THE ROLE OF PHYSICAL ACTIVITY IN THE MANAGEMENT OF POLYCYSTIC OVARY SYNDROME (PCOS): METABOLIC, HORMONAL, REPRODUCTIVE, AND PSYCHOLOGICAL OUTCOMES — A NARRATIVE REVIEW

Abstract

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.