Lifestyle changes in women with polycystic ovary syndrome

Lim, Siew; Hutchison, Samantha; Ryswyk, Emer Van; Norman, Robert J.; Teede, Helena; Moran, Lisa

doi:10.1002/14651858.cd007506.pub4

Cited by 296 publications

(166 citation statements)

References 122 publications

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“…With the exception of THADA and INSR, however, PCOS risk genes do not associate with T2D or obesity [24]. Since currently identified PCOS risk genes account for so little of PCOS prevalence [16,24], etiopathogenesis is considered a combination of polygenic, epigenetic and developmental contributions [7,48,49], exaggerated by obesity or ameliorated by lifestyle [50,51].…”

Section: The Evidence For Genetic Origins Of Pcosmentioning

confidence: 99%

Naturally Occurring and Experimentally Induced Rhesus Macaque Models for Polycystic Ovary Syndrome: Translational Gateways to Clinical Application

et al. 2019

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Indian rhesus macaque nonhuman primate models for polycystic ovary syndrome (PCOS) implicate both female hyperandrogenism and developmental molecular origins as core components of PCOS etiopathogenesis. Establishing and exploiting macaque models for translational impact into the clinic, however, has required multi-year, integrated basic-clinical science collaborations. Paradigm shifting insight has accrued from such concerted investment, leading to novel mechanistic understanding of PCOS, including hyperandrogenic fetal and peripubertal origins, epigenetic programming, altered neural function, defective oocytes and embryos, adipogenic constraint enhancing progression to insulin resistance, pancreatic decompensation and type 2 diabetes, together with placental compromise, all contributing to transgenerational transmission of traits likely to manifest in adult PCOS phenotypes. Our recent demonstration of PCOS-related traits in naturally hyperandrogenic (High T) female macaques additionally creates opportunities to employ whole genome sequencing to enable exploration of gene variants within human PCOS candidate genes contributing to PCOS-related traits in macaque models. This review will therefore consider Indian macaque model contributions to various aspects of PCOS-related pathophysiology, as well as the benefits of using macaque models with compellingly close homologies to the human genome, phenotype, development and aging.

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Section: The Evidence For Genetic Origins Of Pcosmentioning

confidence: 99%

Naturally Occurring and Experimentally Induced Rhesus Macaque Models for Polycystic Ovary Syndrome: Translational Gateways to Clinical Application

et al. 2019

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“…Despite the present study finding most women's exercise activity aligned with recommendations in clinical practice guidelines, 29 the respondents perceptions of low efficacy elucidates a gap in information 17 and a need for guidance despite the absence of high quality evidence. 5 Women in the community still need to make decisions about patterns and types of lifestyle to manage PCOS. Their perceived low efficacy may be complicated by the absence of rigorous information and reflect the trial and error process of self-directed and self-funded searches for the most effective and feasible lifestyle interventions for their case and circumstances.…”

Section: Discussionmentioning

confidence: 99%

“…4 Diet and exercise interventions aimed at weight reduction and prevention of weight gain are first-line management strategies due to their significant impact on clinical outcomes, including reproductive endocrinology and clinical signs and symptoms. [3][4][5] However, current evidence for lifestyle intervention for women with PCOS is not well established. Many studies informing the evidence base are underpowered and report high risk of bias, particularly from high attrition.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies informing the evidence base are underpowered and report high risk of bias, particularly from high attrition. [5][6][7][8] The effectiveness of specific dietary and exercise practices for women centred outcomes has not been established. It has not been shown that if, and to what degree diet and exercise performed outside the confines of study intervention environments correlate with improved health status for women with PCOS in the community.…”

Section: Introductionmentioning

confidence: 99%

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Diet and exercise as a management strategy for symptoms of polycystic ovary syndrome (PCOS): the views of women in the community with PCOS.

Arentz

Smith

Abbott

et al. 2020

Preprint

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Background The international clinical practice guidelines for PCOS emphasize diet and exercise as first-line management of clinical signs and symptoms. This study aimed to describe the patterns, perceptions and experiences of lifestyle interventions for women in the community with PCOS. Method An electronic survey of 493 members of two PCOS consumer support groups described women’s types and patterns of diet and exercise, experiences and perceptions of effectiveness. Women were recruited from the Polycystic Ovary Association of Australia (POSAA) and from the Facebook group, PCOS University Research Group. Associations between participants perceptions of effectiveness, and diet types and exercise patterns were assessed using logistic regression. Response bias for the POSAA group was assessed with a continuum of resistance model. Results 91% of POSAA members aged 16-50 years responded to the survey. Nearly all women reported adjusting their dietary and exercise practices with the aim to improve their health and/or PCOS (82% and 73% respectively), however less than 13% reported achievement of health goals (12.2% and 8.1% respectively). Low carbohydrate, high protein diets, and vigorous activity were associated with self-perceived effectiveness (r.0.16, p<0.01; r.0.15 p<0.01 and r.0.2 p<0.01 respectively). Barriers for lifestyle interventions included psychosocial factors. Response bias was not assessed for the Facebook group, however self-reported PCOS aligned with prevalence of clinical phenotypes and suggests results are generalizable to clinical populations of women with PCOS, who are responsible for self-directing and administering lifestyle interventions to manage their PCOS.Conclusions Perceptions of effectiveness for lifestyle interventions by women with PCOS may be complicated by a lack of rigorous evidence. The strength of recommendations in clinical practice guidelines may be enhanced by clinical trials investigating flexible and feasible lifestyle interventions for women in the community with PCOS.

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“…Current evidence-based guidelines on PCOS recommend that obese women embark on 3-6 months of lifestyle management for weight loss prior to considering assisted reproductive technology (ART). However, adherence is generally low [5,6], and achieving adequate weight loss remains a significant challenge [4,7].…”

Section: Introductionmentioning

confidence: 99%

Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study

Smith

Costello

et al. 2020

Pilot Feasibility Stud

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Background: Polycystic ovary syndrome (PCOS) is a prevalent women's health condition with reproductive, metabolic, and psychological manifestations. Weight loss can improve these symptoms and is a key goal; however, many women find this difficult to achieve. Acupuncture is a Chinese medical treatment that involves insertion of very fine metal needles into specific areas of the body and has been shown to be efficacious for weight loss in non-PCOS populations. However, few studies have been conducted in women with PCOS. A variant of acupuncture, auricular electro-acupuncture (AEA), may have beneficial effects on sympathetic tone, which is associated with insulin resistance, obesity and PCOS.

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Lifestyle changes in women with polycystic ovary syndrome

Abstract: Lifestyle changes in women with polycystic ovary syndrome.

Cited by 296 publications

References 122 publications

Naturally Occurring and Experimentally Induced Rhesus Macaque Models for Polycystic Ovary Syndrome: Translational Gateways to Clinical Application

Naturally Occurring and Experimentally Induced Rhesus Macaque Models for Polycystic Ovary Syndrome: Translational Gateways to Clinical Application

Diet and exercise as a management strategy for symptoms of polycystic ovary syndrome (PCOS): the views of women in the community with PCOS.

Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study

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