Abstract
This trial aimed to explore the effect of supervised breathing exercises (BEs) on depression, sexual function, and exercise capacity in postmenopausal women. Sixty-four depressed postmenopausal women with associated sexual dysfunction were equally assigned to either a BEs group, which received diaphragmatic BEs, or a non-exercising control group. Both groups received individualized antidepressants and vaginal lubricants. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II), sexual function using the Female Sexual Function Index (FSFI), and exercise capacity using the six-minute walk test (6MWT) at baseline and after 12 weeks. At the end of the study, the BEs group showed significantly greater reductions in BDI-II scores (mean difference = − 4.22; 95% CI, − 6.19 to − 2.24; p = 0.001) and significantly greater increases in FSFI scores (mean difference = 5.01; 95% CI, 3.21 to 6.79; p = 0.001) compared with the control group with clinically significant differences for both measures. However, the between-group difference in 6MWT distance was not significant (mean difference = 28.28 m; 95% CI, − 2 to 58.57; p = 0.06). BEs could be an effective therapeutic intervention for managing depression and sexual dysfunction in this population of postmenopausal women, while no significant effect was observed on exercise capacity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-41198-8.