What types and amounts of exercise help or harm PMS?

Background: Premenstrual syndrome (PMS) is characterised by cyclic somatic, emotional, and behavioural symptoms during the luteal phase. Physical activity is a potential non-pharmacological strategy, but its effects may depend on exercise type, intensity, and volume. Aim: This narrative review aimed to discuss the impact of different physical activity types and intensities on PMS, emphasizing the therapeutic role of moderate exercise and risks of high training workloads. Materials and Methods: A narrative literature review was conducted using PubMed/MEDLINE and Google Scholar (2015–2026). The search included randomized controlled trials, observational studies, reviews, and guidelines related to PMS/PMDD, aerobic exercise, resistance training, yoga, training load, low energy availability, and RED-S. Results: Evidence suggests that regular physical activity reduces physical and psychological PMS symptoms (pain, fatigue, anxiety, low mood). The strongest evidence supports aerobic exercise and yoga; data on resistance training are limited. Regular, moderate activity appears most beneficial. Conversely, high training loads combined with insufficient caloric intake may lead to low energy availability, RED-S, menstrual dysfunction, and impaired health. Conclusions: Regular, moderate physical activity adapted to individual tolerance is a useful supportive strategy in PMS management. Recommendations should consider symptom severity, menstrual health, training status, energy availability, and recovery. Further high-quality studies are required to establish optimal exercise protocols for women with PMS.

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