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A new study found that exercising more frequently may help alleviate perimenopause symptoms like hot flashes, anxiety, and urinary issues.
The study results were recently presented at The Menopause Society’s 2026 Annual Conference.
Perimenopause is the transitional period leading up to menopause.
Due to hormonal changes that mark the end of a person’s reproductive years, symptoms like hot flashes, mood swings, brain fog, insomnia, and urinary incontinence are common.
Past studies show that lifestyle modifications, such as eating a healthy diet, managing stress, and getting enough physical activity, can help reduce some perimenopause symptoms.
“Physical activity is low cost, accessible, and already known to benefit sleep, mood, and heart and bone health — all areas that matter a great deal during perimenopause,” said study lead and co-author Liudmila Zhaunova, PhD, director of science at Flo Health — the developer of a women’s health tracking app, which was used to collect health data for this study. “But when we looked at the research, there was surprisingly little evidence specific to perimenopause.”
“Hormone therapy isn’t suitable or desired for everyone, so women deserve a broader set of evidence-based options,” Zhaunova told Healthline. “The more we understand about accessible, lifestyle-based approaches, the better equipped women and their healthcare providers are to build a plan that works for them.”
Higher rates of exercise lower perimenopause symptoms overallStudy researchers recruited more than 1,800 women from around the globe who were using the Flo app.
Study participants were asked to complete online surveys about their physical activity, from not being physically active to exercising more than 5 days a week.
Participants were also asked to report on their perimenopause symptoms in three categories — somatic (body-based issues like hot flashes), psychological (mental health issues like mood changes), and urogenital (issues regarding the urinary or vaginal areas). Researchers rated the severity of these symptoms using the Menopause Rating Scale (MRS).
The researchers found that higher rates of physical activity were associated with fewer perimenopausal symptoms across all three categories.
“Perimenopause symptoms are wide-ranging, and women often experience several at once,” Zhaunova said. “Seeing a lower symptom burden across all three domains suggests that being more active may be relevant to women’s overall experience, not just one symptom.”
Mental health benefits of exercise were most pronouncedAdditionally, the scientists discovered that the greatest exercise benefit was observed in the reduction of perimenopausal psychological symptoms.
“Psychological symptoms, such as low mood, irritability, anxiety, and exhaustion, are among the most disruptive parts of perimenopause, and they’re often overlooked or not recognized as related to this life stage,” Zhaunova explained.
“Our findings suggest that physical activity may matter most for mood and anxiety-related symptoms,” she continued.
“This could help women and clinicians have more informed conversations about how to support mental well-being during perimenopause. That said, women with more symptoms may find it harder to exercise, so we need further research to understand the direction of the relationship.”
How exercise may improve perimenopause symptomsSherry Ross, MD, a board certified OB-GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, said that regular exercise could potentially help relieve perimenopause symptoms like hot flashes and mood changes. Ross wasn’t involved in this study, but noted other benefits of exercising during this life stage:
“Exercise releases endorphins, improves blood vessel health, lowers inflammation, helps reset circadian rhythm, and improves the body’s internal cooling system,” Ross told Healthline. “Collectively, these changes ease anxiety, irritability, mood changes, sleep, and fatigue.”
“There were mixed reviews on how exercise benefits hot flashes, but exercise does help with weight control, which may benefit hot flashes,” she said. “Strengthening the pelvic floor and core may help with the urinary symptoms women many experience in perimenopause.”
Exercise tips for perimenopausal womenPrudence Hall, MD, an OB-GYN in private practice in Santa Monica, CA, and author of “Radiant Again & Forever,” said that building a sustainable exercise routine requires consistency, joy, and community. Hall wasn’t involved in the study, but shared some exercise tips for perimenopausal women.
“Too often in midlife, previously stable women suddenly plummet into deep depression and anxiety, only to be prescribed multiple medications with debilitating side effects that never address the underlying biology,” Hall said.
“While hormone optimization remains essential to correct these endocrine deficiencies, exercise serves as a powerful, non-pharmaceutical therapy that directly targets the true root causes by revitalizing our cellular health and restoring overall vitality.”