Skip to main content
NCBI home page
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
. 2023 Apr 4. Online ahead of print. doi: 10.1016/j.scispo.2022.11.001

Effect of 12-week of aerobic exercise on hormones and lipid profile status in adolescent girls with polycystic ovary syndrome: A study during COVID-19

Effet de 12 semaines d’exercices aérobiques sur les hormones et l’état du profil lipidique chez des adolescentes atteintes du syndrome des ovaires polykystiques : étude pendant la COVID-19

S Babaei Bonab a,*, M Parvaneh b
PMCID: PMC10070775  PMID: 37362083

Abstract

Background and aim

COVID-19 as a viral disease has brought up the need to exercise more than before due to its physiological effects on health. Therefore, this study investigates the effect of 12-week of aerobic exercise on female students’ hormone levels and lipid profile with polycystic ovary syndrome (PCOS) during the COVID-19 pandemic.

Method

Using a 12-week quasi-experimental with pretest, posttest research design among 40 Iranian female students aged 18–14 with PCOS, we randomly allocated the participants to either an experimental (they performed aerobic exercises three 60-minute sessions per week at home using content production) or a control condition. Their anthropometric and blood samples (e.g., testosterone, estrogen, prolactin, and lipid profile) were taken in two stages before and after the training protocol.

Results

The results of analysis indicated that 12-week of aerobic exercise reduced testosterone (P = 0.041), prolactin (P = 0.001), estrogen (P = 0.001), body mass (P = 0.002), body mass index (P = 0.002), cholesterol (P = 0.005), triglyceride (P = 0.001) and low-density lipoprotein (P = 0.001), whilst increased high-density lipoprotein (P = 0.002).

Conclusion

Findings demonstrated that performing aerobic exercises is an effective and non-invasive method that could have a positive effect on young girls’ PCOS during COVID-19 pandemic.

Keywords: Aerobic training, COVID-19 pandemic, Estrogen, PCOS, Testosterone

1. Introduction

The health care system has confronted one of the most critical situations in its history in Iran and many countries in the world in 2020 [1]. The novel coronavirus (COVID-19) pandemic has challenged many of the medical and health science accomplishments [1]. Coronavirus is the name of a large family of viruses (more than 40 viruses) ranging from the common cold to the more severe diseases such as severe acute respiratory syndrome and the Middle East respiratory syndrome [1]. The newly discovered coronavirus that causes an infectious disease is called COVID-19 and is transmitted through droplets or coughing, sneezing, and touching objects [2]. Due to the high prevalence of this virus, many governments have adopted strategies to ban public facilities such as schools, universities, restaurants, and many unnecessary businesses. As a result, performing sports activities in public centers such as gyms and athletic clubs have been banned. Practicing preventive actions and adopting an active lifestyle are the two most important strategies to reduce the risk of COVID-19 in these circumstances [3]. According to the World Health Organization physical inactivity is the fourth leading cause of death after blood pressure, smoking, and hyperglycemia [4]. Therefore, there is a possibility of dysfunction of various body organs with the sedentary behaviors increase during home quarantine [2]. Thus, efforts have been made to integrate an active lifestyle into individuals’ life particularly those who were not active enough during the quarantine period. The importance of sports activities in the health and physical health of the community is quite evident and perceived as an integral part of physical health. Taking into account young girls’ physiological conditions and needs, it is necessary to place importance on their sport as a considerable part of the body of society [5]. Since performing physical activity either increase or decrease the amount of some hormones compared to the amount of rest time. Although the physiological significance of many of these changes is currently unknown, the fact that they react to sports activities is of paramount importance [6]. Polycystic ovary syndrome (PCOS), also known as stein-leventhal syndrome, is a common endocrine disorder among women of reproductive age. PCOS begins during puberty, but the source of impaired ovarian androgen production may occur in childhood or even during fetal development [7]. As a result, the onset of clinical symptoms at puberty which leads to hyperandrogenism and ovulation disorders due to increased serum lutein hormone concentration, is considered an abnormality in adolescents with hyperandrogenism [8]. Early diagnosis and initiation of treatment can help prevent its long-term complications [9]. PCOS is a heterogeneous set of signs and symptoms that make up the mild to severe range of reproductive disorders, endocrine and metabolic functions [10]. Irregular menstrual cycles, abnormal facial hair growth, infertility, weight gain, androgen increase, anovulation, increased testosterone, increased prolactin and many other identifying factors are among the significant symptoms of this syndrome [6], [10].

The prolactin hormone is one of the hormones that is being studied for its involvement in the development of PCOS. It is secreted by lactotroph cells of the anterior pituitary gland, and its secretion rate is under the control of dopamine. The serum level of this hormone in non-pregnant women is low and about 25 ng and increases by 10-times during pregnancy to produce milk [9]. Hyperprolactinemia can lead to infertility, amenorrhea, and galactorrhea; in other words, hyperprolactinemia has been detected in one-third of infertile patients who do not menstruate [9]. The results of some studies suggested that PCOS increases prolactin by secondarily affecting hypothalamic activity. As a result, a higher prevalence of hyperprolactinemia has been reported in patients with PCOS [11], [12].

