by Dr. Richard Fehring

Vigorous exercise has been shown to have more effect on PCOS than moderate or light exercise

Lifestyle modification with weight loss, exercise, and diet are considered the first line treatment for managing and controlling polycystic ovarian syndrome (PCOS). There has been no evidence on the right intensity of exercise that might best treat PCOS. Researchers therefore, set out to determine whether high intensity exercise is better than moderate exercise on metabolic outcomes of women with PCOS.

Participants for this study were recruited from one academic based multidisciplinary PCOS specialty clinic over a 7 year period. Patients from the clinic were enrolled if they met the Rotterdam criteria for the diagnosis of PCOS, i.e., 2 out of the following 3 features, oligomenorrhea, hyperandrogenism, and/or ultrasound visualized polycystic ovaries.

Three hundred twenty-six women met the inclusion guidelines and were classified by Department of Health and Human Services (DHHS) exercise guidelines as to whether they met vigorous, moderate or inactive activity levels through an exercise self-report measurement tool. Vigorous exercise was defined as difficult effort and much harder breathing for at least 75 minutes per week and moderate exercise as moderate effort and breathing somewhat harder than normal for at least 150 minutes per week. The inactive category meant that the participant did not meet these guidelines. Based on the DHHS activity levels, 151 of the 326 participants (56%) met the vigorous level and 31 (17%) met the category of moderate exercise. The remaining 145 did not meet exercise requirements.

The participants were measured for multiple metabolic outcomes including blood pressure, weight, body mass index (BMI), waist circumference, fasting lipids, fasting glucose and insulin, 2-hour glucose tolerance test, and homeostatic model assessment of insulin resistance (HOMA-IR) to determine those participants who had metabolic syndrome. The researchers discovered that the women in the vigorous group had significantly lower, BMI, HOMA-IR, higher levels of high-density lipoprotein cholesterol and reduced prevalence of metabolic syndrome. A multivariate logistic regression analysis determined that controlling for age and BMI, every hour of vigorous exercise reduced the odds of metabolic syndrome by 22% (odds ratio 0.78; 95% confident interval, 0.62-0.99).

The authors concluded that those women with PCOS who met DHHS criteria for vigorous exercise had superior metabolic health parameters compared to women with only moderate exercise levels. They proposed that women with PCOS should be encouraged to meet vigorous levels of exercise. They also recommended that randomized comparison studies between levels of exercise be conducted on metabolic parameters among women with PCOS.

E. A. Greenwood, M. W. Noel, and D. N. Kao, et al. Vigorous Exercise Is Associated with Superior Metabolic Profiles in Polycystic Ovary Syndrome Independent of Total Exercise Expenditure. Fertility and Sterility (Nov. 6, 2015) pii: S0015-0282(15)02031-2. doi: 10.1016/j.fertnstert.2015.10.020.