Abstract
INTRODUCTION: Menopausal hormone therapy (MHT) is widely used to alleviate menopausal symptoms, but concerns regarding its risks have led many women to seek alternative treatments, such as physical activity, mindfulness, and yoga. While research suggests that these non-pharmaceutical interventions may improve quality of life (QoL), their efficacy remains debated. This study investigates the independent and interactive effects of MHT and exercise on psychosocial QoL and perceived stress in menopausal women. METHODS: A cross-sectional online survey recruited 272 women aged 40-60 experiencing menopausal symptoms. Participants reported MHT use and engagement in physical activity, mindfulness, or yoga. Psychosocial QoL was assessed using the Menopause-Specific Quality of Life (MenQoL) scale, and perceived stress was measured using PSS-10. Data were analysed using general linear models and partial correlation analyses. RESULTS: MHT use was significantly associated with poorer psychosocial QoL and worse memory complaints. However, physical activity and yoga were linked to lower perceived stress and better psychosocial QoL. In contrast, mindfulness, as a standalone therapy, was associated with higher perceived stress and depression. No significant interaction effects were observed between MHT and exercise. CONCLUSION: While MHT remains a common treatment for menopausal symptoms, its association with poorer psychosocial QoL and memory issues suggests a need for personalised approaches. Engaging in physical activity and yoga appears to offer greater mental health benefits, whereas mindfulness alone is associated with worse mental health. Future research should explore the mechanisms underlying these relationships and the long-term effects of MHT and exercise, especially in early and surgical menopausal women.