The Effect of Exercise on Reproductive and Metabolic Outcomes in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.

TL;DR

This meta-analysis of 22 RCTs (1044 women) demonstrates that exercise alone significantly reduces androgens, insulin resistance, and improves lipid profiles in PCOS patients. Benefits are optimized with ≥150 min/week of moderate-to-low intensity activity and vary by ethnicity and baseline BMI.

Key findings

• Exercise reduced total and free testosterone, fasting insulin, HOMA-IR, and increased HDL regardless of combined interventions
• Moderate-to-low intensity exercise specifically increased sex hormone-binding globulin levels
• ≥150 min/week of exercise produced more pronounced testosterone reductions than lower volumes
• Asian populations showed the largest metabolic improvements; non-obese PCOS patients had greater androgen reductions than obese counterparts

Why this matters at the bedside

Establishes exercise as an independent, effective first-line intervention for PCOS with measurable endocrine and metabolic benefits; findings support personalized exercise prescription based on intensity, duration, and patient characteristics including ethnicity and obesity status.