Moreover, the ovaries produce too much androgen in women with PCOS. Androgens are male hormones such as testosterone that are produced by women as well [13]. An increase in these hormones will affect ovum formation and release during the ovulation period [13]. Accordingly, the endocrine system, which during a period of follicle development plays an essential role in oocyte maturation before ovulation, is abnormal in women with PCOS and is associated with increased follicular vascularity and abnormal granulosa cell function [13], [14]. According to studies, patients with polycystic ovary syndrome have higher cholesterol, triglycerides, low-density lipoprotein (LDL) total levels and lower high-density lipoprotein (HDL) levels than healthy women [15]. As we know, all steroid hormones like estrogen derived from cholesterol, so the increase of cholesterol increases the synthesis of steroid hormones like estrogen as well [16]. Physical activity intervention, health counseling, and medication are some of the ways that can prevent and treat PCOS [13]. Among these, physical activity is known as the most basic method of reducing the PCOS symptoms [14]. In their research, Gilani et al. concluded that 8-week of resistance training reduces prolactin levels in PCOS patients [17]. The hormones involved in PCOS improved in obese women by doing 12-week of exercise and weight loss, Gaeini et al., concluded [18]. Physical activity decreases body fat, which stores estrogen and produces steroid hormones [6]. In a study that examined the effect of physical activity on hyperandrogenism and azoospermia amenorrhea in 84 women with PCOS number of androgens and other estrogens, as well as 17 beta-estradiol, decreased after exercise and the menstrual frequency increased [19]. Also, the effect of 12-week of aerobic exercise on 24 women with PCOS was examined in a study by Abazar et al. They reported that body mass index (BMI), cholesterol, triglyceride, and LDL decreased and HDL increased [20].

Given that the importance of PCOS different dimensions in each society varies according to cultural and social factors specifically in Iran due to differences in the type of women's clothing, some dimensions of this syndrome may be more important than others, as example obesity is less important than other dimensions such as hair or acne [21]. Therefore, it seems necessary to define the experiences of women suffering from this disease in Iran. This can lead to the improvement of the services provided to these patients. On the other hand, lifestyle modifications through setting diet and exercise programs that aim to normalize androgen levels and ovulation were considered the primary treatment for polycystic ovary syndrome. Exercise that further engages the muscles is an important part of non-drug therapies even in women who are genetically predisposed to polycystic ovary syndrome, proper lifestyle can help prevent the disease or control its effects [22]. During the pandemic, the conditions of physical activity of people have become less than before. And has led governments to implement disease control measures such as school closures, social isolation and quarantine at home, which have affected the living activities of people, especially children and adolescents, within 24 hours [23]. Children and adolescents have long been physically isolated from their peers, teachers, and social networks [23] who appear to experience anxiety, anger, confusion, post-traumatic stress, and anxiety during isolation. Show significant discomfort [24]. Preliminary evidence suggests that the social constraints needed to reduce the prevalence of COVID-19 increase a wide range of psychological problems, including depression, anxiety, social dysfunction [25], fear [25] loneliness and rumination [26] as well as reduced physical activity opportunities for children and adolescents [27]. Furthermore, as commented before, restriction in mobility, social distancing, or school closures have been increased sedentary behavior. Thus, it is expected that health-related quality of life (HRQoL) would be reduced in children and adolescents. Previous studies have indicated that HRQoL have been reduced due to COVID-19 [28]. In this regard, the present study investigated the condition of female students’ hormone levels and lipid profiles with PCOS polycystic ovary syndrome during the coronavirus COVID-19 pandemic.

2. Materials and methods

2.1. Participants

Forty female students (aged: 14 to 18 years, BMI: 28.52 kg/m2) with polycystic ovary syndrome voluntarily participated in this study. Inclusion criteria were as follows: having polycystic ovary syndrome, the onset of menstruation, physical health and ability to perform physical activity, having no mental disease background, age 14 to 18, and having students’ enrollment. On the other hand, exclusion criteria were performing no physical activity for two sessions, taking specific medicine, and suffering from coronavirus. Out of 88 volunteers in the study who met all of the above conditions, 46 girls with polycystic ovary syndrome were available by sampling to participate in this study. Due to various reasons such as physical illness, lack of cooperation, the number of participants reduced to 40. All ethical issues related to research were observed in this study. Confidentiality and the right to withdraw from research have been considered for participants at all times. Some of the ethical issues of the research were: Before starting the work, the participants’ consent was confirmed, they were informed about the research subject and method. The participants’ privacy and personal information were protected, and the necessary instructions were provided to the participants in case of any disturbances. Participation in the research did not have any financial burden for the participants and this was approved by the ethics committee of the Sport Science Research Institute with the IR.SSRI.REC.1398.485 code (Fig. 1 ).

