Background: This study aimed to investigate the effectiveness of Pilates exercises on emotion regulation and distress tol89erance 
in female students with premenstrual syndrome (PMS). 
Methods: The present study used a quasi-experimental pretest-posttest design with a nonequivalent control group. The research 
population consisted of female students with PMS at the Islamic Azad University of Doroud during the academic year of 2021-
2022. A convenience sampling method was employed, and 30 individuals were selected and randomly assigned to either the 
Pilates or control group. The research tools included the Premenstrual Symptoms Screening Tool (PSST), Distress Tolerance Scale 
(DTS), and Emotion Regulation Questionnaire (ERQ). These tools were administered to both the Pilates group and the control 
group in 3 stages: pretest, posttest, and follow-up. Pilates exercises were taught to the Pilates group by a professional instructor 
at the university gymnasium. Data analysis for this study was conducted using repeated measures analysis of variance (ANOVA) 
using SPSS version 22.
Results: The findings showed that considering P≤0.05, there were significant changes in the variable of emotion regulation. In the 
Pilates group, the mean score of the emotion suppression subscale increased from 12 in the pretest to 15.33 in the posttest and
16.8 in the follow-up. Similarly, the mean score of the emotion reappraisal subscale increased from 22.4 in the pretest to 26.26 
in the posttest and 26.06 in the follow-up. Additionally, the distress tolerance in the Pilates group showed an increase from 40.93 
in the pretest to 47.06 in the posttest and 47 in the follow-up.
Conclusion: Pilates exercise has an effective role in improving emotion regulation and distress tolerance in female students with 
PMS.