The Effectiveness of Diet and Exercise in Treating Polycystic Ovary Syndrome: A Systematic Review

Abstract

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in reproductive-aged women, frequently linked to obesity, insulin resistance, and reproductive dysfunction. Lifestyle modifications, particularly diet and exercise, are primary management strategies, but their effectiveness varies across studies. Objective: To systematically evaluate the impact of dietary and exercise interventions on metabolic, hormonal, and reproductive outcomes in women with PCOS. Methods: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2011 and July, 2025. Eligible studies included randomized controlled trials and cohort studies assessing dietary changes, physical activity, or combined interventions in women with PCOS. Data extracted included sample size, intervention type, duration, and outcomes related to weight, insulin sensitivity, androgen levels, and reproductive function. Results: Most studies reported weight loss ranging from 3% to 10%, particularly with combined diet and exercise interventions. Insulin sensitivity improved significantly, especially when aerobic and resistance training were combined. Reductions in total and free testosterone were consistently observed, mainly with low-glycemic and Mediterranean-style diets. Menstrual regularity improved across many studies, often correlating with adherence to dietary protocols. Ovulation and fertility outcomes showed notable enhancement, particularly when lifestyle interventions were sustained over time. Conclusion: Diet and exercise interventions are effective in improving metabolic and reproductive outcomes in women with PCOS. Personalized and sustained lifestyle changes should be part of routine PCOS care. More long-term studies are needed to determine the durability and comparative effectiveness of different intervention strategies.