THE ROLE OF PHYSICAL ACTIVITY IN THE MANAGEMENT OF POLYCYSTIC OVARY SYNDROME (PCOS): METABOLIC, HORMONAL, REPRODUCTIVE, AND PSYCHOLOGICAL OUTCOMES — A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6207Keywords:
Polycystic Ovary Syndrome, PCOS, Physical Activity, Exercise, Quality Of Life, Insulin ResistanceAbstract
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and is associated with insulin resistance, hyperandrogenism, ovulatory dysfunction, adverse cardiometabolic profiles, and a substantial burden of psychological distress. Lifestyle modification is recommended as first-line management, and physical activity has emerged as a central, modifiable component of non-pharmacological care.
Objective: This narrative review synthesises current evidence on the effects of physical activity and structured exercise on metabolic, hormonal, reproductive, and psychological outcomes in women with PCOS, and considers the comparative value of different exercise modalities.
Methods: A narrative review was conducted using PubMed, Google Scholar, and Scopus for publications from 2015 to 2025, supplemented by seminal earlier work. Randomised controlled trials, cohort studies, systematic reviews, and meta-analyses evaluating structured or habitual physical activity in women with PCOS were analysed qualitatively.
Results: Regular exercise was consistently associated with improved insulin sensitivity, favourable changes in body composition and lipid profiles, reductions in circulating androgens with increased sex hormone-binding globulin, and improvements in menstrual regularity, ovulation, psychological well-being, and quality of life. Many benefits occurred independently of substantial weight loss. Aerobic, resistance, high-intensity interval, and combined training all conferred benefits, with effect sizes varying by modality, intensity, and duration.
Conclusions: Physical activity is an effective and broadly beneficial element of PCOS management. Individualised exercise prescription, strategies to improve adherence, and higher-quality trials are needed to optimise and standardise recommendations.
References
Almenning, I., Rieber-Mohn, A., Lundgren, K. M., Shetelig Løvvik, T., Garnæs, K. K., & Moholdt, T. (2015). Effects of high intensity interval training and strength training on metabolic, cardiovascular and hormonal outcomes in women with polycystic ovary syndrome: A pilot study. PLOS ONE, 10(9), e0138793.
Banting, L. K., Gibson-Helm, M., Polman, R., Teede, H. J., & Stepto, N. K. (2014). Physical activity and mental health in women with polycystic ovary syndrome. BMC Women's Health, 14, 51. https://doi.org/10.1186/1472-6874-14-51
Benham, J. L., Yamamoto, J. M., Friedenreich, C. M., Rabi, D. M., & Sigal, R. J. (2018). Role of exercise training in polycystic ovary syndrome: A systematic review and meta-analysis. Clinical Obesity, 8(4), 275–284. https://doi.org/10.1111/cob.12258
Bozdag, G., Mumusoglu, S., Zengin, D., Karabulut, E., & Yildiz, B. O. (2016). The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 31(12), 2841–2855.
Brutocao, C., Zaiem, F., Alsawas, M., Morrow, A. S., Murad, M. H., & Javed, A. (2018). Psychiatric disorders in women with polycystic ovary syndrome: A systematic review and meta-analysis. Endocrine, 62(2), 318–325.
Cooney, L. G., Lee, I., Sammel, M. D., & Dokras, A. (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 32(5), 1075–1091.
dos Santos, I. K., Nunes, F. A. S. S., Queiros, V. S., Cobucci, R. N., Dantas, P. B., Soares, G. M., Cabral, B. G. A. T., Maranhão, T. M. O., & Dantas, P. M. S. (2021). Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 16(1), e0245023. https://doi.org/10.1371/journal.pone.0245023
Hakimi, O., & Cameron, L.-C. (2017). Effect of exercise on ovulation: A systematic review. Sports Medicine, 47(8), 1555–1567. https://doi.org/10.1007/s40279-016-0669-8
Harrison, C. L., Lombard, C. B., Moran, L. J., & Teede, H. J. (2011). Exercise therapy in polycystic ovary syndrome: A systematic review. Human Reproduction Update, 17(2), 171–183. https://doi.org/10.1093/humupd/dmq045
Kałużna, M., Człapka-Matyasik, M., Wachowiak-Ochmańska, K., Moczko, J., Kaczmarek, J., Janicki, A., Ruchała, M., & Ziemnicka, K. (2022). Effect of habitual physical activity on fatigue, mood disturbances, and selected metabolic parameters in women with polycystic ovary syndrome. Journal of Clinical Medicine, 11(3), 561.