Figure 1.

Figure 1

Open in a new tab

Participants’ flow chart.

2.2. Study design

This is a quasi-experimental design that has been done with pre- and posttest. Before starting the first test, height, weight, and BMI were assessed. These variables measurements were performed in the morning. First, information about the implementation of the research was provided online by sending the research call to the online groups of high schools in Piranshahr city. Through the collected data, students with polycystic ovary syndrome were identified, then the volunteers were registered. Candidates were informed of the objectives, method, benefits, and potential risks, after that the participants filled out the consent form, which was designed electronically. In the consent form, it was emphasized that participation and exclusion from the study were completely free and optional by the volunteers and all the information of the volunteers was entirely confidential, and also the research results would be published generally. After consenting to participate in the study, individuals were selected based on inclusion criteria and were divided into experimental and control groups as our participants.

2.3. Anthropometric measurements

Stature was measured with a stadiometer [Seca model 213, Germany (accuracy of ± 5 mm)]. Participants stood barefoot and touched their lower back, head, shoulder blades, buttocks, and heel to the stadiometer, with their feet placed together. After adopting the correct position, height was measured vertically by the rod from above the head. Body mass was measured using weighing scales [Seca model 813, United Kingdom (accuracy ± 0.1 per kg)]. Each subject, with light clothes, stood, and the scale recorded the subjects’ mass. The technical error of anthropometric measurements, interobserver and intraobserver, with the same observer was less than 3% [29]. Body mass index (BMI) was calculated as the ratio of weight (kg) to the square of the height (m). If technical error was higher than 5%, the measurements were executed again, and the median value was recorded [29]. All anthropometric and body composition measurements were taken by a skilled practitioner, with a 5-year history in this area, and all measurements were assessed in the morning [30].

2.4. Blood samples

First of all, in the pretest stage, coordination was made with participants to go to the hospital and take a blood sample to observe the health protocols and maintain the participants’ health due to the existing conditions (COVID-19). The time to take a blood sample was announced in advance, and each participant was required to come at certain times. The researcher was present at all stages of blood sampling. Subjects reported to the Emam KHomeini Hospital's lab for blood sampling following a 12 h fasting, and at least 48 h following the last training session. To account for circadianrhythms, 10 cm3 of blood were collected from the antecubital vein before 9 a.m. Samples were immediately centrifuged, the serum was separated, and then assayed on the same day to measure the prolactin, testosterone, estrogen, triglyceride, cholesterol, LDL and HDL.

Prolactin level was measured by chemiluminescence method using Italian liaison kits, the testosterone level was measured using a German Roth kit, and estrogen level was measured using a luminescence electrochemical method by a Vaidas machine. Lipid index (cholesterol, TG, LDL and HDL) was done automatically using enzymatic method and using kits of Pars Azmoon Company and by Alcyon 3000 device (Abbotte-USA).

2.5. Exercise program

After the pretest, the participants were randomly and equally divided into two groups: the exercise group (aerobics) and the control group. The training protocol of the intervention group included performing a 12-week aerobic training program at home. The training safety principles, training intensity, and performing movements (such as warm-up and cool down, and basic aerobic moves) were designed by a sports scientist in the form of electronic training content and presented to the participants to correctly perform the exercises in the training group before starting the training sessions. All participants needed to do the exercises at a specific time. The exercise plan included 12 weeks and subalternation of 3 sessions each week between the hours of 8 to 9 a.m. under the supervision of Aerobic instructor and each session lasted 45 minutes. The exercise program used in this study followed Gallahue and Ozmun recommendations about physical education programs and four levels of classified growth rhythmic movements [31]. It was tried as far as possible, to use movements in which the two main elements of Teens actions that means stability and mobility exist. Each session consisted of 10 minutes of warm-up exercises such as slow and stretching movements, 30 minutes of main aerobic workout including exercises with low impact such as in situ step, step 7, step 8, the knee, the leg, hamstring, L, biceps, and finally, 10 min of cooling down. At first, the movements were taught simply by understandable names. For example, in Fig. 2 , image A was taught as move seven, and image B was trained as eight. When children learned movements, movements were taught in combination. Like image C that shows the combination of seven and eight.

Figure 2.

Figure 2

Open in a new tab

The method of training aerobic movements.

Besides learning the shapes of the movements, they had to pay attention to order, rhythm, balance, the order to use right and left leg, and controlling balance without looking at the leg. Practice sessions’ music was selected by the instructor with the rhythm that its aim is to use 60 to 65% of heart rate reserve in subjects. Subjects’ heart beat was controlled with electronic stethoscope during the practice and the amounts of subjects’ stored heart beat were calculated by the Karvonen formula. Heart rate was measured at 8 a.m., after 15 minutes of rest and in a sitting position [31]. At the end of the practice period the evaluation process of the posttest was done for both groups and the results of pretest and posttest were controlled and statistical analysis was performed (Table 1 ).

