Pilates for Depression in Perimenopause: How Mindful Movement Lifts Your Mood
Find out how Pilates can help with depression during perimenopause by reducing cortisol, improving body image, and supporting emotional regulation.
Depression and Perimenopause: A Common and Under-Recognised Link
Perimenopause significantly raises the risk of depression, even in women with no prior history of mood disorders. Research suggests women are two to four times more likely to experience a major depressive episode during perimenopause than at other times in their reproductive life. The reasons are hormonal but also psychological. Estrogen helps regulate serotonin, dopamine, and norepinephrine, the neurotransmitters most closely associated with mood and motivation. As estrogen fluctuates and eventually declines, these systems become less stable. Poor sleep, hot flashes, and the broader life changes that often coincide with perimenopause, caring for aging parents, shifting identity, and health concerns, add significant psychological weight. Depression during perimenopause is real, it is hormonally influenced, and it deserves to be taken seriously. Exercise is one of the few interventions with strong evidence across both the hormonal and psychological dimensions of this kind of depression.
Why Pilates Is Particularly Well Suited to Perimenopausal Depression
Pilates offers something that running or gym-based cardio often does not: a combination of physical exertion and mindful, present-focused movement. Depression is closely associated with rumination, the tendency to dwell on negative thoughts, regrets, and worries. Pilates interrupts this because it demands your full attention. Following precise movement cues, controlling your breath, maintaining form, and engaging the right muscles simultaneously leaves very little mental space for rumination. This present-moment focus produces an effect similar to meditation. Pilates also strengthens the deep core and postural muscles, which tend to weaken with age and inactivity. Improved posture has been shown to directly affect mood, partly through the physical confidence it creates and partly because upright posture influences brain chemistry and self-perception. Women who feel stronger and more capable in their bodies often report improvements in mood that go beyond the direct neurochemical effects of exercise.
What Pilates Does to Your Brain Chemistry
Like other forms of exercise, Pilates triggers the release of endorphins, dopamine, and serotonin. These are the neurochemicals that antidepressants also target, through different mechanisms. Exercise produces these effects naturally and without side effects. Regular Pilates practice also lowers cortisol over time. Elevated cortisol is both a symptom and a driver of depression, and reducing it helps break that cycle. Pilates specifically supports the body-brain connection through its emphasis on breathing. Slow, diaphragmatic breathing activates the vagus nerve, which is the main channel of the parasympathetic nervous system. Vagal activation reduces the body's stress response at a physiological level, reducing the physical tension that accompanies depression and helping regulate the emotional brain.
Research on Pilates and Mood in Midlife Women
A 2021 randomised controlled trial published in the Journal of Bodywork and Movement Therapies found that 12 weeks of mat Pilates significantly reduced depression and anxiety scores in middle-aged women compared to a control group. A 2020 meta-analysis in Complementary Therapies in Clinical Practice reviewed 17 studies on Pilates and psychological wellbeing and found consistent evidence for reduced depression, anxiety, and perceived stress. The studies also noted improvements in body image and self-efficacy, which are particularly relevant for perimenopausal women dealing with body changes. A review in Maturitas in 2022 concluded that mind-body exercises, which include Pilates, yoga, and tai chi, are especially effective for the psychological symptoms of menopause compared to conventional gym exercise, possibly because of the mindfulness component that is built into the practice.
Getting Started With Pilates for Depression
A beginner Pilates class, either mat-based or reformer-based, is an accessible starting point. Mat Pilates requires no special equipment beyond a mat and can be done at home with guided videos if attending a studio is not practical. When depression is present, the barrier to starting anything new can feel enormous. If that resonates, give yourself permission to start with just one session, ideally a structured class rather than a solo home practice at first, because the social element and the teacher's guidance remove some of the cognitive load. Many gyms and community centres offer beginner Pilates classes specifically for women in midlife. Two to three sessions per week is enough to begin experiencing mood benefits. The benefits build over weeks, so committing to a month before evaluating whether it is helping gives a fair trial.
Tracking Your Mood and Movement Together
Depression can blunt the ability to notice gradual improvements. You may be getting better without it feeling that way from day to day. Tracking your Pilates sessions and your mood over time gives you an objective record that depression itself might obscure. PeriPlan lets you log your workouts and record how you are feeling emotionally so you can look back over weeks and see whether patterns are shifting. Even small, consistent upward trends in your mood ratings across weeks are meaningful and worth noticing. If you are also working with a doctor or therapist on depression during perimenopause, your logs provide concrete information about what you have been doing and how you have been feeling, which helps them support you more effectively.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.