Effect of Exercise and Nutrition on Oxidative Stress in Females with Polycystic Ovary Syndrome, a Current Status and Future Perspective in Narrative Review
Oxidative Stress in Females with Polycystic Ovary Syndrome
DOI:
https://doi.org/10.54393/pjhs.v6i6.3179Keywords:
Polycystic Ovarian Syndrome, Hormonal Imbalance, Oxidative Stress, Lifestyle InterventionsAbstract
Women in their reproductive years are prone to the widespread endocrinological disorder known as Polycystic Ovarian Syndrome (PCOS). To provide in-depth insights into the factors contributing to hormonal imbalances, inflammation, and oxidative stress in women with PCOS. Additionally, it evaluates the impact of exercise and nutritional interventions on oxidative stress and overall metabolic health in PCOS women to improve their quality of life. This review analyzed existing literature and clinical evidence related to endocrine disturbances in PCOS, including hormonal changes such as elevated androgens, insulin resistance, inflammation, and oxidative stress. The effects of lifestyle interventions specifically physical exercise, dietary modifications, and supplementation on these metabolic and hormonal abnormalities were studied. Hormonal Imbalance: Women with PCOS show dysregulated production of Growth Hormone (GH), ghrelin, LEAP-2, Gonadotropin-Releasing Hormone (GnRH), insulin, LH/FSH ratio, androgens, and estrogens. Inflammation and Oxidative Stress: Hyperandrogenism and insulin resistance promote chronic inflammation and increased Reactive Oxygen Species (ROS), leading to oxidative stress, gut microbiome alterations, and metabolic dysfunction. PCOS is a multifactorial disorder influenced by hormonal imbalance, chronic inflammation, and oxidative stress. Lifestyle modifications, particularly tailored exercise regimens and nutritional strategies, play a critical role in mitigating these factors.
References
Butt MS, Saleem J, Zakar R, Aiman S, Bukhari GM, Fischer F. Comparison of physical activity levels and dietary habits between women with polycystic ovarian syndrome and healthy controls of reproductive age: a case-control study. BioMed Central Women's Health. 2024 Jan; 24(1): 29. doi: 10.1186/s12905-023-02866-3. DOI: https://doi.org/10.1186/s12905-023-02866-3
Krishnan A and Muthusami S. Hormonal alterations in PCOS and its influence on bone metabolism. Journal of Endocrinology. 2017 Feb; 232(2): R99-113. doi: 10.1530/JOE-16-0405. DOI: https://doi.org/10.1530/JOE-16-0405
Stener-Victorin E, Teede H, Norman RJ, Legro R, Goodarzi MO, Dokras A et al. Polycystic ovary syndrome. Nature Reviews Disease Primers. 2024 Apr; 10(1): 27. doi: 10.1038/s41572-024-00511-3. DOI: https://doi.org/10.1038/s41572-024-00511-3
Eshre TR, Asrm-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility. 2004 Jan; 81(1): 19-25. doi: 10.1016/j.fertnstert.2003.10.004. DOI: https://doi.org/10.1016/j.fertnstert.2003.10.004
Scarfò G, Daniele S, Fusi J, Gesi M, Martini C, Franzoni F et al. Metabolic and molecular mechanisms of diet and physical exercise in the management of polycystic ovarian syndrome. Biomedicines. 2022 Jun; 10(6): 1305. doi: 10.3390/biomedicines10061305. DOI: https://doi.org/10.3390/biomedicines10061305
Choudhari R, Tayade S, Tiwari A, Satone P, Choudhari RG, Satone PD. Diagnosis, management, and Associated comorbidities of Polycystic Ovary Syndrome: a narrative review. Cureus. 2024 Apr; 16(4). doi: 10.7759/cureus.58733. DOI: https://doi.org/10.7759/cureus.58733
