Structured Exercise Training in Polycystic Ovary Syndrome: A Randomized Controlled Trial on Hormonal, Oxidative, and Inflammatory Mechanisms

Abstract

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by hyperandrogenism, menstrual irregularities, and metabolic disturbances, often accompanied by oxidative stress and chronic low-grade inflammation. Lifestyle modifications and  interventions, particularly exercise, are emerging as effective strategies to modulate these dysregulated pathways. This study investigates the mechanistic role of structured exercise on hormonal, oxidative, and inflammatory markers in women with PCOS. A total of 100 participants were randomly assigned to an exercise intervention group (n = 50) or a control group receiving standard care (n = 50). The exercise program lasted 12 weeks and included aerobic and resistance training components. Hormonal parameters (total testosterone, luteinizing hormone [LH], follicle-stimulating hormone [FSH], and LH/FSH ratio), oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], total antioxidant capacity [TAC]), and inflammatory cytokines (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]) were measured pre- and post-intervention. Statistical analysis revealed that exercise significantly reduced total testosterone and LH/FSH ratio while improving oxidative balance, evidenced by decreased MDA and increased SOD and TAC levels. Inflammatory markers were also significantly lowered in the exercise group compared to controls, suggesting systemic anti-inflammatory effects. Correlation analysis indicated strong interrelationships among hormonal, oxidative, and inflammatory markers, highlighting the integrated mechanistic impact of exercise. These findings support the concept that structured physical activity can modulate endocrine, oxidative, and inflammatory circuits in PCOS, providing a non-pharmacological approach to improve reproductive and metabolic health. Future studies should explore individualized exercise prescriptions and long-term outcomes.