Effects of exercise and lifestyle management on reproductive function in overweight women with polycystic ovary syndrome

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Polycystic ovary syndrome (PCOS) is a complex disorder present in 5-10% of women of reproductive age. It is associated with obesity, increased menstrual dysfunction and infertility and metabolic conditions such as increased serum insulin, high cholesterol, diabetes and heart disease. Lifestyle interventions aimed at reducing obesity and insulin resistance, which include dietary weight loss and physical activity, are advocated for the management of PCOS. However, while research indicates that weight loss through diet improves many symptoms, there is a paucity of research evaluating the combined role of physical exercise in managing this condition. In addition, there is no research examining the optimal form of exercise that should be undertaken to achieve long-term reproductive fitness and metabolic health and consequently there is a lack of evidence-based exercise guidelines for patients with PCOS. We plan to perform a clinical study to investigate whether combining exercise with weight loss by diet in patients with PCOS provides any additional benefit for improving menstrual function, fertility and metabolic health beyond those that can be achieved using dietary restriction alone. We will also assess whether, when combined with dietary restriction, a program of physical activity incorporating both endurance and resistance exercise provides a greater benefit than the more common prescription of endurance exercise alone. This information will be used to assist in the development of guidelines for the effective management of reproductive dysfunction in patients with PCOS.