Lifestyle Interventions And Menstrual Regularity In Women With PCOS: A Systematic Review

Abstract

Background: PCOS is a common endocrine disorder in women of reproductive age, commonly linked to menstrual abnormalities, anovulation, hyperandrogenism, and metabolism. As a first-line approach, lifestyle interventions, such as dietary change, systematic physical exercise, and behavioral guidance are becoming more commonly advised to enhance reproductive and metabolic outcomes.

Aim: The purpose of the systematic review was to determine the effect of lifestyle interventions on menstrual regularity in women with PCOS, with results including ovulary functionality, menstrual rhythm renewal, androgenicity, insulin resistance, and weight control.

Methods: Cohort studies, quasi-experimental studies, and randomized controlled trials published in 2019-2025 were identified in PubMed, Scopus, Web of Science, and Google Scholar. The participants of the study were women with PCOS who received structured lifestyle interventions and mentioned one or more outcomes associated with menstrual and metabolic health. The synthesis of data involved alterations in the menstrual cycle regularity, hormonal, anthropometric and adherence to interventions.

Findings: 9 studies with 646 participants were included. The results consistently showed that menstrual cycle regularity, ovulatory, reduced body mass index, and lowered hyperandrogenism had been improved after lifestyle interventions. Interventions that combined dietary counseling, moderate aerobic activity and behavior change reported the strongest effects. Increased compliance with the intervention procedures was associated with increased improvements.

Conclusion: Lifestyle interventions are effective primary measures that enhance regular menstrual cycles and metabolic health in PCOS women. Future studies need to be personalized on optimization of individualized programs, durability of adherence, and reproductive outcomes of various populations.