Armanini D, Boscaro M, Bordin L, Sabbadin C. Controversies in the pathogenesis, diagnosis and treatment of PCOS: focus on insulin resistance, inflammation, and hyperandrogenism. International Journal of Molecular Sciences. 2022 Apr; 23(8): 4110. doi: 10.3390/ijms23084110. DOI: https://doi.org/10.3390/ijms23084110
Orisaka M, Mizutani T, Miyazaki Y, Shirafuji A, Tamamura C, Fujita M et al. Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging. Frontiers in Endocrinology. 2023 Dec; 14: 1324429. doi: 10.3389/fendo.2023.1324429. DOI: https://doi.org/10.3389/fendo.2023.1324429
Alesi S, Ee C, Moran LJ, Rao V, Mousa A. Nutritional supplements and complementary therapies in polycystic ovary syndrome. Advances in Nutrition. 2022 Jul; 13(4): 1243-66. doi: 10.1093/advances/nmab141. DOI: https://doi.org/10.1093/advances/nmab141
Rehman R, Alam F, Amjad S, Henkel R. Oxidative Stress in Infertility. InBiomarkers of Oxidative Stress: Clinical Aspects of Oxidative Stress 2024 Nov: 123-150. doi: 10.1007/978-3-031-69962-7_6. DOI: https://doi.org/10.1007/978-3-031-69962-7_6
Masenga SK, Kabwe LS, Chakulya M, Kirabo A. Mechanisms of oxidative stress in metabolic syndrome. International Journal of Molecular Sciences. 2023 Apr; 24(9): 7898. doi: 10.3390/ijms24097898. DOI: https://doi.org/10.3390/ijms24097898
Gu Y, Zhou G, Zhou F, Wu Q, Ma C, Zhang Y et al. Life modifications and PCOS: old story but new tales. Frontiers in Endocrinology. 2022 Apr; 13:808898. doi: 10.3389/fendo.2022.808898. DOI: https://doi.org/10.3389/fendo.2022.808898
Lalonde-Bester S, Malik M, Masoumi R, Ng K, Sidhu S, Ghosh M et al. Prevalence and etiology of eating disorders in polycystic ovary syndrome: a scoping review. Advances in Nutrition. 2024 Feb: 100193. doi: 10.1016/j.advnut.2024.100193. DOI: https://doi.org/10.1016/j.advnut.2024.100193
Kogure GS, Lopes IP, Ribeiro VB, Mendes MC, Kodato S, Furtado CL et al. The effects of aerobic physical exercises on body image among women with polycystic ovary syndrome. Journal of Affective Disorders. 2020 Feb; 262: 350-8. doi: 10.1016/j.jad.2019.11.025. DOI: https://doi.org/10.1016/j.jad.2019.11.025
Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Human Reproduction Update. 2011 Mar; 17(2): 171-83. doi: 10.1093/humupd/dmq045. DOI: https://doi.org/10.1093/humupd/dmq045
Breyley-Smith A, Mousa A, Teede HJ, Johnson NA, Sabag A. The effect of exercise on cardiometabolic risk factors in women with polycystic ovary syndrome: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2022 Jan; 19(3): 1386. doi: 10.3390/ijerph19031386. DOI: https://doi.org/10.3390/ijerph19031386
Murri M, Luque-Ramírez M, Insenser M, Ojeda-Ojeda M, Escobar-Morreale HF. Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Human Reproduction Update. 2013 May; 19(3): 268-88. doi: 10.1093/humupd/dms059. DOI: https://doi.org/10.1093/humupd/dms059
Covington JD, Bajpeyi S, Moro C, Tchoukalova YD, Ebenezer PJ, Burk DH et al. Potential effects of aerobic exercise on the expression of perilipin 3 in the adipose tissue of women with polycystic ovary syndrome: a pilot study. European Journal of Endocrinology. 2015 Jan; 172(1): 47-58. doi: 10.1530/EJE-14-0492. DOI: https://doi.org/10.1530/EJE-14-0492
Moro C, Pasarica M, Elkind-Hirsch K, Redman LM. Aerobic exercise training improves atrial natriuretic peptide and catecholamine-mediated lipolysis in obese women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2009 Jul; 94(7): 2579-86. doi: 10.1210/jc.2009-0051. DOI: https://doi.org/10.1210/jc.2009-0051
Aghaie F, Khazali H, Hedayati M, Akbarnejad A. The effects of moderate treadmill and running wheel exercises on oxidative stress in female rats with steroid-induced polycystic ovaries. Physiology and Pharmacology. 2016 Nov; 20(4): 277-86.
