Polycystic Ovary Syndrome and Physical Exercise

Polycystic ovarian syndrome (PCOS) constitutes a hormonal disorder that most commonly affects women of childbearing age. It can also occur after menopause. In women with PCOS, the ovarian follicle, in which the oocyte matures, does not function properly, causing the oocyte not to reach the fallopian tube. This process negatively impacts the regularity of the menstrual cycle and significantly hinders conception. The ovarian follicle dies and transforms into a cyst. PCOS was first diagnosed in 1935 by American doctors Irving Stein and Michael Leventhal. A few years ago, diagnosing PCOS was not an easy task, so it was likely not properly diagnosed in many women.

To diagnose PCOS in a woman, at least 2 of the 3 criteria must be met: – ovarian dysfunction, manifesting as ovulation less than 6 times a year or its complete absence, – high levels of male sex hormones (usually testosterone), – the ultrasound image characteristic of this syndrome.

It is often recommended that high-intensity exercise should not be performed by PCOS patients, as intense physical activity can make it difficult to restore a normal menstrual cycle. It is also said that women with PCOS should not engage in strength training, as this can increase testosterone levels. However, these recommendations raise many questions. In the case of PCOS, hyperandrogenism is caused by an increase in AMH production, which inhibits the development of the cell nucleus, reduces sensitivity to FSH, and reduces aromatase activity. In a study conducted in 2018, it was found that both training protocols contributed to a decrease in the anthropometric index and hyperandrogenism. In a review paper from 2020, it was found that regular intense aerobic training sessions in combination with heart rate and/or VO2max monitoring (60% VO2max) can improve insulin sensitivity. Strength training can likely have a positive impact on androgens. The impact of yoga on insulin sensitivity and androgens appears promising, but further detailed research is needed.

Hundreds of studies have been conducted to evaluate the impact of physical activity on the fertility of women diagnosed with polycystic ovary syndrome (PCOS).. In a 2014 study, it was observed that regular physical activity could have a positive influence on weight loss and contribute to the restoration of menstrual cycle regularity (D. Mahoney 2014). Another study demonstrated that exercise could reduce the risk of ovulatory infertility by increasing insulin sensitivity (J. E. Chavarro et al. 2007). In yet another study, it was shown that high-intensity physical activity decreases the chance of pregnancy, except for overweight and obese women, and moderate exercise can also have a significant effect on a person's health (L. A. Wise et al. 2012). Physical activity can bring many benefits in the fight against infertility resulting from ovulatory disorders.. A positive impact on physical health and the course of fertilization has also been noted.. However, it is crucial to remember to choose the appropriate intensity of exercise according to the level of the person exercising.

Upon meticulous review of existing research, it can be concluded that there is no persuasive evidence suggesting that physical activity has adverse effects on the health of women with polycystic ovary syndrome. In fact, numerous studies indicate many advantages provided by consistent physical activity, such as lowering androgen levels or improving insulin response. Women afflicted with polycystic ovary syndrome should not avoid physical exercise, whether it involves aerobic training or strength training.