Table 1.

Aerobic exercise program of the participants.

Week Warm-up (10 min) Movements Aerobic exercise program (40 min)
 Cooling down (10 min)
Exercise intensity (maximum heartbeat %)
1st–2nd Jogging and stretching March, V step, (7 step, 8 step) knee, leg movement, hamstring, movement 50 to 55 Walking
Stretching and ground movement
3rd–4th March, V step, (7 step, 8 step) knee, leg movement, L, hamstring, movement, box 50 to 55
5th–6th March, V step, (7 step, 8 step) knee, leg movement, hamstring, movement, L, box, jazz 55 to 60
7th–8th March, V step, (7 step, 8 step) knee, leg movement, hamstring, movement, box, jazz, L, mambo 60 to 65
9th–10th March, V step, (7 step, 8 step) knee, leg movement, hamstring, movement, box, jazz, L, mambo, mambo chasse 65 to 70
11th–12th March, V step, (7 step, 8 step) knee, leg movement, hamstring, movement, box, jazz, mambo, mambo chasse 65 to 70
Open in a new tab

2.6. Statistical analysis

2.6.1. Statistical methods

Data are presented as the group mean ± standard deviation. After data normality hypothesis was verified using the Shapiro–Wilk test, analysis of covariance (ANCOVA) was performed with pretest values as a variable to examine the differences between groups. Partial eta-square (ηp2) was calculated as the effect size of the analysis of covariance. Statistical calculations were performed with SPSS model 22.0 (IBM) and Graph Pad Prism, Model 8.0.1 with a significance level of P  ≤ 0.05. The sample size was calculated with the selected study design. ANOVA, F-test, repeated measures, within and between interactions, error probability of α 0.05, probability of power error 1-β 0.95, number of groups and measurement two were performed by considering the mean between all experiments.

3. Results

Physiological characteristics and changes in weight and body mass index are presented in Table 2 in the pretest and posttest stages after 12 weeks of aerobic exercise. In addition, the results of the analysis of covariance in Table 2 showed that by eliminating the effect of pretest, the comparison of posttests between the control and experimental group demonstrated that there was a significant difference in weight and body mass index (P  < 0.05).

Table 2.

Descriptive data of the group control and experimental.

Characteristics Level Control (n = 20) Experimental (n = 20)
Age (years) 16.01 ± 54.64 16.02 ± 32.47
Height (cm) 158.4 ± 31.47 158.6 ± 64.37
Weight (kg) Pre 71.15 ± 11.11 70.13 ± 5.47
Post 70.78 ± 5.65 64.04 ± 0.56
Body mass index (kg.m−2) Pre 28.57 ± 0.07 28.16 ± 0.8
Post 28.42 ± 21.07 25.71 ± 1.07
Open in a new tab

Besides, we evaluated prolactin, testosterone, estrogen indexes, and lipid profile and their changes in pretest and posttest stages after twelve weeks of aerobic exercise. The results of the analysis of covariance revealed that there was a significant difference between the control and experimental groups in covariates by eliminating the effect of pretest comparison of posttest (Table 3 ). These findings indicated that 12 weeks of aerobic exercise had a significant effect on prolactin (P  < 0.05), testosterone (P  < 0.05), estrogen (P  < 0.05) reduction, and improved lipid profile (P  > 0.05).

Table 3.

Results of analysis of covariance to investigate the intervention influence on the evaluated indexes.

Dependent variables Group M SE DF F P-value Eta-square
Weight (kg) Control 5.65 70.78 1.37 0.69 0.002 2.07
Experimental 0.56 64.04
BMI Control 21.7 28.42 1.37 0.87 0.002 19.08
Experimental 1.07 25.71
Prolactin (ng/mL) Control 0.35 20.51 1.37 34.49 0.001 0.898
Experimental 16.27 18.47
Estrogen (ng/mL) Control 12.61 145.02 1.37 65.76 0.001 0.875
Experimental 16.04 105.41
Testosterone (ng/mL) Control 1.51 0.49 1.37 69.34 0.041 0.324
Experimental 0.23 0.4
Triglyceride (mg/dh) Control 2.73 171.2 1.37 32.69 0.001 0.698
Experimental 7.59 166.98
Cholesterol (mg/dh) Control 3.76 176.9 1.37 53.37 0.005 0.589
Experimental 3.28 167.61
LDL (mg/d) Control 2.54 106.05 1.37 55.98 0.001 0.645
Experimental 0.38 93.43
HDL (mg/dh) Control 3.5 41.3 1.37 47.76 0.002 0.877
Experimental 3.76 46.43
Open in a new tab

LDL: low-density lipoprotein; HDL: high-density lipoprotein.

Presented data in Table 2 indicated that the posttest scores in weight and body mass indexes decreased in the experimental group compared to the control group.

