Polycystic Ovarian Syndrome: An Investigation of Non-Pharmacologic Management Strategies and Cardiometabolic Consequences

Background: Preliminary evidence suggests exercise training may result in improved reproductive, anthropometric, cardiometabolic and psychosocial health in women with polycystic ovary syndrome (PCOS).Objective: To evaluate the effects of exercise training on reproductive, anthropometric, cardiometabolic, and sleep quality health measures in reproductive-aged women with PCOS.Methods: First, we performed a systematic review and meta-analysis of studies assessing the effects of exercise training on reproductive outcomes. Second, we performed a pilot randomized controlled trial evaluating the feasibility of conducting a larger trial evaluating reproductive, anthropometric, cardiometabolic, and sleep quality health measures. Feasibility outcomes included: participant recruitment, attrition, adherence to prescribed exercise and daily ovulation assessment.Results: The systematic review included 14 studies involving 617 women. Semi-quantitative analysis suggested exercise training may increase ovulation rates, menstrual regularity and pregnancy. In the trial, all recruitment methods were important as each recruited participant was not reached by the other methods. 47 participants were randomized: no-exercise control (n=17), high-intensity interval training (HIIT) (n=16), continuous aerobic exercise training (CAET) (n=14). Across all groups, attrition was 15%. Median exercise adherence was 68% (IQR 53%, 86%). Ovulation assessment adherence dropped from 87% (IQR 61%, 97%) in the first 3-months of the intervention to 65% (IQR 0%, 96%) in the final 3-months. 22/33 (66.7%) women ovulated during the intervention period with no between-group differences. Body mass index decreased for CAET compared with HIIT (-0.9 kg/m2, p=0.04) and control (-1.0 kg/m2, p=0.01). Mean waist circumference decreased significantly (-7.3 cm, -6.9 cm, -4.5 cm in HIIT, CAET and control) with no significant between-group differences. In HIIT compared with CAET, LDL-C decreased significantly (-0.33 mmol/L, p=0.03). In HIIT compared with control, HDL-C increased (0.18 mmol/L, p=0.04). 79% of participants reported poor sleep quality.Conclusions: While exercise training may improve anthropometric, reproductive and sleep quality health markers in women with PCOS, the effects of exercise training on reproductive health measures remain unclear. Feasibility challenges with exercise training and daily ovulation assessment adherence limited the ability to analyze the effect of exercise on ovulation. Further studies are needed to determine optimal exercise prescriptions for this population.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Discipline thesis:degree_discipline

Medicine – Community Health Sciences

Grantor

Cumming School of Medicine

Year dc:date.issued

2021

Author dc:creator

• Benham, Jamie L.

Advisor dc:contributor.advisor

• Sigal, Ronald J.

Committee members dc:contributor.committeemember

• Corenblum, Bernard
• Rabi, Doreen M.
• Friedenreich, Christine M.

• Polycystic Ovary Syndrome
• Randomized Controlled Trial
• Exercise
• High-Intensity Interval Training
• Ovulation
• Ovulation Prediction
• Women’s Health

Language dc:language.iso

English

DOI

https://dx.doi.org/10.11575/PRISM/dspace/41133

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:1880/116289