The Effect of Exercise on Reproductive and Metabolic Outcomes in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
Abstract
Aim: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder, and the independent effect of exercise as a fundamental intervention for it remains to be clarified. Therefore, this study aimed to examine the effect of exercise intervention alone on improving reproductive endocrine and metabolic profiles in individuals with PCOS.
Methods: A systematic search of multiple databases was conducted for randomized controlled trials (RCTs) published until July 2025. Data from eligible RCTs were collected, and quality evaluation with meta-analysis was performed.
Results: This investigation encompassed 22 RCTs involving 1044 women with PCOS. The meta-analysis indicated that exercise significantly reduced total testosterone (TT), free testosterone, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR), while increasing high-density lipoprotein levels. Subgroup analyses showed that moderate-to-low intensity exercise specifically increased sex hormone-binding globulin. Exercise duration ≥ 150 min per week yielded more pronounced reductions in TT. Concerning population characteristics, Asian cohorts exhibited particularly prominent improvements in reducing body mass index, TT, low-density lipoprotein, fasting insulin, and HOMA-IR. South American and European populations showed significant benefits in lowering TT and fasting insulin, respectively. Moreover, non-obese women with PCOS experienced greater reductions in TT compared to their obese…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,044 participants or records.
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