Effectiveness of exercise interventions on mental health and health-related quality of life in women with polycystic ovary syndrome: a systematic review

Abstract

Background Polycystic ovary syndrome (PCOS) is a complex condition, impacting cardio-metabolic and reproductive health, mental health and health-related quality of life. The physical health benefits of exercise for women with PCOS are well-established and exercise is increasingly being recognised as efficacious for improving psychological wellbeing. The aim of this review was to summarise the evidence regarding the effectiveness of exercise interventions on mental health outcomes in women with PCOS. Methods A systematic search of electronic databases was conducted in March of 2020. Trials that evaluated the effect of an exercise intervention on mental health or health-related quality of life outcomes in reproductive aged women with diagnosed PCOS were included. Methodological quality was assessed using the modified Downs and Black checklist. Primary outcomes included symptoms of depression and anxiety, and health-related quality of life. Results Fifteen articles from 11 trials were identified and deemed eligible for inclusion. Exercise demonstrated positive improvements in health-related quality of life in all of the included studies. Half of included studies also reported significant improvements in depression and anxiety symptoms. There was large variation in methodological quality of included studies and in the interventions utilised. Conclusions The available evidence indicates that exercise is effective for improving health-related quality of life and PCOS symptom distress. Exercise also shows some efficacy for improving symptoms and/or prevalence of depression and anxiety in women with PCOS. However, due to large heterogeneity of included studies, conclusions could not be made regarding the impact of exercise intervention characteristics. High-quality trials with well reported exercise intervention characteristics and outcomes are required in order to determine effective exercise protocols for women with PCOS and facilitate translation into practice.

Efficacy of high-intensity interval training for improving mental health and health-related quality of life in women with polycystic ovary syndrome

“…Although exercise is an effective means for managing mental health concerns in a general population 50 , this relationship has been relatively understudied in women with PCOS. Existing research reports a combination of positive and null findings, with approximately half of existing studies reporting significant improvements in symptoms of anxiety and/or depression 23 , 24 . To the best of our knowledge, this is the first study to compare work-matched HIIT and MICT exercise interventions on mental health and HRQoL in women with PCOS.…”

“…In line with the Australian physical activity guidelines, the International evidence-based guidelines for the assessment and management of PCOS recommend a minimum of 150 min per week of moderate intensity physical activity or 75 min per week or vigorous intensity exercise 19 . Exercise is well established as a therapeutic tool to improve metabolic and reproductive health outcomes in women with PCOS 21 , 22 , however, the impact on mental health and HRQoL is less clear 23 , 24 . In populations with other chronic conditions, exercise is known to be an effective tool for promoting positive mental health 25 , 26 .…”

A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women

“…They concluded that, regardless of modality, any exercise program with a duration of 45–60 min per session and at least moderate intensity significantly improved cognitive function. In a systematic review involving 11 randomized, non-randomized, and uncontrolled trials, Pattern et al [ 38 ] examined the effects of exercise interventions on mental health and health-related quality of life in women with poly ovary syndrome. In that study, they showed that exercise training improved health-related quality of life in all 11 trials, and half of the 11 studies reported significant improvements in depression and anxiety symptoms.…”

Evaluation of Bodily Pain Associated with Polycystic Ovary Syndrome: A Review of Health-Related Quality of Life and Potential Risk Factors

“…Mental disorders may increase the severity of pain, whereas prolonged periods of pain contribute to the increased severity of mental disorders involving fear, stress, depression, and anxiety. Numerous HRQoL surveys have characterized mental disorders as a dominant aspect of the lives of patients with PCOS [ 16 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 26 , 134 ] and a factor that may affect their pain perception. However, the association between pain and mental disorders in patients with PCOS requires further clarification.…”