The results of analysis of covariance demonstrated the significance of the intergroup effect on the prolactin (F = 34.49, P  = 0.001), estrogen (F = 65.76, P  = 0.001), testosterone (F = 69.34, P  = 0.041), triglycerides (F = 32.69, P  = 0.001), cholesterol (F = 53.37, P  = 0.005), LDL (F = 55.98, P  = 0.001) and HDL (F = 47.76, P  = 0.002) variables. Therefore, there was a significant difference in the mentioned variables between two groups. According to the table and the reported size effect, the effect of sports intervention was more on the mentioned variables.

4. Discussion

Maintaining or increasing physical activity during quarantine is very important to deal with the dangerous effects of inactive behaviors. During the quarantine period, doing sports activities at home is recommended by various sports and health institutions. Moreover, doing exercise with music at the same time is more effective [2]. On the other hand, training is considered a polycystic ovary syndrome treatment. This study aimed to investigate the effect of 12 weeks of aerobic exercise on hormone levels and lipid profile of female students with polycystic ovary syndrome during coronavirus pandemic.

The results revealed that 12 weeks of aerobic exercise at home reduced prolactin levels in girls with polycystic ovary syndrome. Turangir et al. mentioned that long-term exercise reduced prolactin levels [32]. Furthermore, Gilani et al. [17] indicated that 8 weeks of resistance training reduced prolactin levels in women with polycystic ovary syndrome, which is consistent with the results of the present study. However, Vigorito et al. [33] and Humberg et al. [34] findings revealed that exercise did not significantly change the prolactin level of women with polycystic ovary syndrome that is inconsistent with the results of the present study. Intensity, duration, and training conditions can be mentioned as reasons for the inconsistency of the findings.

To clarify this finding, it can be noted that since the use of antidepressant drugs increased prolactin level, exercise reduces the use of antidepressants by decreasing stress and depression and can reduce prolactin level in these patients [35].

Some researchers believe that prolactin is higher than normal in women with polycystic ovary syndrome [11] different hypotheses are made to explain this statement. One theory is that polycystic ovary syndrome is caused by a disorder in the central regulation of neurotransmitters especially dopaminergic transmitters, which leads to abnormal secretion of gonadotropin and ovarian performance. Patients with polycystic ovary syndrome suffer from a relative decrease in dopamine in the hypothalamus, which in turn causes hyperprolactinemia and secretion of GnRH [11], [31], [36]. In the study of Carmina et al., hyperprolactinemia was associated with increased estrogen serum level, and also it was stated that estrogen and dopaminergic system increased prolactin level in patients with polycystic ovary syndrome [37].

Current results revealed that 12 weeks of aerobic exercise reduced estrogen and testosterone in girls with polycystic ovary syndrome. Studies have shown that exercise can help treat patients with polycystic ovary syndrome. Vivo et al. examined polycystic ovary syndrome and exercise intervention and suggested that estrogen serum levels and testosterone in patients with this syndrome are higher than in healthy individuals [38]. In their research, Rafiei et al. and Omar et al. concluded that exercise modulates the androgenic hormones serum level [22], [34], [39]. Physical activity lessens body fat, which is a site for estrogen storage and steroid hormone production [40]. Performing physical activities activates the hypothalamic-pituitary-adrenal axis and exerts an inhibitory effect on the female reproductive system function. Accordingly, growth hormone inhibitory hormones inhibit the gonadotropin-releasing hormone secretion, and glucocorticoid produced during exercise inhibits the ovarian estrogen secretion [33], [34], [40], [41]. On the other hand, training, body weight, and body mass index reduction lead to testosterone reduction and prevent prolactin increase and prevent the detrimental effects of hyperandrogenism [42]. Due to changes in weight and sex hormones, moderate-intensity exercise improves the symptoms of polycystic ovary syndrome [43]. Miri et al. believed that low-intensity exercise reduces testosterone levels in patients with polycystic ovary syndrome [6]. Giallauria et al. also mentioned that after 6 weeks of exercise intervention, testosterone and estradiol levels decreased in obese women [44].

The results of the present study indicated that 12 weeks of aerobic exercise reduced weight and improved lipid profile. Research demonstrated that half of the patients with polycystic ovary syndrome are obese.

According to studies, patients with polycystic ovary syndrome have higher cholesterol, triglyceride, and LDL levels and lower HDL levels than healthy women [7]. In addition, the current study results indicated that performing aerobic exercise at home reduced weight, triglycerides, cholesterol, and LDL and increased HDL in girls with polycystic ovary syndrome. In their study, Lenarcik and Bidzińska-Speichert suggested that obesity is the most significant factor in the development of polycystic ovary syndrome, and a slight decrease in women weight with the syndrome can be associated with the development of appropriate ovarian cycles that are consistent with the results of the present study [45]. Studies reveal that weight loss can improve hyperandrogenism, menstrual disorders, and fertility by 5 to 10% [46]. The increase in fat oxidation capacity through increasing beta-oxidation enzymes and Krebs cycle following exercise is one of the physiological reasons of exercise influence on weight and body mass index. By increasing fat metabolism, the fat ratio of the participant drops and anthropometric factors improve [9], [11], [40]. Several studies have reported increased LDL in women with polycystic ovary syndrome, which suggested a heterogeneous source of dyslipidemia in these patients [15]. Obesity and weight gain are related to HDL reduction and patients with polycystic ovary syndrome have low HDL [15]. Exercise reduces LDL, cholesterol, and triglycerides and increases HDL in women with polycystic ovary syndrome [47]. The findings of Saremi and Kazemi study revealed that 8 weeks of aerobic exercise improved lipid profile in women with polycystic ovary syndrome, which supported the results of the present study [47].

