Physical and mental health outcomes of organized sports participation in adult women: a systematic review and meta-analysis

Physical inactivity and associated non-communicable diseases disproportionately burden adult women globally. Organized sport, defined as structured, rule-governed, and socially embedded physical activity, offers a promising public health framework, yet its multi-factorial health outcomes have not been exclusively synthesized for this population. This systematic review and meta-analysis aims to evaluate the physical and mental health effects of organized sports participation among community-dwelling adult women. PubMed/MEDLINE, Scopus, PsycINFO, and Cochrane CENTRAL were systematically searched from inception to April 2026 for randomized controlled trials (RCTs), quasi-experimental, prospective cohort, and cross-sectional studies evaluating organized sports in women aged 18–65 years. Quantitative data synthesis was performed using random-effects meta-analyses in Review Manager (RevMan 5.4). Risk of bias was evaluated using the Cochrane RoB 2 and ROBINS-I tools. The study protocol was prospectively registered in PROSPERO (Registration number: CRD420251184921). Sixteen studies ( n = 6,271 women) were included. Methodological quality assessment revealed low to moderate internal validity across the randomized controlled trials, alongside a high susceptibility to residual confounding in the non-randomized designs. Meta-analysis showed that organized sports improved VO₂peak (MD = 1.51, 95% CI: 0.59 to 2.42), reduced depression (MD = − 5.30, 95% CI: −6.49 to − 4.11), increased social capital (MD = + 7.30, 95% CI: 3.78 to 10.82), reduced fat (MD = − 1.14 kg), and increased lean mass (MD = 0.90 kg). Narrative synthesis further confirmed that organized sports interventions significantly reduced absolute fat mass, optimized lean skeletal tissue, up-regulated bone-formation biomarkers, and enhanced long-term occupational functioning and social connectedness. Organized sport consistently improves physical fitness, mental health, and quality of life in adult women. Its social and structural dimensions amplify benefits beyond unstructured exercise, supporting its integration into public health strategies.