Table 2.
Studies of aerobic exercise interventions on hormones in women with PCOS.
| Study | Participants | Exercise Intervention | Hormonal Changes | Unchanged |
|---|---|---|---|---|
| RCT, aerobic ex or no ex [84,85] | 90, 124 PCOS (~half/group); mean 22 y; BMI mean 29; Rotterdam criteria | 3-month structured ex. training or non-ex. CG; 3 d/wk; 30 min cycling at 60–70% VO2max; supervised by medical personnel; continuous electrocardio monitoring | ↓FI, AUCin | FSH, LH, PRL E2, P, 17-OHP, T, FAI, A4, DHEA-S SHBG |
| RCT, aerobic ex and detraining [86] | 64 PCOS (32/group); BMI mean 29; Rotterdam criteria | 24-week structured ex. training or 12-week ex. training plus 12-week detraining; 3 d/wk; 30–40 min cycling at 60–70% VO2max; supervised by medical personnel; continuous electrocardio monitoring | ↓FI, AUCins (24 wk ex.) | FSH, LH, PRL E2, P, 17-OHP, T, FAI, A4, DHEA-S SHBG |
| RCT with aerobic ex. [87] Trials NCT02105428 and NCT01477164 |
25 PCOS with OB, IR; Rotterdam criteria | 12-week aerobic exercise or sedentary control; 5 d/wk; 60 min cycling at 65% VO2max |
↑GIR ↑IS ↓C-peptide |
E2, P FI, HOMA-IR |
| RCT w/3 arms (ex, OC, or vitamins) [88] Trial NCT00593294 |
150 PCOS (50/group); 18–40 y; BMI 18–30; NIH criteria | 6-month aerobic ex; 3 d/wk for 45 min at 60–70% VO2max; cycling; supervised by medical personnel; HRM | ↓FI, HOMA-IR (ex) ↑GIR (ex) |
FSH, LH, TSH, PRL E2, P, 17-OHP, T, A4, FAI, SHBG DHEA-S |
| RCT w/2 parallel arms, ex or no ex [89] | 27 PCOS, sedentary; 18–34 y; BMI 25–39.9; Rotterdam criteria | 16-week progressive aerobic exercise; 3 d/wk for 50 min; indoor track using HRM to regulate walk/jog pace; supervised | N/A (hormones) | FI, HOMA-IR |
| RCT w/3 parallel arms [90,91,92,93] Trial ISRCTN10416750 |
69 PCOS (~23/group); 18–39 y, BMI 18–39.9, sedentary; Rotterdam criteria | 16-week CAT, IAT, or CG; 3 d/wk; treadmill; HRM for intensity, personal trainer for compliance |
↓TT (CAT, IAT groups) ↓FAI (IAT group) |
A4, E2 LH, FSH SHBG |
| RCT, ex vs no ex [96] | 20 PCOS; 18–50 y; median BMI 37.9 ex. group; Rotterdam criteria | 16–24-week aerobic ex. individualized program, adapted from STRRIDE study, 14 kcal/kg/wk to determine duration w/recheck half-way; supervised and HRM for compliance | AUCins trended lower | FI, HOMA-IR, 2 h Ins, IS |
| RCT w/3 parallel arms (electroacupuncture, ex, untreated) [97,98,99] Trial NCT00484705 |
20 PCOS (5 ex group); BMI 26.8 ± 4.8; Rotterdam criteria 74 PCOS (30 ex group, 2012, 2015 study) |
16-week aerobic ex. at self-selected pace; at least 3 d/wk; 30–45 min at faster than normal walking pace; weekly phone call to advise how to increase ex. | N/A Note: Low n (5) in 2009 study |
LH, FSH, TT, fT, FAI, DHEA-S SHBG, T4, TSH, IGF-1 FI, HOMA-IR APN (2012 study) AMH (2015 study) |
| RCT w/3 parallel arms (electroacupuncture, ex, untreated) [100] Trial NCT00484705 |
