scientific conference, and its full findings still need further evaluation.
Dr. Stephanie Faubion, medical director of The Menopause Society, said the results support the importance of physical activity during midlife while acknowledging that more research is necessary.
"Although additional research is needed to better understand this relationship, encouraging regular physical activity is a low-risk strategy that may help improve overall well-being during the menopause transition," she said.
For women experiencing disruptive symptoms, exercise should be considered part of a broader approach rather than a replacement for medical treatment.
The UK's National Institute for Health and Care Excellence recommends discussing evidence-based options, including hormone replacement therapy and menopause-specific cognitive behavioral therapy, depending on the symptoms and individual circumstances.
A simple habit that may make the transition easier
Perimenopause can last for several years, and symptoms vary considerably from one woman to another. Some experience relatively minor changes, while others struggle with sleep, emotional well-being and physical discomfort that affect their daily lives.
The new study offers a potentially encouraging message: regular movement may be associated with a lower overall burden of symptoms, especially those affecting mood.
That does not mean every woman needs to exercise six days a week or that a daily walk will make hot flashes disappear.
But finding time for physical activity, whether through walking, cycling, swimming or strength training, can support long-term health and may also help women feel better during the menopause transition.
For those struggling with persistent symptoms, combining healthy habits with appropriate medical advice remains the most sensible approach.
This article is made and published by Aksel Kryhlmand, who may have used AI in the preparation.