Based on PubMed | Does regular moderate-intensity exercise improve menstrual regularity and insulin sensitivity in women with polycystic ovary syndrome?

Regular moderate‑intensity exercise is associated with meaningful improvements in insulin sensitivity and can support restoration of ovulation and menstrual regularity in many women with polycystic ovary syndrome (PCOS), although the size of benefits and the degree of cycle normalization can vary by individual. ^[1] Regular physical activity also helps with weight management and hormonal balance, which are key drivers of PCOS symptoms. ^[2]

Why exercise helps in PCOS

• PCOS is closely linked with insulin resistance, which raises insulin and androgen (male‑type hormone) levels and disrupts ovulation. Improving how the body uses insulin can reduce these hormonal imbalances and make periods more regular. ^[3] Increasing daily activity and structured exercise can lower blood sugar and improve insulin sensitivity, which may treat or even prevent insulin resistance in PCOS. ^[3]
• Clinical guidance commonly recommends weight control through a low‑calorie diet plus moderate exercise; even a modest weight loss (about 5% of body weight) may improve symptoms and fertility potential. ^[2] Exercise contributes by burning calories and building muscle, which reduces insulin resistance and can lower cholesterol and testosterone levels. ^[4]

Evidence from clinical research

• A systematic review of five randomized controlled trials and three cohort studies found that interventions using moderate‑intensity aerobic and/or resistance exercise for 12–24 weeks consistently produced improvements in ovulation and menstrual outcomes, reduced insulin resistance by about 9–30%, and led to 4.5–10% weight loss. ^[1] These benefits were observed across different exercise types and schedules, suggesting the key factor is regular moderate‑intensity activity rather than any single program. ^[1]
• In a 20‑week randomized study of overweight/obese women with PCOS, all groups on a calorie‑restricted diet diet alone, diet plus aerobic exercise, and diet plus combined aerobic‑resistance exercise showed weight loss, better reproductive function, and improved cardiometabolic markers (blood pressure, lipids, glucose, insulin, and androgens). ^[5] Adding exercise improved body composition (more fat loss and better preservation of lean mass) but did not outperform the diet‑only group on hormonal and reproductive outcomes within the study window. ^[5] This suggests diet and weight loss are powerful drivers, while exercise adds important body‑composition and metabolic advantages that complement menstrual and insulin improvements. ^[5]

What counts as “moderate‑intensity” and how much to do

• Moderate intensity typically means activities that raise your heart rate and breathing but still allow conversation like brisk walking, cycling on level ground, water aerobics, or light jogging. Many clinical and public health recommendations aim for at least 150 minutes per week (for example, 30 minutes on five days), plus 2–3 days of resistance training. ^[3]
• Consistency appears more important than specific modes or session lengths; programs in the studies varied yet still produced better ovulation, insulin sensitivity, and weight outcomes when performed regularly. ^[1]

Practical takeaways

• Insulin sensitivity: Moderate‑intensity exercise can reduce insulin resistance by roughly 10–30% over 3–6 months in study settings, with greater improvements when paired with dietary changes and weight loss. ^[1] Improved insulin action helps lower circulating insulin and androgens, which supports ovarian function. ^[3]
• Menstrual regularity and ovulation: Many women regain ovulation and experience more regular cycles after sustained lifestyle changes that include exercise, especially when weight decreases. ^[1] Some may need additional dietary optimization or medications (such as metformin or hormonal therapies) to achieve consistent cycles, depending on baseline factors. ^[2]
• Broader health: Exercise also helps lower cholesterol and may reduce testosterone levels, contributing to improvements in acne, hirsutism, and long‑term cardiometabolic risk. ^[4] Because PCOS raises lifetime risks for type 2 diabetes and heart disease, staying active offers important preventive benefits beyond cycle control. ^[2]

Putting it into action

• Aim for: 150–300 minutes/week of moderate‑intensity aerobic activity (e.g., brisk walking, cycling, swimming) plus 2–3 days/week of resistance training that works major muscle groups. Start where you are and build up gradually to reduce injury risk and improve adherence. ^[3]
• Combine with nutrition: A calorie‑aware, nutrient‑dense eating plan that emphasizes vegetables, fruits, whole grains, legumes, lean proteins, and healthy fats can amplify exercise benefits and support weight loss if needed. ^[2]
• Track outcomes: Monitor cycle patterns, energy levels, and, if possible, simple metabolic markers (fasting glucose, insulin, lipids) with a clinician to gauge progress and adjust your plan. If cycles remain irregular after sustained lifestyle changes, discussing add‑on treatments may be helpful. ^[2]

Bottom line

• Moderate‑intensity exercise, performed regularly, is a core part of first‑line care for PCOS and is linked to better insulin sensitivity and more regular ovulation/menstrual cycles for many users. ^[1] While exercise alone can be beneficial, pairing it with tailored dietary strategies often yields the strongest improvements in both metabolic and reproductive outcomes. ^[5]