Impact of Physical Activity on Polycystic Ovary Syndrome in Women: Systematic Review and Meta-Analysis

Aim: The aim of this study is to assess the impact of different types of exercise on important outcomes related to reproductive function as well as factors related to metabolic parameters in females with poly cystic ovary syndrome (POCS). Methods: This systematic review and meta-analysis adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Included randomized trials' risk of bias was evaluated using the updated Cochrane Risk of Bias Tool (RoB 2). With discrepancies resolved by a third reviewer, two independent reviewers examined research papers, gathered data, and assessed methodological quality. Results: Our systematic search identified 35 studies involving 7526 patients. The analysis revealed that exercise interventions significantly increased menstruation frequency/year (SMD: 0.51, 95% CI: 0.15–0.87). No significant effects were observed on FSH (SMD: −0.02, 95% CI: −0.19, 0.14), LH (SMD: −0.44, 95%CI: −1.06, 0.18), and testosterone (SMD: 0.13, 95% CI: −0.09, 0.35). For metabolic outcomes, exercise reduced BMI (SMD: −0.11 kg/m², 95% CI: −0.23, −0.01) and homeostatic model assessment for insulin resistance (HOMA-IR) (SMD: −0.43 kg/m², 95% CI: −0.73, −0.13). Conclusion: The meta-analysis found that exercise therapies improved menstruation frequency and metabolic outcomes, particularly insulin resistance and waist circumference, in women with PCOS. However, exercise did not significantly differ from dietary interventions in terms of lowering BMI or enhancing insulin sensitivity. The study suggests the need for consistent, structured interventions to achieve significant clinical improvements, while supporting current guidelines primarily for metabolic benefits.