The present study, like other studies, had some limitations such as lack of control over participants’ diet and stress, the small number of samples, and the lack of complete control of the researcher over their food and dietary intake. Furthermore, performing complete and correct exercises by the participants was another limitation of this study, although the researcher was able to control this limitation to some extent by providing complete explanations and providing the full content of sports exercises to the participants. We suggest that a self-selective physical activity approach be used to encourage girls with polycystic ovary syndrome to be engaged in their favorite physical activity during the coronavirus pandemic. It is also suggested to conduct further research with more samples and investigate risk factors. We hope that it will be a better way to identify and treat patients in a timely and effective manner in future planning and decision-making of managers and officials to improve female students’ health.

5. Conclusion

Due to the coronavirus restrictions and the increased level of inactivity and stress during the quarantine period, it seems that home-based aerobic exercise is a suitable, easy strategy and required approach during the COVID-19 pandemic to improve the physical health and condition of girls with polycystic ovary syndrome. As a result, according to previous studies and the results of the current study, it can be stated that home-based aerobic exercise can address and eliminate the most significant concern of single women that is the detrimental effects of this syndrome on their physical beauty and infertility in the future.

Disclosure of interest

The authors declare that they have no competing interest.

Acknowledgment

I would like to express my sincere gratitude to all the participants for their cooperation and Ms. Parvaneh who cooperated throughout the training programs. The present study was not sponsored but conducted at personal expense.

