A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is characterized by menstrual irregularity and elevated serum androgens, and is often accompanied by insulin resistance. The etiology of PCOS is unknown. Lifestyle interventions and weight loss, where appropriate, remain first-line treatments for women with PCOS. Regular physical activity is recommended for women with PCOS to maintain a healthy weight and cardiovascular fitness. Purpose: To review the evidence for the impact of various exercise interventions on hormone levels in women with PCOS. Methods: A systematic review of original studies indexed in PubMed that utilized an exercise intervention in women with PCOS and reported hormone values pre- and post-intervention. Studies in which the effects of the exercise intervention could be determined were included. Results: Vigorous aerobic exercise improves insulin measures in women with PCOS. Resistance or strength training may improve androgen levels, though additional studies are warranted. Studies with yoga are limited but suggest improvements in androgens. Limited information is available on the impact of exercise on adipokines and anti-Müllerian hormone, warranting further investigation. Conclusions: Recommended guidelines for women with PCOS include vigorous aerobic exercise and resistance training to improve measures of insulin sensitivity and androgen levels.

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

“…In our analysis, neither HITT nor MISS significantly improved HOMA-IR. Similar results have been reported recently, with no improvement in HOMA-IR or fasting insulin following 16 weeks of HIIT exercise (Lionett et al, 2021) and equivocal results following MISS exercise (Shele et al, 2020) in individuals with PCOS. However, we did observe a significant reduction in fasting insulin following MISS exercise, which may suggest improved insulin sensitivity, as a reduced amount of insulin is required to act upon a given concentration of glucose in order to maintain normal metabolic homeostasis (Iaccarino et al, 2021).…”

Polycystic Ovary Syndrome in Insulin-Resistant Adolescents with Obesity: The Role of Nutrition Therapy and Food Supplements as a Strategy to Protect Fertility

“…Thus far, no pharmacological treatment has been approved in adolescents, but there are different options for coping with PCOS symptomatology, divided into baseline and additional treatments [18]. Among the baseline interventions, the first line of treatment is lifestyle modification, including diet [37], physical activity and weight loss [38]. These interventions have been shown to alter the course of disease in overweight and obese girls [3], decreasing androgen levels and menstrual irregularities and improving cardiometabolic health [18].…”

Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome

“…Exercise increases levels of anti-inflammatory cytokines (IL-4, IL-10), decreases levels of the proinflammatory cytokine TNF-α and reduces the levels of phosphorylation of the main inflammatory response pathways IKKα/β/JNK [ 113 ]. Additionally, exercise is known to improve the levels of sex hormones (testosterone, follicle-stimulating hormone) and insulin sensitivity [ 114 , 115 ]. There are several known molecular mechanisms involved in the beneficial effects of exercise.…”