Physical Exercise on Aerobic Capacity in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Most patients present insulin resistance (IR) and impaired VO₂max associated with cardiovascular mortality. While exercise is recommended as the first-line treatment, there is a lack of certainty of the exercise intensity effect on improvement of pathogenic factors. The aim of the study was to determine the effect of MICT on VO₂max and HOMA-IR compared to other exercise intensities in women with PCOS. Search was performed on PubMed, Scopus and Web of Science during February 2025. Eligible studies included RTCs, women with PCOS diagnosis, moderate-intensity training and/or other intensities intervention lasting ≥8 weeks, and VO₂max measured by direct method. Meta-analyses included 10 studies involving 289 participants. MICT improved cardiorespiratory capacity as follows: 4.65 mL/kg/min, 95% CI: 3.07-6.23 P < 0.001, I² = 84% n = 9; and HIIT: 3.55 mL/kg/min, 95% CI: 1.84-5.26, P < 0.001, I² = 0% n = 4. No effect was seen on HOMA-IR with MICT: 0.06, 95% CI: -0.67-0.78 P < 0.88, I² = 0% n = 3; or HIIT: -0.20, 95% CI: -0.70-0.31, P < 0.44, I² = 0% n = 3. In conclusion, MICT appears to promote greater changes of VO₂max than HIIT and none of those exercises had a significant impact on IR.