Related Experiment Video
Updated: Jan 17, 2026
Author Spotlight: Investigating the Mechanisms and Inducing Models of Polycystic Ovary Syndrome
Published on: July 5, 2024
Effects of Physical Exercise on Cardiovascular Autonomic Modulation in Women with Polycystic Ovary Syndrome: A
João Vitor Martins Bernal1, Juan Carlos Sánchez-Delgado2, Noemi Marchini de Souza Couto1
1Laboratory of Physiology and Cardiovascular Physiotherapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Objective:
Women with polycystic ovary syndrome (PCOS) exhibit cardiovascular autonomic imbalance, an important predictor of mortality. Physical exercise is an intervention known to enhance cardiovascular autonomic modulation in various populations. However, it remains unclear whether these benefits extend to women with PCOS, given that specific pathophysiological characteristics may influence autonomic adaptations. Therefore, this review aimed to synthesize the available evidence to improve understanding of this topic.
Design:
Systematic review and meta-analysis.
Methods:
A systematic search of CENTRAL, Embase, PubMed, Scopus, and Web of Science was conducted, followed by a snowball search to ensure comprehensive coverage of relevant randomized and non-randomized clinical trials. Random-effects meta-analyses were performed to quantitatively summarize the effects of exercise interventions on autonomic cardiovascular regulation in this population. The certainty of evidence was assessed using the GRADEpro tool.
Results:
Five studies were selected, including 316 women with PCOS (214 in the exercise group and 102 in the control group). The meta-analysis indicated that aerobic exercise reduces the percentage of sequences with three consecutive cardiac cycles without significant variations (mean difference [MD = -6.13; 95% CI = -8.56 to -3.71, p < 0.001; I2 = 0%; moderate-certainty evidence) and increase the percentage of sequences with three consecutive cardiac cycles with two different variations (MD = 7.16; 95% CI = 4.61 to 9.72; p < 0.001; I2 = 8%; moderate-certainty evidence) and the root mean square of successive differences (MD = 12.84; 95% CI = 2.66 to 23.03; p = 0.01; I2 = 52%; low-certainty evidence).
Conclusion:
The benefits of aerobic exercise on cardiovascular autonomic modulation appear to extend to women with PCOS, increasing vagal modulation and reducing sympathetic modulation. However, further studies are needed to strengthen the evidence and clarify the effects of other exercise modalities.
Related Concept Videos
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:17Exercise and Cardiac Output
Sustained exercise increases the muscles' oxygen demand, which can be...
01:30Hormonal Control of the Ovarian Cycle
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
01:22Hormonal Regulation of the Menstrual Cycle
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
01:29Pathophysiology of Cardiac Performance
01:17Hormonal Regulation of Blood Pressure
Epinephrine and Norepinephrine
The adrenal medulla releases epinephrine and norepinephrine, catecholamines that enhance and extend the sympathetic or "fight or flight" physiological response. These hormones escalate heart rate and the force of contraction...