Can Exercise Ease Perimenopause? What the New Research Says About Mood, Sleep and Symptoms

Can moving more make perimenopause easier? New research presented this week at The Menopause Society's 2026 Annual Meeting adds to the conversation about exercise and perimenopause. In a survey of 1,808 women in perimenopause, those who were physically active more often reported a lower overall symptom burden, and the difference appeared strongest for psychological symptoms like low mood, irritability and anxiety. Here's what the study found, what it can't tell us, and how movement fits alongside other treatment options.

What the study looked at

Liudmila Zhaunova, PhD, director of science at Flo Health, and colleagues analyzed data from users of the Flo menstrual tracking app, as reported by Healio. The 1,808 participants were from 87 countries, were at least 35 years old and self-reported being in perimenopause. They completed an online survey that asked how often they exercised (five options, from "not physically active" to "5 or more days per week") and included the Menopause Rating Scale (MRS), a validated questionnaire that measures symptom severity in three areas: psychological, somatic (physical) and urogenital. Higher scores mean a heavier symptom burden, out of a possible 44 points.

What it found

Average total MRS scores were lower in each group that exercised more often. They ranged from 17.46 among women who did not exercise to 13.77 among those active 5 or more days a week. The same pattern showed up in all three areas:

• Somatic symptoms: 6.06 with no exercise vs 4.48 at 5+ days a week
• Psychological symptoms: 7.77 vs 6.41
• Urogenital symptoms: 3.63 vs 2.87

Zhaunova said in a press release quoted by Healio that the benefits of physical activity "seemed to be strongest for psychological symptoms," naming low mood, irritability and anxiety.

What this exercise and perimenopause study can and can't tell us

This was a cross-sectional study, meaning it captured a single snapshot in time. It shows that more frequent exercise and lower symptom scores went together. It does not show that exercise caused symptoms to improve. Some important limits:

• The direction isn't clear. Women with fewer or milder symptoms may simply find it easier to exercise, rather than exercise lowering their symptoms.
• Everything was self-reported. Both exercise frequency and symptoms came from an online survey of app users, who may not represent all women in perimenopause.
• It's early research. The findings were presented at a scientific meeting, and the Menopause Society's medical director, Stephanie Faubion, MD, MBA, said "additional research is needed to better understand this relationship."
• The study came from the app maker. It was conducted by researchers at Flo Health, including its director of science.

Even with those limits, Dr. Faubion called encouraging regular physical activity "a low-risk strategy that may help improve overall well-being during the menopause transition." She noted that regular activity "is already recommended as part of a healthy lifestyle during midlife."

What about sleep?

This study did not report sleep results on their own, so it can't tell us whether exercise helps perimenopausal sleep. Sleep matters, though. ACOG reports that 16–66% of U.S. women experience menopause-related sleep disruption, and its expanded 2026 guidance covers treatment options for sleep as well as hot flashes and mood. The Menopause Society meeting also devoted a session to what is known and what can be done about sleep at menopause, as part of a lifestyle-medicine symposium that included the evidence on exercise, stress and mental well-being, and social connectedness.

Where exercise fits with other treatments

ACOG's 2026 guidance lists exercise among evidence-based nonpharmacologic options for hot flashes, sleep and mood symptoms, along with cognitive behavioral therapy, mindfulness-based approaches, clinical hypnosis and acupuncture. ACOG notes these approaches can be used alone but are generally recommended alongside hormonal or other medications. The same guidance reviews hormone therapy and nonhormonal prescription options, and stresses that treatment choices should be made through shared decision making based on your symptoms, age, health history and goals. Hormone therapy isn't right for everyone. Estrogen-alone therapy in someone who still has a uterus raises the risk of endometrial (uterine) cancer, a boxed warning on systemic estrogen-alone products, and hormone therapy can raise the risk of blood clots, stroke and breast cancer depending on age, health history and the type used.

In other words, movement is one tool, not a replacement for medical care. If your symptoms are affecting your daily life, you don't have to rely on exercise alone. You can learn more about the full range of menopause symptoms, or read about what CBT can and can't do for hot flashes.

Practical ways to get started

Exercise isn't a replacement for medical care, but it's one evidence-based option ACOG lists for symptoms, and staying active is part of overall midlife health. You don't need a perfect plan. In a perspective published alongside the Healio report, lifestyle medicine physician Michelle L. Tollefson, MD, suggested asking what you enjoy, what gets in the way and what would make movement feel possible. Some ideas from that perspective:

• Start with something you like. A walk with a friend or dancing can be a starting point.
• Adapt to how you feel. Choose activities that work with your symptoms, not against them.
• Think beyond exercise. Dr. Tollefson places movement within a bigger picture that includes healthy eating, restorative sleep, social connection, and stress management.
• Check with a clinician before starting a new exercise routine, especially if you have a heart, joint or other health condition, are pregnant, or haven't been active in a while. Stop and seek care if you have chest pain, faintness or severe shortness of breath.

When to get support for mood

Mood changes in perimenopause are common. ACOG reports that more than one-third of perimenopausal and postmenopausal women worldwide experience depressive symptoms. If low mood, anxiety or irritability are affecting your life, talk with a clinician. ACOG's guidance notes that some nonhormonal medicines can help with both hot flashes and depression.

Get help right away if you have thoughts of harming yourself. In the U.S., call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency.

Want to talk through your perimenopause symptoms and options? Talk with a licensed clinician at Kindr Health.

Sources: Healio, "Exercise may reduce perimenopause symptom burden"; The Menopause Society, 2026 Annual Meeting Program; ACOG, "ACOG Expands Recommendations for Management of Menopause Symptoms".

This article is for educational purposes only and is not medical advice. It does not replace a consultation with a licensed healthcare professional. Talk with your clinician before starting, stopping or changing any treatment. See our full medical disclaimer.

Medically reviewed by Kindr Health Clinical Team
Kindr Health Inc. — Editorial & Clinical Team, led by Kevin Wolfe, CMO
NPI 1609792902 · Last reviewed: October 22, 2026