Physiotherapy Can Effectively Reduce Menopausal Symptoms of Insomnia, Depression

The use of noninvasive, nonpharmacologic interventions, such as physiotherapy, can improve sleep quality and depression in women during menopause.

Physiotherapy modalities, such as exercise, yoga, and manual therapeutic interventions, may effectively reduce insomnia and depression and improve the quality of life in menopausal women, according to study findings published in BMC Women’s Health.

Insomnia and depression are 2 symptoms that women often experience when experiencing menopause. These symptoms can significantly impact well-being, quality of life, and participation in activities of daily living.

Many of the available interventions for these menopause symptoms involve hormone replacement therapy (HRT), nonhormonal medications, and nonpharmacologic treatments. Physiotherapy is one of these nonpharmacologic interventions that may benefit menopausal women without causing adverse side effects that may arise from HRT or medications.

Researchers in Egypt conducted a systematic review, searching through the Cochrane, PubMed, ScienceOpen, MIDRIS, and Embase databases for studies published within the last 12 years (2010-2022). They selected 31 studies that assessed the effects of 1 of 7 different noninvasive physiotherapy modalities on insomnia and depression in menopausal women.

Exercise…yoga, walking, reflexology, and massage may reduce insomnia and depression in perimenopausal, menopausal, and postmenopausal women.

The 7 physiotherapy modalities under investigation included exercise (9 studies), walking (4 studies), reflexology (4 studies), footbath (1 study), yoga (7 studies), therapeutic, craniofacial, and/or aromatherapy massage (5 studies), and acupressure (1 study).

Most of the varying forms of exercise, including aerobic exercise with or without nutritional education, resistance training, Pilates, and stretching, improved sleep quality, but resulted in conflicting evidence regarding improvements in depression. The types of exercise that did reduce depression involved total body resistance training, strengthening/stretching exercises, aerobic exercise plus nutritional education, and Pilates. Aerobic exercise alone was not as effective in improving depressive symptoms; however, aerobic exercise did help improve sleep quality.

Yoga, walking, aromatherapy massage, and reflexology all improved both depression and insomnia symptoms in menopausal women. In contrast, acupressure, footbath, and craniofacial massage did not have sufficient evidence to confirm or deny impact on menopausal insomnia or depression since each intervention only had 1 study describing these effects.

“Physiotherapy is a safe, noninvasive nonpharmacological intervention for improving sleep quality and depression during menopause,” the researchers wrote. “Exercise…yoga, walking, reflexology, and massage may reduce insomnia and depression in perimenopausal, menopausal, and postmenopausal women,” they added.

Study limitations included the self-reported nature of the outcome measures, the language restriction including only studies published in English in the review, and the small number of studies on certain PT modalities that decreased the ability to establish definitive conclusions.


Lialy HE, Mohamed MA, AbdAllatif LA, Khalid M, Elhelbawy A. Effects of different physiotherapy modalities on insomnia and depression in perimenopausal, menopausal, and postmenopausal women: a systematic review. BMC Womens Health. Published online July 8, 2023. doi:10.1186/s12905-023-02515-9