BACKGROUND: Premenstrual symptoms in women of reproductive age are associated with substantial distress and functional impairments. A healthy lifestyle is the first step to manage premenstrual symptoms. Recreational physical activities have been recommended as an alternative to medical management in easing premenstrual symptoms. OBJECTIVE: The objective of this systematic review is to analyze the effects of aerobic exercises in improving premenstrual symptoms among healthy women. METHODS: Randomized controlled trials (RCTs) published from inception to February 2022, were searched using keywords in electronic databases such as, Scopus, PubMed, PEDro, Cochrane and web of science. RCTs published in English, comparing the effects of aerobic exercise with other interventions or controls were included. PEDro scale and Cochrane collaboration tool for risk of bias was used to assess the methodological quality of included trials. Data from the included study and the participant's characteristics, interventions, outcome and results were extracted. RESULTS: Five RCTs with 492 participants were included in this systematic review. Methodological quality assessed by PEDro (4.8/10) and Cochrane collaboration tool for risk of bias were moderate. Allocation concealment, blinding of participants and outcome assessors were the most common bias in all included studies. Walking, swimming and running were the common aerobic exercises performed in the RCTs. Aerobic exercise is effective in improving physical physiological symptoms among women with premenstrual syndrome (PMS). CONCLUSION: Aerobic exercises are effective in improving premenstrual symptoms. This review provides moderate evidence for improving hematological parameters during PMS. Further RCTs with long term follow up and quality of life would consolidate our findings.

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