Effect of Lifestyle Modifications on Polycystic Ovary Syndrome in Predominantly Young Adults: A Systematic Review.

Objective: To improve counseling and outcomes for the adolescent population (ages 10-24-years-old), with polycystic ovary syndrome we conducted a systematic review of randomized controlled trials with the primary objective to generate evidence-based recommendations for which lifestyle interventions with or without medications lead to the best outcomes.

Methods: A literature search was conducted. Randomized controlled trials on lifestyle interventions with or without medications in the adolescent population were included. Nonrandomized trials, case-control studies, observational studies, and animal studies were excluded. Of 3,699 articles, 13 studies including 789 participants were included. Each included study was assessed for bias using the Cochrane Risk of Bias 2 tool. Due to significant interstudy heterogeneity, meta-analysis was infeasible; we synthesized results across lifestyle intervention/control types and outcome.

Results: Thirteen studies met inclusion criteria. These studies offer mixed support for lifestyle interventions improving hyperandrogenism. There is some evidence that lifestyle interventions improve menstrual regularity, cardiometabolic health, and metabolic function. Almost all studies found reduced body mass index, adiposity among participants who completed combined exercise and diet, exercise only, and diet only interventions.

Conclusions: The studies in this systematic review demonstrated that lifestyle interventions incorporating increased physical activity and/or healthy dietary choices show beneficial effects in the adolescent population aged ≥ 18-years-old with polycystic ovary syndrome. Medications may also play a key role in treating the disorder. More quality research is needed to identify specific lifestyle interventions that optimize the management of polycystic ovary syndrome amongst those aged 10-17-years-old as well.