Background: Premenstrual syndrome refers to a constellation of cyclical somatic, psychological, and behavioral changes that recur during the late luteal phase of the menstrual cycle. These recurring disturbances impair daily life and occupational performance, and their long-term accumulation may predispose individuals to more severe physical or psychological conditions.
Objective: We aimed to systematically evaluate the efficacy of exercise interventions for alleviating negative affect, pain, and fatigue in women diagnosed with premenstrual syndrome (PMS).
Design: A systematic review and meta-analysis was conducted.
Methods: Search of publications was conducted in Web of science, Embase, Pubmed, and The Cochrane Library. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan’s Q test and quantified using the I2 index.
Results: Of the 20 articles selected, six applied running ; three, Pilate ; and eleven, yoga. The meta-analysis showed that exercise improved negative affect (P < 0.01), pain symptoms (P < 0.01), and fatigue symptoms (P < 0.01). Subgroup analyses revealed that running for 9–12 weeks at a frequency of three or more sessions per week appeared to be more effective in alleviating negative affect. Similarly, yoga practiced with the same duration and frequency (9–12 weeks and ≥ 3 sessions/week) appeared to be more effective in pain symptoms, while a program of 9–12 weeks appeared to be more effective for reducing fatigue.
Conclusion: Exercise has a ameliorative effect on negative affect, pain, and fatigue in women with PMS. Among the programs studied, running for 9–12 weeks at ≥ 3 sessions/week appeared to be more effective in negative affect, while yoga for 9–12 weeks at ≥ 3 sessions/week appeared to be more effective for pain relief, and yoga for 9–12 weeks appeared to be more effective for fatigue alleviation.
Prospero registration: CRD420251088581.
Supplementary Information: The online version contains supplementary material available at 10.1186/s12905-025-04242-9.
Keywords: Exercise; Fatigue; Negative affect; Pain; Premenstrual syndrome; Systematic review.