Kite, C., Lahart, I. M., Afzal, I., Broom, D. R., Randeva, H., Kyrou, I., & Brown, J. E. (2019). Exercise, or exercise and diet, for the management of polycystic ovary syndrome: A systematic review and meta-analysis. Systematic Reviews, 8(1), 51.
Kogure, G. S., & Lara, L. A. S. S. (2021). Effects of physical exercise on the polycystic ovary syndrome. Minerva Medica, 112(5), 596–611.
Lim, S. S., Hutchison, S. K., Van Ryswyk, E., Norman, R. J., Teede, H. J., & Moran, L. J. (2019). Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 2019(3), CD007506. https://doi.org/10.1002/14651858 CD007506.pub4
Moran, L. J., Ko, H., Misso, M., Marsh, K., Noakes, M., Talbot, M., & Teede, H. J. (2013). Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics, 113(4), 520–545.
Palomba, S., Giallauria, F., Falbo, A., Russo, T., Oppedisano, R., Tolino, A., Colao, A., Vigorito, C., Zullo, F., & Orio, F. (2008). Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: A 24-week pilot study. Human Reproduction, 23(3), 642–650. https://doi.org/10.1093/humrep/dem391
Pandit, U., Singh, M., Ranjan, R., Ahmad, L., & Kumari, A. (2022). The effect of exercise training on body composition, insulin resistance and high sensitivity c-reactive protein (Hs-CRP) in women with polycystic ovary syndrome: A pilot study from north india. Cureus, 14(4), e23994.
Patten, R. K., Boyle, R. A., Moholdt, T., Kiel, I., Hopkins, W. G., Harrison, C. L., & Stepto, N. K. (2020). Exercise interventions in polycystic ovary syndrome: A systematic review and meta-analysis. Frontiers in Physiology, 11, 606.
Patten, R. K., Pascoe, M. C., Moreno-Asso, A., Boyle, R. A., Stepto, N. K., & Parker, A. G. (2021). Effectiveness of exercise interventions on mental health and health-related quality of life in women with polycystic ovary syndrome: A systematic review. BMC Public Health, 21(1), 2310. https://doi.org/10.1186/s12889-021-12280-9
Richards, C. T., Meah, V. L., James, P. E., Rees, D. A., & Lord, R. N. (2021). HIIT'ing or MISS'ing the optimal management of polycystic ovary syndrome: A systematic review and meta-analysis of high- versus moderate-intensity exercise prescription. Frontiers in Physiology, 12, 715881. https://doi.org/10.3389/fphys.2021.715881
Shele, G., Genkil, J., & Speelman, D. (2020). A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. Journal of Functional Morphology and Kinesiology, 5(2), 35.
Szczuko, M., Kikut, J., Szczuko, U., Szydłowska, I., Nawrocka-Rutkowska, J., Ziętek, M., Verbanac, D., & Saso, L. (2021). Nutrition strategy and life style in polycystic ovary syndrome — narrative review. Nutrients, 13(7), 2452.
Tay, C. T., Moran, L. J., Harrison, C. L., Brown, W. J., & Joham, A. E. (2020). Physical activity and sedentary behaviour in women with and without polycystic ovary syndrome: An australian population-based cross-sectional study. Clinical Endocrinology, 93(2), 154–162. https://doi.org/10.1111/cen.14205
Teede, H. J., Tay, C. T., Laven, J. J. E., Dokras, A., Moran, L. J., Piltonen, T. T., Costello, M. F., Boivin, J., Redman, L. M., Boyle, J. A., Gibson-Helm, M., Wijeratne, N. H., Butcher, B. E., Lim, S. S., Norman, R. J., Mousa, A., & Joham, A. E. (2023). Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 108(10), 2447–2469.
Woodward, A., Klonizakis, M., & Broom, D. (2020). Exercise and polycystic ovary syndrome. Advances in Experimental Medicine and Biology, 1228, 123–136.
Zhang, X., Zheng, X., Fang, M., & Liu, W. (2023). Physical activity and polycystic ovary syndrome: Associations with risk and metabolic features. BMC Women's Health, 23(1), 114.
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Copyright (c) 2026 Weronika Plichtowicz-Kordowska, Aleksandra Stępka, Lena Jaworowicz, Agnieszka Jóźwicka, Wojciech Janikowski, Karina Lewandowska, Ewa Bąkowska
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