References

  • 1.Heidari M. The necessity of knowledge management in novel coronavirus (COVID-19) crisis. Depiction Health. 2020;11(2):94–97. [Google Scholar]
  • 2.Molanouri S.M., Amani S.S. 2020. Exercise training, immune system, and coronavirus. [Google Scholar]
  • 3.King A.J., Burke L.M., Halson S.L., Hawley J.A. The challenge of maintaining metabolic health during a global pandemic. Sports Med. 2020;50:1233–1241. doi: 10.1007/s40279-020-01295-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.World Health Organization . World Health Organization; 2010. Global recommendations on physical activity for health. [PubMed] [Google Scholar]
  • 5.Hatami H.R.S., Eftekhar A.H. 1st ed. Arjmand Publ; Tehran: 2006. Textbook of public health; pp. 16–56. [Google Scholar]
  • 6.Miri M. Effect of exercise on sex-hormone in rats with polycystic ovary syndrome. J Jahrom Univ Med Sci. 2013;11(3):36. [Google Scholar]
  • 7.Naderi T., Akbarzadeh M., Dabbaghmaneh M., Tabatabaei H. Prevalence of various phenotypes of polycystic ovarian syndrome among high school girls of Shiraz (2009) J Inflamm Dis. 2012;15(4):60–67. [Google Scholar]
  • 8.Chhabra S., McCartney C.R., Yoo R.Y., Eagleson C.A., Chang R.J., Marshall J.C. Progesterone inhibition of the hypothalamic gonadotropin-releasing hormone pulse generator: evidence for varied effects in hyperandrogenemic adolescent girls. J Clin Endocrinol Metab. 2005;90(5):2810–2815. doi: 10.1210/jc.2004-2359. [DOI] [PubMed] [Google Scholar]
  • 9.Kachoie A., Jahanipoor A., Ghahiri A. Evaluation of serum prolactin levels in patients with polycystic ovary syndrome. J Isfahan Med School. 2012;30(182):353–358. [Google Scholar]
  • 10.Legro R., Adashi A., Leung P. Elsevier Acad Press; San Diego: 2004. Polycystic ovarian syndrome in the ovary. [Google Scholar]
  • 11.Ghanbari Andarieh M. The serum prolactin level in infertile women with polycystic ovary syndrome. J Babol Univ Med Sci. 2014;16(8):63–68. [Google Scholar]
  • 12.Legro R.S., Arslanian S.A., Ehrmann D.A., Hoeger K.M., Murad M.H., Pasquali R., et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565–4592. doi: 10.1210/jc.2013-2350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Akbari Z.F.M. The effect of 12 weeks of aerobic exercise on body composition, strength aerobics and some hormones have infertile women Polycystic ovary syndrome. Iran J Obstet Gynecol Infertil. 2016;19(5):1–10. [Google Scholar]
  • 14.Knochenhauer E., Key T., Kahsar-Miller M., Waggoner W., Boots L., Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83(9):3078–3082. doi: 10.1210/jcem.83.9.5090. [DOI] [PubMed] [Google Scholar]
  • 15.Lankarani M., Valizadeh N., Heshmat R., Shafaee A.R., Amini M.R., Nouri M., et al. Evaluation of dyslipidemia in polycystic ovary syndrome. J Diabetes Metab Disord. 2004;4(10):102–107. [Google Scholar]
  • 16.Mokhtari M., Ebrahimpoor M.R., Harfsheno S. The effects of alcoholic extract of Marrubum vulgare on hormonal parameters in female rat model of polycystic ovarian syndrome. Med Sci J Islamic Azad Univ Tehran Med Branch. 2014;24(2):74–80. [Google Scholar]
  • 17.Gilani N., Zamani Rad F., Ebrahimi M., Haghshenas R. Effect of eight weeks endurance training on ovarian androgens in women with polycystic ovary syndrome: application of multivariate longitudinal models. Int J Appl Exerc Physiol. 2019;8(2.1):757–762. [Google Scholar]
  • 18.Gaeini A., Satarifard S., Mohamadi F., Choobineh S. The effect of 12 weeks aerobic exercise on DHEAso4, 17OH-Progestron concentrations, number of follicles and menstrual condition of women with PCOS. Hormozgan Med J. 2014;18(4):298–305. [Google Scholar]
  • 19.Jedel E., Labrie F., Odén A., Holm G., Nilsson L., Janson P.O., et al. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab. 2011;300(1):E37–E45. doi: 10.1152/ajpendo.00495.2010. [DOI] [PubMed] [Google Scholar]
  • 20.Abazar E., Taghian F., Mardanian F., Forozandeh D. Effects of aerobic exercise on plasma lipoproteins in overweight and obese women with polycystic ovary syndrome. Adv Biomed Res. 2015;4 doi: 10.4103/2277-9175.153892. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Shobeiri F., Ataollahi M., Jahanara S., Roshanaei G. Comparing perceived social support and perceived stress in women with and without polycystic ovary syndrome refereed to Fatemiyeh Hospital in Hamadan City. Pajouhan Sci J. 2018;16(4):46–52. [Google Scholar]
  • 22.Rafiei S., Edalatmanesh M.A. The effect of swimming training, Gallic acid and high-fat diet on the serum levels of sex hormones in rats with polycystic ovary syndrome. KAUMS J (FEYZ) 2018;22(6):564–572. [Google Scholar]
  • 23.Loades M.E., Chatburn E., Higson-Sweeney N., Reynolds S., Shafran R., Brigden A., et al. Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218–1239. doi: 10.1016/j.jaac.2020.05.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Brooks S.K., Webster R.K., Smith L.E., Woodland L., Wessely S., Greenberg N., et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–920. doi: 10.1016/S0140-6736(20)30460-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Yıldırım M., Arslan G., Özaslan A. Perceived risk and mental health problems among healthcare professionals during COVID-19 pandemic: exploring the mediating effects of resilience and coronavirus fear. Int J Ment Health Addict. 2022;20(2):1035–1045. doi: 10.1007/s11469-020-00424-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Tanhan A. COVID-19 Sürecinde Online Seslifoto (OSF) Yöntemiyle Biyopsikososyal Manevi ve Ekonomik Meseleleri ve Genel İyi Oluş Düzeyini Ele Almak: OSF’nin Türkçeye Uyarlanması. Electron Turk Stud. 2020;15(4.) [Google Scholar]
