Zhejiang Da Xue Xue Bao Yi Xue Ban · Oct 30, 2026

Effects of aerobic exercise on reproductive hormone profiles in women with polyendocrine metabolic ovarian syndrome (polycystic ovary syndrome): a meta-analysis

By Zhuang M, Liu Z, Yan H et al.

OBJECTIVES: To systematically synthesise and quantify the effects of aerobic exercise on reproductive hormone profiles in women with polyendocrine metabolic ovarian syndrome (PMOS; formerly polycystic ovary syndrome, PCOS), to explore potential moderators, and to provide high-level evidence for precision exercise prescription. This study was prospectively registered in PROSPERO, the international prospective register of systematic reviews (registration number: CRD420251138313). METHODS: In accordance with the PRISMA guidelines, PubMed, Web of Science, Cochrane Library, Embase, and Scopus were searched from inception to 25 September 2025 to identify randomised controlled trials. Risk of bias was assessed with the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Statistical analyses were performed in R 4.4.3 with the meta and metafor packages for main-effect pooling (Hedges'g), subgroup and meta-regression analyses, sensitivity analyses, and publication bias assessment. RESULTS: Twenty-five randomized control trials involving 1286 participants were included. Compared with control groups, aerobic exercise reduced testosterone [Hedges' g = -0.45, 95% confidence interval (CI): -0.62 to -0.30; 95% prediction interval (PI): -1.11 to 0.20, P < 0.05], free testosterone (Hedges' g= -0.59, 95% CI: -0.90 to -0.28, 95% PI: -0.99 to -0.19, P < 0.05), the free androgen index (Hedges' g = -0.17, 95% CI: -0.32 to -0.02, 95% PI: -0.32 to -0.02, P = 0.02), dehydroepiandrosterone sulphate (Hedges' g = -0.20, 95% CI: -0.40 to -0.01, 95% PI: -0.43 to 0.02, P = 0.04), and luteinising hormone (Hedges' g = -0.29, 95% CI: -0.53 to -0.05, 95% PI: -1.10 to 0.52, P = 0.02) in women with PMOS, while increasing sex hormone-binding globulin (Hedges' g = 0.17, 95% CI: 0.04 to 0.31, 95% PI: 0.03 to 0.31, P = 0.01) and follicle-stimulating hormone (Hedges' g = 0.26, 95% CI: 0.06 to 0.45, 95% PI: -0.36 to 0.87, P = 0.01). No significant effects were observed on the follicle-stimulating hormone/luteinising hormone ratio (Hedges' g = -0.22, 95% CI: -0.48 to 0.05, 95% PI: -0.56 to 0.13, P = 0.11) or anti-Müllerian hormone (Hedges' g = -0.17, 95% CI: -0.52 to 0.19, 95% PI: -1.12 to 0.78, P = 0.35). Subgroup and meta-regression analyses indicated that younger age was associated with greater improvements in SHBG (β < 0, P < 0.05); effects on testosterone and the free androgen index were more pronounced in trials with passive control groups than in those with active control groups; intervention duration was negatively associated with changes in FSH (P = 0.05); and session duration showed a trend towards a positive association with the magnitude of luteinising hormone reduction (P = 0.06). CONCLUSIONS: Aerobic exercise reduces androgen-related markers and luteinising hormone levels and increases sex hormone-binding globulin and follicle-stimulating hormone in women with PMOS, with no significant effects on the follicle-stimulating hormone/luteinising hormone ratio or anti-Müllerian hormone. Age, control type, and exercise modality may moderate intervention effects, and cycling showed potential advantages. However, the number of relevant studies and the sample sizes were limited, and further high-quality randomised controlled trials are needed to confirm these findings.

doi.org/10.3724/zdxbyxb-2026-0084Open accessPubMed 42967810Interventions