Factors Influencing Exercise Engagement Among Women With Depression: A Systematic Review

Exercise is a potentially effective treatment for depression, but some evidence suggests that women with depression are less likely than men to engage in exercise as a treatment. This review aims to identify barriers and enablers to women engaging in exercise and/or physical activity as a treatment for depression. MEDLINE (OVID), PsycINFO (OVID), CINAHL (EBSCOhost) and SportDISCUS were searched until February 2025. Studies of any design that examine barriers and enablers to women participating in exercise interventions for treatment of depression that were published from 2004 (the year clinical practice guidelines first recommended exercise as a standard treatment for depression) were included. Studies that did not report findings separately for women were excluded. Quality appraisal tools were used to assess the methodological quality according to study design. Six studies (four qualitative and two observational) involving 139 participants were included. Lack of time, symptoms of depression, weather conditions and low self-efficacy were identified as barriers to women engaging in exercise as treatment for depression. Barriers unique to women included caregiving responsibilities, safety concerns and, in some cases, the need for permission. Support from family and friends, exercise related to weight loss and perceived impact on health and wellbeing were reported as enablers. Critical appraisal identified important sources of bias in all but one of the included studies. Exercise has potential as a treatment for depression in women, but barriers like time constraints and depressive symptoms can hinder adoption, while factors such as support from others can encourage it.