  • 27.Moore S.A., Faulkner G., Rhodes R.E., Brussoni M., Chulak-Bozzer T., Ferguson L.J., et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. Int J Behav Nutr Phys Activ. 2020;17(1):1–11. doi: 10.1186/s12966-020-00987-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Nobari H., Fashi M., Eskandari A., Villafaina S., Murillo-Garcia Á., Pérez-Gómez J. Effect of COVID-19 on health-related quality of life in adolescents and children: a systematic review. Int J Environ Res Public Health. 2021;18(9):4563. doi: 10.3390/ijerph18094563. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Nobari H., Tubagi Polito L.F., Clemente F.M., Pérez-Gómez J., Ahmadi M., Garcia-Gordillo MÁ, et al. Relationships between training workload parameters with variations in anaerobic power and change of direction status in elite youth soccer players. Int J Environ Res Public Health. 2020;17(21):7934. doi: 10.3390/ijerph17217934. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Nobari H., Alves A.R., Clemente F.M., Pérez-Gómez J., Clark C.C., Granacher U., et al. Associations between variations in accumulated workload and physiological variables in young male soccer players over the course of a season. Front Physiol. 2021;12:233. doi: 10.3389/fphys.2021.638180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Masoudi M., Seghatoleslami A., Saghebjoo M. The effect of 8 weeks of aerobic training on cognitive performance in children with learning disorders. J Fundam Ment Health. 2016;18(3):161–168. [Google Scholar]
  • 32.Tworoger S.S., Sorensen B., Chubak J., Irwin M., Stanczyk F.Z., Ulrich C.M., et al. Effect of a 12-month randomized clinical trial of exercise on serum prolactin concentrations in postmenopausal women. Cancer Epidemiol Prev Biomark. 2007;16(5):895–899. doi: 10.1158/1055-9965.EPI-06-0701. [DOI] [PubMed] [Google Scholar]
  • 33.Vigorito C., Giallauria F., Palomba S., Cascella T., Manguso F., Lucci R., et al. Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92(4):1379–1384. doi: 10.1210/jc.2006-2794. [DOI] [PubMed] [Google Scholar]
  • 34.Al-Mahrizi S., Tulandi T. Treatment of uterine fibroids for abnormal uterine bleeding: myomectomy and uterine artery embolization. Best Pract. Res Clin Obstet Gynaecol. 2007;21(6):995–1005. doi: 10.1016/j.bpobgyn.2007.03.017. [DOI] [PubMed] [Google Scholar]
  • 35.Gaeini A., Satarifard S., Mohamadi F., Rajaei M. Exercise on ovarian androgens and body composition of women with polycystic ovary syndrome. Armaghane Danesh. 2012;17(5):387–397. [Google Scholar]
  • 36.Porcile A., Gallardo E., Venegas E. Normoprolactinemic anovulation nonresponsive to clomiphene citrate: ovulation induction with bromocriptine. Fertil Steril. 1990;53(1):50–55. [PubMed] [Google Scholar]
  • 37.Carmina E., Rosato F., Maggiore M., Gagliano A.M., Indovina D., Jannì A. Prolactin secretion in polycystic ovary syndrome (PCO): correlation with the steroid pattern. Eur J Endocrinol. 1984;105(1):99–104. doi: 10.1530/acta.0.1050099. [DOI] [PubMed] [Google Scholar]
  • 38.Wu C., Lin F., Qiu S., Jiang Z. The characterization of obese polycystic ovary syndrome rat model suitable for exercise intervention. PLoS One. 2014;9(6):e99155. doi: 10.1371/journal.pone.0099155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Omar A.-N., Habib F., Mojaddidi M., El-Bab M.F. Body weight reduction and metformin: roles in polycystic ovary syndrome. Pathophysiology. 2013;20(2):131–137. doi: 10.1016/j.pathophys.2013.03.002. [DOI] [PubMed] [Google Scholar]
  • 40.Omidali F. Effects of Pilates training on the quality of life in polycystic ovary syndrome women. Iran J Rehabil Res. 2016;2(3):49–58. [Google Scholar]
  • 41.Thomson R.L., Buckley J.D., Noakes M., Clifton P.M., Norman R.J., Brinkworth G.D. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93(9):3373–3380. doi: 10.1210/jc.2008-0751. [DOI] [PubMed] [Google Scholar]
  • 42.Dewailly D., Catteau-Jonard S., Reyss A.-C., Leroy M., Pigny P. Oligoanovulation with polycystic ovaries but not overt hyperandrogenism. J Clin Endocrinol Metab. 2006;91(10):3922–3927. doi: 10.1210/jc.2006-1054. [DOI] [PubMed] [Google Scholar]
  • 43.Pehlivanov B., Orbetzova M. Characteristics of different phenotypes of polycystic ovary syndrome in a Bulgarian population. Gynecol Endocrinol. 2007;23(10):604–609. doi: 10.1080/09513590701536246. [DOI] [PubMed] [Google Scholar]
  • 44.Giallauria F., Palomba S., Maresca L., Vuolo L., Tafuri D., Lombardi G., et al. Exercise training improves autonomic function and inflammatory pattern in women with polycystic ovary syndrome (PCOS) Clin Endocrinol. 2008;69(5):792–798. doi: 10.1111/j.1365-2265.2008.03305.x. [DOI] [PubMed] [Google Scholar]
  • 45.Lenarcik A., Bidzińska-Speichert B. Cardiopulmonary functional capacity and the role of exercise in improving maximal oxygen consumption in women with PCOS. Endokrynol Pol. 2010;61(2):207–209. [PubMed] [Google Scholar]
  • 46.Shayan A., Masoumi S.Z., Shobeiri F., Ahmadinia H. Analysis of the factors affecting polycystic ovary syndrome. Iran J Obstet Gynecol Infertil. 2017;19(36):11–18. [Google Scholar]
  • 47.Saremi A., Kazemi M. Eight-week aerobic training in women with polycystic ovary syndrome: effects on chronic low-grade inflammation and lipid profiles. Hormozgan Med J. 2014;18(2):131–138. [Google Scholar]

Articles from Science & Sports are provided here courtesy of Elsevier

RESOURCES