74 PCOS (30 ex. group); 30.2 ± 4.7 y; BMI 27.7 ± 6.4; Rotterdam criteria | 16-week aerobic ex., self-selected pace; at least 3 d/wk; at least 30 min at faster than normal walking pace; weekly call to advise increase of ex.; 16-wk follow-up (32 wk) | ↓fT, DHEA-S (16, 32 wk) ↓E1-S, E2 (16 wk) |
T, DHT, DHEA LH, FSH, SHBG |
| Non-randomized, aerobic ex vs diet [101] Trial NCT00473538 |
40 PCOS (20 ex. group), self-selected group; 26.8 ± 5.1 y; BMI 33.1 ± 1.3; Rotterdam criteria | 24-week structured ex. training; 30–40 min cycling at 60–70% VO2max 3 d/wk; supervised by medical personnel; continuous electrocardio monitoring | ↓T, FAI (ov., 12, 24 wk) ↓FI, HOMA-IR (ov., 12, 24 wk) ↑glucose:ins (ov., 12, 24 wk) ↑SHBG (ov., 12, 24 wk) |
FSH, LH, TSH, PRL E2, P, A4, DHEA-S |
| Prospective, case-control [102] Trial ISRCTN84763265 |
7 PCOS, 8 non-PCOS; BMI > 25 NIH criteria |
12-week intensified endurance ex training program; 3 d/wk; 1 h; treadmill, alternating intensity (moderate and high) | ↑GIR (both groups) ↓AMH (PCOS) |
T, FAI, SHBG |
| Prospective, intensified aerobic ex., case-control [103] Trial ISRCTN84763265 |
20 PCOS, 14 non-PCOS; 20-40 y, BMI > 27; NIH criteria | 12-week intensified aerobic ex.; 3 h/wk; treadmill; supervised by ex. physiologist |
↑GIR ↓HOMA-IR, FI |
T, FAI, SHBG |
| Prospective, case-control, aerobic ex [104] Trial ISRCTN84763265 |
8 PCOS, 8 non-PCOS from subset of earlier study; Rotterdam criteria | 12-week individualized, progressive aerobic ex on motorized treadmill; 3 d/wk for 1h; alternate mod. or high intensity; supervised | ↓FI ↑GIR (both) |
HOMA-IR T, FAI, SHBG |
| Prospective, case-control [105] Trial ISRCTN84763265 |
16 PCOS, 13 non-PCOS; BMI > 27; NIH criteria | 12-week supervised aerobic ex; treadmill, alternating intensity (moderate and vigorous); 3 d/wk; 1 h; HRM | ↓FI ↑GIR |
SHBG, T, FAI |
| Prospective, aerobic ex, case-control [106] Trial ISRCTN84763265 |
9 PCOS, 7 non-PCOS; BMI > 25, inactive; post-study, categorized as responders (lost ≥ 5% body fat) or nonresponders; Rotterdam criteria | 12-week supervised aerobic exercise; 3 d/wk, 45–60 min; treadmill, alternating moderate (20–60 min walk/jog at 75–80% HRmax) or high (6–8 5 min intervals at 95–100% HR, 2 min rest) intensity; HRM for intensity; compliance monitored by HRM, session sign-ins & duration | ↑GIR/FFM (PCOS nonresponders), positively correlated with FBG | GIR, HOMA-IR, FI |
| Single-arm, aerobic ex [107] | 8 HA PCOS; 25 ± 1 y; BMI 32 ± 1.6; controls for baseline comparison only; NIH criteria | 16-week supervised and individualized aerobic exercise; 5 d/wk; treadmill at 55% VO2max; HRM for ExEE | ↑GDR ↑ANP pD2 (−log[EC50]) |
TT, FAI, SHBG FI ANP |
| Prospective, individualized aerobic ex., case-control [108] Trial NCT01150539 |
8 PCOS, 7 non-PCOS; BMI ≥ 25; NIH criteria | 16-week individualized aerobic ex. program; 5 d/wk; treadmill at 55% VO2max; supervised | Improved IS (↑glucose, FFA uptake) 34% ↑ glucose uptake |
