BACKGROUND: Menopause, a major transition in a woman's life characterized by decline of estrogen and progesterone levels, is a hormonal shift associated with a range of symptoms that can adversely impact women's quality of life, including vasomotor symptoms such as hot flushes and night sweats, and urogenital symptoms such as vaginal dryness and sexual dysfunction. This study aimed to investigate the effects of Pilates exercises on menopausal symptoms and sexual dysfunction in postmenopausal women. METHODS: A total of 30 postmenopausal women, divided into a Pilates group and a control group, participated in this study. The Pilates group took part in an 8-week Pilates exercise program, while the control group received no exercise intervention, but attended menopause information sessions. The data were collected using the Menopause Rating Scale, the Menopausal-Specific Quality of Life scale, and the Female Sexual Function Index before and after the intervention. Body mass index was recorded, but not used in the primary analysis. RESULTS: Post-intervention scores on the Menopause Rating Scale and Menopausal-Specific Quality of Life scales indicated better management of menopausal symptoms and an enhancement in the quality of life in the Pilates group. The Female Sexual Function Index scores in the Pilates group also improved, suggesting a positive impact of Pilates exercise program on sexual function. Taken together, the findings demonstrate the potential of Pilates exercises as an effective non-pharmacological intervention for alleviating menopausal symptoms, enhancing quality of life, and improving sexual function in postmenopausal women. CONCLUSION: This study suggests that regular Pilates exercises can be an effective non-pharmacological intervention to alleviate menopausal symptoms and improve sexual dysfunction in postmenopausal women. The findings support the integration of Pilates into postmenopausal care strategies to enhance overall wellbeing among postmenopausal women.

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