Exercise to Combat the Effect of Insulin Resistance in PCOS: A Narrative Review

PCOS is a complex multigenic condition influenced by significant epigenetic and environmental variables, including nutrition and lifestyle. Insulin resistance IR is found in roughly 80% of obese women with PCOS and 30-40% of lean women. IR is an impairment of insulin to mediate metabolism in skeletal muscle, adipocytes and liver. Following weight gain, the severity of IR in women with PCOS increases. IR affects many PCOS women who are not overweight, and minor weight loss improves clinical results in those with near-normal body weight. The effect of exercise on Insulin sensitivity IS is optimized through glucose transport and metabolism. Exercise is the first-line treatment for PCOS. Moderate intensity (60-70% VO2max; comparable to 75-80% HRmax) and high-intensity aerobic exercise (heart rate >80%) improves IR in women with PCOS. These exercises are performed for at least 30 minutes per session and 3-5 days per week. A single bout of exercise (2-72 hours postexercise) can improve IS immediately. Exercise improves IS and glycemic management as well as helps in lowering the abdominal fat. Therefore, exercise performed on a regular basis can help improve insulin resistance in women with PCOS.