Ins, TT, FAI SHBG |
| Prospective, aerobic ex., case-control [109] Trial NCT01150539 |
8 PCOS, 8 non-PCOS; Rotterdam criteria |
16-week supervised aerobic ex; 5 d/wk; treadmill at 55% VO2max |
↓Leptin/HMW APN ↑GDR Trend: ↓leptin, ↑DHEA-S |
APN, HMW APN T, FAI, SHBG HOMA-IR |
| Prospective, case-control or self-selected ex or no ex [110,111] | 11 PCOS, 6 non-PCOS; 29 ± 7 y; BMI 34 ± 5; Rotterdam criteria 17 PCOS, self-selected to ex (10) or no ex (7) group; mean 28 y; mean BMI 33; Rotterdam criteria |
16-week supervised moderate-intensity aerobic ex on treadmill; 3 d/wk for 30 min at 30% HRR progressing up to 5 d/wk for 45 min at 60% HRR | N/A (hormones) Note: Low n (6–7) |
FSH, LH P, E2, T, FAI, SHBG FI, HOMA-IR |
| Prospective, aerobic ex, case-control [112] | 12 PCOS, 10 non-PCOS; Rotterdam criteria | 8-week supervised aerobic exercise; 3 d/wk for 1 h; treadmill at 60% VO2max |
↓GDR Decreased lipid-induced IR |
TT, FAI, SHBG FI |
| Prospective, case-control, aerobic ex [113] Trial ISRCTN42448814 |
12 PCOS 10 non-PCOS; mean 28.3 y (PCOS); mean BMI 29.4 (PCOS); Rotterdam criteria | 8-week supervised aerobic ex; 3 d/wk for 1h; treadmill at 60% VO2max | N/A (hormones) | HOMA-IR |
| Single-arm, aerobic ex [114] | 21 PCOS (12 compliant, 9 non); 30.6 ± 6.6 y; BMI 35.5 ± 7.6 NIH criteria |
6-month self-selected brisk walking; at least 3 d/wk; 20–60 min; frequency and duration targets increased fortnightly; self-reported diary submitted monthly | N/A (hormones) | Ins FAI T4 |
All studies are longitudinal. Unless otherwise noted, changes are described for PCOS exercise group(s) pre- vs. post-intervention. Abbreviations: A4, androstenedione; AMH, anti-mullerian hormone; ANP, atrial natriuretic peptide; APN, adiponectin; AUC, area under curve; BMI, body mass index; bpm, beats per minute; CAT, continuous aerobic training; CG, control group; d, days; DHEA-S, dehydroepiandrosterone sulfate; E1-S, estrone; E2, estradiol; ex, exercise; ExEE, exercise energy expenditure; FAI, free androgen index; FBG, fasting blood glucose; FFM, fat free mass; FI, fasting insulin; FSH, follicle stimulating hormone; fT, free testosterone; GDR, glucose disposal rate; GIR, glucose infusion rate; HMW, high molecular weight; HOMA-IR, homeostatic model assessment of insulin resistance; HR, heart rate; HRR, heart rate reserve (HRmax–HRrest); HRM, heart rate monitor; IAT, intermittent aerobic training; Ins, insulin; IR, insulin resistance; IS, insulin sensitivity; LH, luteinizing hormone; N/A, not applicable; OB, overweight or obese; OC, oral contraceptive; ov, ovulatory; P, progesterone; PA, physical activity; PRL, prolactin; PRT, progressive resistance training; RCT, randomized controlled trial; SHBG, sex hormone binding globulin; T, testosterone; T4, thyroxine; TSH, thyroid stimulating hormone; TT, total testosterone; wk, week(s); y, years.