Mind-body exercise ranks best for easing depression after menopause

Exercise has been identified as a promising non-drug therapy for managing depression, but there is genuine controversy over which type works best. For postmenopausal women in particular, that question has lacked a direct answer, because trials have tested everything from aerobic sessions to combined programmes to gentler practices pairing movement with breath and attention. Without comparing those options against each other, women and clinicians are left guessing about where to start. This review set out to compare and rank exercise types for depression specifically in postmenopausal women.

The researchers searched eight databases, including PubMed, Web of Science, the Cochrane Library and EMBASE, for randomised controlled trials published up to 1 March 2024 that tested exercise against a control for depression in postmenopausal women. Twenty-six studies with 2,170 participants met the criteria. Changes from before to after each intervention were pooled in a pairwise analysis, and a network analysis then compared the exercise types against each other to estimate which was most likely to be the most effective. Risk of bias was assessed with the revised Cochrane tool, and confidence in each comparison was formally graded.

Overall, exercise had a significant positive effect on depression, with a pooled standardised effect of -0.71 versus control. In the network comparison, mind-body exercise showed the largest effect at -0.97, followed by aerobic exercise at -0.58 and multicomponent exercise at -0.57, and mind-body exercise had the highest probability of being the most effective type. Exercise interventions also showed positive effects on anxiety. The individual trials disagreed with each other considerably, most were judged to have some concerns about bias, and confidence in the evidence was often rated very low.

Exercise already has a reputation as an aid against depression in the general population, and this review extends that picture to postmenopausal women specifically while adding something new: a ranking of exercise types. The finding that mind-body exercise had the highest probability of being most effective is intriguing, but the authors themselves grade the supporting evidence as very low to moderate quality. That means the ranking could shift as larger and better-conducted trials arrive. It also remains unclear how much benefit depends on session frequency, duration or supervision, questions this analysis was not designed to settle.

For a woman navigating low mood after menopause, this is a reason to see movement itself as part of the toolkit rather than waiting for a single best answer. The pooled data suggest several forms of exercise helped, so the type a person will actually keep doing may matter as much as the type that topped the ranking. Mind-body practices earned the strongest position here, which makes them a reasonable place for the curious to look first. The evidence quality is mixed, so firm promises are not on offer, and none of this replaces professional care for depression.