![]() Adopting a healthy lifestyle may result in weight loss or reduction in male hormone levels in some individuals. There were no studies that investigated the effect of a healthy lifestyle on live birth, miscarriage or regularity of menstrual cycles. The risk of bias in the studies varied and was generally unclear. One study compared behavioural intervention to minimal intervention. Five studies compared combined dietary, exercise and behavioural intervention to minimal intervention. Ten studies compared physical activity to minimal dietary and behavioural intervention or no intervention. We found 15 studies that included 498 participants. A healthy lifestyle consists of a healthy diet, regular exercise and achieving and maintaining a healthy weight. PCOS affects quality of life and can worsen anxiety and depression either due to its symptoms or due to the diagnosis of a chronic disease. PCOS is also associated with metabolic features, with risk factors for diabetes and cardiovascular disease including high levels of insulin or insulin resistance and abnormal cholesterol levels. These clinical features include reproductive issues such as reduced frequency of ovulation and irregular menstrual cycles, reduced fertility, polycystic ovaries on ultrasound and high levels of male hormones such as testosterone, which can cause unwanted facial or body hair growth and acne. ![]() Being overweight worsens all clinical features of PCOS. Polycystic ovary syndrome (PCOS) is a very common condition affecting 8% to 13% of women. We reviewed the evidence on the effects of lifestyle interventions on reproductive, anthropometric (body measurement), metabolic and quality of life outcomes in women with polycystic ovary syndrome. The effect of a healthy lifestyle for women with polycystic ovary syndrome We are uncertain of the effect of lifestyle intervention on glucose tolerance (glucose outcomes in oral glucose tolerance test) (mmol/L/minute) (SMD ‐0.02, 95% CI ‐0.38 to 0.33, 3 RCTs, N = 121, I 2 = 0%, low‐quality evidence). Lifestyle intervention may reduce body mass index (BMI) (kg/m 2) (‐0.34 kg/m 2, 95% CI ‐0.68 to ‐0.01, 12 RCTs, N = 434, I 2= 0%, low‐quality evidence). Lifestyle intervention may reduce weight (kg) (MD ‐1.68 kg, 95% CI ‐2.66 to ‐0.70, 9 RCTs, N = 353, I 2 = 47%, low‐quality evidence). Lifestyle intervention may improve a secondary (endocrine) reproductive outcome, the free androgen index (FAI) (MD ‐1.11, 95% confidence interval (CI) ‐1.96 to ‐0.26, 6 RCTs, N = 204, I 2 = 71%, low‐quality evidence). No studies reported the secondary reproductive outcome of menstrual regularity, as defined in this review. Risk of bias varied: eight studies had adequate sequence generation, seven had adequate clinician or outcome assessor blinding, seven had adequate allocation concealment, six had complete outcome data and six were free of selective reporting. No studies assessed the fertility primary outcomes of live birth or miscarriage. ![]() We included 15 studies with 498 participants.
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