Effects of Traditional Chinese Exercise on Menopausal Symptoms, Bone Health and Mental Health in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis

Background: Perimenopausal and postmenopausal women commonly experience vasomotor symptoms, bone loss, and mental health challenges that diminish quality of life (QoL). Although Traditional Chinese Exercise (TCE) has shown benefits in alleviating certain menopausal symptoms, its overall effects on health-related outcomes remain controversial. Objectives: This study aimed to systematically analyze the effects of TCE on menopausal symptoms, bone health, and mental health in perimenopausal and postmenopausal women. Methods: A systematic search was conducted across 7 databases through April 2025 for randomized controlled trials (RCTs) investigating the effects of TCE in perimenopausal and postmenopausal women. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2 (RoB 2). Stata 17.0 was used for meta-analysis, with pooled outcomes reported as standardized or mean differences (SMD/MD) with 95% confidence intervals (CIs). Results: Twelve RCTs involving 1,023 participants were included. Meta-analysis showed that TCE significantly reduced menopausal symptoms (SMD = −0.82, 95% CI: −1.41 to −0.22), and depression (SMD = −1.73, 95% CI: −2.49 to −0.98). TCE also improved spine BMD (MD = 0.05, 95% CI: 0.02 to 0.08). For upper limb, thigh, pelvis, trunk, and whole-body BMD, effects remained uncertain due to the limited number of studies. Three studies assessed QoL, and pooled results showed no significant improvement in physical (MD = 4.52, 95% CI: −2.93 to 11.97) or mental component scores (MD = 3.28, 95% CI: −3.67 to 10.23). Conclusions: TCE appears to be an effective intervention for menopausal symptoms, spine BMD, and depression. However, its effects on QoL and other skeletal sites remain inconclusive. Larger, high-quality RCTs are warranted to clarify optimal protocols and long-term benefits.