Physical Activity in the Management of Polycystic Ovary Syndrome: Current Perspectives on Clinical, Metabolic, and Endocrine Health

Abstract

Background. Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic, hormonal, and clinical disturbances. Physical activity is a first-line non-pharmacological intervention, although heterogeneity in exercise modalities and outcomes limits consistent clinical conclusions. Objective. To synthesize current evidence on the effects of physical activity on clinical, metabolic, and hormonal outcomes in women with PCOS. Methods. PubMed, Scopus, and Web of Science were searched (2020–2026) for peer-reviewed systematic reviews, meta-analyses, randomized controlled trials, and position statements evaluating structured exercise interventions, metabolic and hormonal outcomes, and patient-reported outcomes in women with PCOS. Results. Regular physical activity improves metabolic health in women with PCOS, particularly insulin sensitivity, waist circumference, and cardiometabolic risk factors, with additional benefits for menstrual regularity and psychological well-being. Hormonal effects are variable, with modest improvements in androgen levels and sex hormone-binding globulin. Resistance and combined training appear particularly beneficial for metabolic outcomes. Conclusions.Physical activity is a key component of PCOS management, providing meaningful metabolic and clinical benefits. Individualized and sustainable exercise approaches should be prioritized, while future research should address standardized outcomes and longer intervention durations.