Lifestyle changes in women with polycystic ovary syndrome
Open accessAbstract
BACKGROUND: Polycystic ovary syndrome (PCOS) affects 8% to 13% of reproductive-aged women and is associated with reproductive and metabolic dysfunction. Obesity worsens the presentation of PCOS and weight management (weight loss, maintenance or prevention of excess weight gain) is proposed as an initial treatment strategy, best achieved through lifestyle changes incorporating diet, exercise and behavioural interventions. OBJECTIVES: To assess the effectiveness of lifestyle treatment in improving reproductive, anthropometric (weight and body composition), metabolic and quality of life factors in PCOS. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL and AMED (date of last search March 2018). We also searched controlled trials registries, conference abstracts, relevant journals, reference lists of relevant papers and reviews, and grey literature databases, with no language restrictions applied. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing lifestyle treatment (diet, exercise, behavioural or combined treatments) to minimal or no treatment in women with PCOS. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials, assessed evidence quality and risk of bias, and extracted data. Our primary outcomes were live birth, miscarriage and pregnancy. We used inverse variance and fixed-effect models in the meta-analyses. We reported dichotomous outcomes as an odds ratio and continuous outcomes as a mean difference (MD) or standardised mean difference (SMD). MAIN RESULTS: = 0%, low-quality evidence). AUTHORS' CONCLUSIONS: Lifestyle intervention may improve the free androgen index (FAI), weight and BMI in women with PCOS. We are uncertain of the effect of lifestyle intervention on glucose tolerance. There were no studies that looked at the effect of lifestyle intervention on live birth, miscarriage or menstrual regularity. Most studies in this review were of low quality mainly due to high or unclear risk of bias across most domains and high heterogeneity for the FAI outcome.
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Eating low-glycemic, fiber-rich foods was very effective in quitting weight over a period, and successful long-term maintenance of PCOS-related obesity and metabolic dysfunction.
“According to Lim et al. (2019), eating low-glycemic, fiber-rich foods was found to be very effective in quitting weight over a period, which then the successful long-term areas were the maintenance of PCOS-related obesity and metabolic dysfunction [125].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [125]
The Discussion (Summary of main results; page unavailable) reports modest weight loss and improved abdominal obesity with lifestyle treatment in women with PCOS. It does not establish that low-glycemic, fiber-rich foods specifically are very effective, or that they produce successful long-term maintenance of weight or metabolic improvements. The Implications for research section calls for better long-term studies. (LLM, conf=0.90)
Experimental — accuracy not yet measuredEating low-glycemic, fiber-rich foods was very effective in quitting weight over a period, and successful long-term maintenance of PCOS-related obesity and metabolic dysfunction.
“According to Lim et al. (2019), eating low-glycemic, fiber-rich foods was found to be very effective in quitting weight over a period, which then the successful long-term areas were the maintenance of PCOS-related obesity and metabolic dysfunction [125].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as Lim et al. (2019)
The Discussion’s Summary of main results (page unavailable) reports modest weight loss and improved abdominal obesity with lifestyle treatment, with possible improvements in some metabolic markers. It does not establish that low-glycemic, fiber-rich foods specifically were very effective or that they produced successful long-term maintenance; it says the effect on glucose tolerance is uncertain. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA Cochrane review including 498 participants from 15 randomized controlled trials showed that lifestyle modification can decrease the free androgen index and body mass index in women with PCOS.
“A Cochrane database systematic review including 498 participants from 15 randomized controlled trials showed that lifestyle modification can decrease the free androgen index and body mass index in women with PCOS [33].”
From Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome (2024) · cites this paper as [33]
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- to studies awaiting assessment Gaeini 2012 {published data only} Gaeini AA, Satarifard S, Mohamadi F, Rajaei M. The effect of a twelve-weeks aerobic exercise on ovarian androgens and body composition of women with polycystic ovary syndrome. Armaghane Danesh Journal 2012;17(5):387-97. References to other published versions of this review Psychotherapy.tw. (29898) psychosocial.tw. (79410) exp Behavior Therapy/ (65028) (Behavio?r adj2 therap$).tw. (7095) behavio?r modif$.tw. (2844) (behavio?r adj2 manage$).tw. (2052) CBT.tw. (8291) exp life style/ or exp life change events/ (79697) ((life*style adj2 change$) or intervention$).tw. (802804) counselling.tw. (22827) social support/ (62628) (social adj2 support).tw. (32109) relaxation.tw. (106728) exp self efficacy/ (16694) self efficacy.tw. (21044) exp Health Promotion/ (67559) (Health adj2 Promotion).tw. (26138) exp Health Education/ (222221) (Health$ adj2 Education).tw. (37503) (motivation$ adj2 therap$).tw. (643) or/7-46 (6457272) 6 and 47 (6244) randomised controlled trial.pt. (454849) controlled clinical trial.pt. (92204) randomized.ab. (404382) placebo.tw. (191916) clinical trials as topic.sh. (182777) randomly.ab. (285994) trial.ti. (178689) (crossover or cross-over or cross over).tw. (75504) or/49-56 (1162984) exp animals/ not humans.sh. (4430952) 57 not 58 (1069796) 48 and 59 (1164) (sport$ or walk$).tw. (205224) swim$.tw. (39325) train$.tw. (555945) (fit or fitness).tw. (185779) exp cognitive therapy/ or exp relaxation techniques/ (50976) (cognitive adj2 therap$).tw. (23682) exp Psychotherapy/ (224673) Psychotherapy.tw. (38441) exp Behavior Therapy/ (41912) (Behavio?r adj2 therap$).tw. (9809) CBT.tw. (12487) (behavio?r adj2 manage$).tw. (2438) behavio?r modif$.tw. (3212) exp life style/ or exp life change events/ (133701) ((life*style adj2 change$) or intervention$).tw. (1082857) social support/ (76878) (social adj2 support).tw. (39360) counselling.tw. (34265) relaxation.tw. (108745) kinesiotherapy/ (27939) exp weight control/ or exp weight reduction/ (151665) exp self concept/ (170129) exp health promotion/ (87093) exp health education/ (285721) (health$ adj2 promotion$).tw. (31256) (health$ adj2 education).tw. (41685) or/1-39 (3832956) exp ovary polycystic disease/ or exp stein leventhal syndrome/ (22972) Polycystic Ovar$.tw. (19367) (PCOS or PCOD).tw. (14084) (sclerocystic adj3 ovar$).tw. (97) stein leventhal.tw. (402) 41 or 42 or 43 or 44 or 45 (26576) Clinical trial/ (962537) Randomized controlled trials/ (140047) Random Allocation/ (73840) Single-Blind Method/ (29077) Double-Blind Method/ (121142) Cross-Over Studies/ (47847) Placebos/ (250001) Randomi?ed controlled trial$.tw. (175245) RCT.tw. (27377) Random allocation.tw. (1747) Randomly allocated.tw. (28945) Allocated randomly.tw. (2291) (allocated adj2 random).tw. (791) Single blind$.tw. (20345) Double blind$.tw. (179235) ((treble or triple) adj blind$).tw. (749) Placebo$.tw. (262971) Prospective Studies/ (331626) or/47-64 (1767706) Case study/ (52324) Case report.tw. (346377) Abstract report/ or letter/ (1020578) or/66-68 (1410943) 65 not 69 (1717764) animal/ (1828109) human/ (19121849) 71 not 72 (1390128) 70 not 73 (1688418) 40 and 46 and 74 (1654) exp Running/ (1759) exp psychotherapy/ (205466) exp Behavior Therapy/ (18933) exp Lifestyle/ (10672) or/1-41 (1552673) exp endocrine sexual disorders/ (1128) Polycystic Ovar$.tw. (371) pco$.tw. (841) (sclerocystic adj3 ovar$).tw. (1) stein leventhal.tw. (2) or/43-47 (1963) 42 and 48 (748) random.tw. (52311) control.tw. (403643) double-blind.tw. (21298) clinical trials/ (10820) placebo/ (5068) exp Treatment/ (707355) or/50-55 (1099613) 49 and 56 (425)
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- Authors
- Lim, S. S., Hutchison, S. K., Van Ryswyk, E., Norman, R. J., Teede, H. J., & Moran, L. J.
- Affiliations
- Monash University (AU)
- Monash Health (AU)
- College of Medicine and Public Health, Flinders University; Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence; Sturt Road Adelaide South Australia Australia 5042
- The University of Adelaide (AU)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2019-03-28
- Volume
- 2019
- Issue
- 3
- Pages
- CD007506-CD007506
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6438659
- OpenAlex
- W1513555214
- Cited by
- 725
- References
- 40
- Citations by year
- 2026: 35 · 2025: 66 · 2024: 72 · 2023: 84 · 2022: 79 · 2021: 62 · 2020: 45 · 2019: 31 · 2018: 22 · 2017: 33 · 2016: 35 · 2015: 47 · 2014: 43 · 2013: 26 · 2012: 30
- FWCI
- 7.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- Monash University Research Portal (Monash University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, lifestyle intervention, diet, physical activity, behavioral interventions, weight management, obesity, free androgen index, body mass index, glucose tolerance, live birth, miscarriage, menstrual cycle regularity, quality of life
- MeSH terms
- Female, Humans, Insulin Resistance, Life Style, Obesity, Polycystic Ovary Syndrome, Virilism, Weight Loss, Exercise, Randomized Controlled Trials as Topic, Abdominal Fat, Waist Circumference
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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