Comparison of the Effect of Intermittent and Continuous Aerobic Physical Training on Sexual Function of Women With Polycystic Ovary Syndrome: Randomized Controlled Trial

Abstract

Background Polycystic ovary syndrome (PCOS) is a common condition characterized by hyperandrogenism, anthropometric changes (increased weight and waist-to-hip ratio [WHR]), behavioral changes (sexual dysfunction, anxiety, and depression), and reduced quality of life. Physical exercise may reduce many of the adverse effects of PCOS. However, no studies have yet evaluated the effects of aerobic exercise on the sexual function of women with PCOS. Aim To compare the effects of continuous and intermittent aerobic physical training on the sexual function and mood of women with PCOS. Methods This is a secondary analysis of a controlled clinical trial in which women with PCOS (18–39 years of age) were randomly allocated to 1 of 3 groups for 16 weeks: continuous aerobic training (CAT, n = 23), intermittent aerobic training (IAT, n = 22), or no training (control group, n = 24). The Female Sexual Function Index (FSFI) was used to assess sexual function, and the Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Main Outcome Measure The main outcome measure used was the FSFI. Outcomes The primary outcomes were changes from baseline in total FSFI score and HAD scores at week 16 to prove the superiority of intermittent aerobic exercise compared with continuous aerobic exercise. Results After 16 weeks, the CAT group had a significant increase in the total FSFI score, improvements in the FSFI domains of satisfaction and pain, and a reduction in the WHR. The CAT and IAT groups also had significantly lower levels of testosterone after 16 weeks. The IAT group had a significant increase in the total FSFI score and improvements in the desire, excitation, lubrication, orgasm, and satisfaction FSFI domains. The CAT and IAT groups both had significant reductions in anxiety and depression scores after 16 weeks. Clinical Implications Aerobic physical training protocols could be indicated to promote mental and sexual health in women with PCOS. Strength & Limitations This is one of the first studies to examine the effects of different physical training protocols on the sexual function of women with PCOS. The limitations of this study are that we did not consider diet or the frequency of sexual relations of participants with their partners. These factors could have interfered with the outcomes. Conclusion The CAT and IAT protocols improved the sexual function and reduced the anxiety and depression of women with PCOS. Both protocols were similar to improve FSFI domain scores.

Effects of Physical Exercise on Sexual Function and Quality of Sexual Life Related to Menopausal Symptoms in Peri- and Postmenopausal Women: A Systematic Review

“…Similarly, exercise appears to activate the sympathetic nervous system, which is involved in both sexual arousal and orgasm [41]. As for traditional forms of exercise, it has been proven that physical resistance training and aerobic physical training are effective in improving sexual function in women with polycystic ovary syndrome [42,43]. However, among the articles included in our review, aerobic training yielded inconsistent results.…”

Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials

“…The mean age of the participants ranged from 18 to 40 years. Six RCTs included women that had a mean BMI classified as overweight or obese [22,23,[25][26][27][28]; in only one study were the participants classified as "normal weight" [24].…”

“…Only one study compared high-intensity aerobic exercise vs. strength training with a control group (received recommended > 150 minutes per week) [23]. Four studies compared intermittent aerobic training vs. continuous aerobic training with a control group [22,[25][26][27]. The duration of intervention for four studies was 12 weeks, 16 weeks for two studies, and 10 weeks for only one study.…”

“…Only one study (Faryadian et al, 2019) [24] did not analyze the pre-and post-intervention anthropometric indices of women with PCOS. However, four studies ( [23,25,26,28]. Only two studies reported information on the menstrual cycle (self-report) of the participants [23,28].…”

Sexual dysfunction in polycystic ovary syndrome: a complex entity that may find improvement with the simplest of solutions

“…It is not clear whether compliance with this aspect of the program was measured by the study authors, but further exploration of the links between exercise execution and changes in sexual functioning may be warranted. Indeed, such an investigation was recently published by Lopes et al (4). These investigators compared the impact of a continuous versus intermittent exercise program on FSFI scores in women with PCOS and showed both programs were effective in significantly improving total sexual function scores, as well as scores across multiple sexual function domains.…”