ArticleBMJ open sport & exercise medicine2026
Evaluating the efficacy of aerobic exercise as therapy for depression and anxiety in women with PCOS: a systematic review.
Article in BMJ open sport & exercise medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Objective: This systematic review aims to evaluate the effectiveness of exercise interventions in alleviating depression and anxiety symptoms in women with polycystic ovary syndrome (PCOS). Data sources: PubMed, CINAHL, Cochrane Library, SportDiscus, EMBASE and Web of Science databases were searched from their inception to July 2025. Eligibility criteria for selecting studies: Randomised controlled trials were eligible if they examined the effects of exercise lasting ≥4 weeks on validated measures of depression and/or anxiety in women aged 18-45 with PCOS diagnosed using the Rotterdam criteria. Publications not written in English were excluded. Data extraction and synthesis: Two reviewers independently extracted data and assessed study quality using the Cochrane Risk of Bias tool. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science guidelines. A narrative/qualitative synthesis was used to provide an overview of the current literature on the topic. Given the limited number of eligible trials, outcomes and measurement tools, a meta-analysis was not undertaken. Results: From 363 full-text records, three trials (n=221) met the inclusion criteria. Interventions lasted 12-16 weeks, and aerobic exercise (continuous, intermittent or high-intensity interval training) was prescribed at least three times per week. Across all studies, depression symptoms improved by 4.8%-32.4%, with one study indicating a minimal clinically important difference, while anxiety symptoms decreased by 3.6%-42.2%, measured using validated scales, including Hospital Anxiety and Depression Measurement Scale, Depression, Anxiety, and Stress Scale-21, Montgomery Åsberg Depression Rating Scale and Brief Scale for Anxiety. Conclusion: Findings should be interpreted cautiously due to limited report numbers, methodological concerns and heterogeneity in interventions and outcome measures. While this review aimed to assess all exercise modalities, only aerobic exercise interventions were identified. These interventions appear effective in reducing depression and anxiety symptoms in women with PCOS. Future research should include psychological outcomes and explore resistance or combined diet-exercise interventions. PROSPERO registration number: CRD42023408190.
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