Li N, Yang C, Xie H, Liu Y, Liao Y. Effects of aerobic exercise on rats with hyperandrogenic polycystic ovarian syndrome. International Journal of Endocrinology. 2021 Aug; 2021(1): 5561980. doi: 10.1155/2021/5561980. DOI: https://doi.org/10.1155/2021/5561980
Gao Y, Zou Y, Wu G, Zheng L. Oxidative stress and mitochondrial dysfunction of granulosa cells in polycystic ovarian syndrome. Frontiers in Medicine. 2023 Jun; 10: 1193749. doi: 10.3389/fmed.2023.1193749. DOI: https://doi.org/10.3389/fmed.2023.1193749
Rudnicka E, Duszewska AM, Kucharski M, Tyczyński P, Smolarczyk R. Oxidative stress and reproductive function: oxidative stress in polycystic ovary syndrome. Reproduction. 2022 Dec; 164(6): F145-54. doi: 10.1530/REP-22-0152. DOI: https://doi.org/10.1530/REP-22-0152
Santos WL, da Silva Pinheiro C, de Oliveira Santos R, da Silva AC, Severo JS, Mendes PH et al. Physical exercise alleviates oxidative stress in brown adipose tissue and causes changes in body composition and nutritional behavior in rats with polycystic ovary syndrome. Life Sciences. 2023 Jul; 325: 121754. doi: 10.1016/j.lfs.2023.121754. DOI: https://doi.org/10.1016/j.lfs.2023.121754
Bhattacharya K, Dey R, Sen D, Paul N, Basak AK, Purkait MP et al. Polycystic ovary syndrome and its management: In view of oxidative stress. Biomolecular Concepts. 2024 Jan; 15(1): 20220038. doi: 10.1515/bmc-2022-0038. DOI: https://doi.org/10.1515/bmc-2022-0038
Naragatti S. The Role of Yoga in Balancing Hormones: A Comprehensive Research Review. Volume. 2025 Jan-Feb; 7 (1). DOI: https://doi.org/10.36948/ijfmr.2025.v07i01.36061
Lőrincz CE, Börzsei D, Hoffmann A, Varga C, Szabó R. Mechanisms and target parameters in relation to polycystic ovary syndrome and physical exercise: focus on the master triad of hormonal changes, oxidative stress, and inflammation. Biomedicines. 2024 Mar; 12(3): 560. doi: 10.3390/biomedicines12030560. DOI: https://doi.org/10.3390/biomedicines12030560
Patten RK, Boyle RA, Moholdt T, Kiel I, Hopkins WG, Harrison CL et al. Exercise interventions in polycystic ovary syndrome: a systematic review and meta-analysis. Frontiers in Physiology. 2020 Jul; 11: 606. doi: 10.3389/fphys.2020.00606. DOI: https://doi.org/10.3389/fphys.2020.00606
Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M et al. Nutrition strategy and life style in polycystic ovary syndrome-narrative review. Nutrients. 2021 Jul; 13(7): 2452. doi: 10.3390/nu13072452. DOI: https://doi.org/10.3390/nu13072452
Jones R, Green R, Cunning K, Williams R, Douglas C. Limited nutrition knowledge and altered dietary patterns among collegiate females with PCOS (P16-009-19). Current Developments in Nutrition. 2019 Jun; 3: nzz050-P16. doi: 10.1093/cdn/nzz050.P16-009-19. DOI: https://doi.org/10.1093/cdn/nzz050.P16-009-19
Barrea L, Frias-Toral E, Verde L, Ceriani F, Cucalón G, Garcia-Velasquez E et al. PCOS and nutritional approaches: Differences between lean and obese phenotype. Metabolism Open. 2021 Dec; 12: 100123. doi: 10.1016/j.metop.2021.100123. DOI: https://doi.org/10.1016/j.metop.2021.100123
Ghafari A, Maftoohi M, Samarin ME, Barani S, Banimohammad M, Samie R. The last update on polycystic ovary syndrome (PCOS), diagnosis criteria, and novel treatment. Endocrine and Metabolic Science. 2025 Mar: 100228. doi: 10.1016/j.endmts.2025.100228. DOI: https://doi.org/10.1016/j.endmts.2025.100228
Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F et al. Polycystic ovary syndrome: etiology, current management, and future therapeutics. Journal of Clinical Medicine. 2023 Feb; 12(4): 1454. doi: 10.3390/jcm12041454. DOI: https://doi.org/10.3390/jcm12041454
Shele G, Genkil J, Speelman D. A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. Journal of Functional Morphology and Kinesiology. 2020 May; 5(2): 35. doi: 10.3390/jfmk5020035. DOI: https://doi.org/10.3390/jfmk5020035
Dubey P, Reddy S, Boyd S, Bracamontes C, Sanchez S, Chattopadhyay M et al. Effect of nutritional supplementation on oxidative stress and hormonal and lipid profiles in PCOS-affected females. Nutrients. 2021 Aug; 13(9): 2938. doi: 10.3390/nu13092938. DOI: https://doi.org/10.3390/nu13092938
Shahid R, Mahnoor, Awan KA, Iqbal MJ, Munir H, Saeed I. Diet and lifestyle modifications for effective management of polycystic ovarian syndrome (PCOS). Journal of Food Biochemistry. 2022 Jul; 46(7): e14117. doi: 10.1111/jfbc.14117. DOI: https://doi.org/10.1111/jfbc.14117
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments