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Repeated passive heat exposure (termed heat therapy) is a novel lifestyle intervention for improving health in obese women with PCOS. The purpose of this study was to examine changes in metabolic function in obese women with PCOS following heat therapy. Eighteen age- and BMI-matched obese women with PCOS (age: 27\u2009\u00b1\u20091 yr, BMI: 41.3\u2009\u00b1\u20091.1 kg\/m<jats:sup>\u22122<\/jats:sup>) were assigned to heat therapy (HT) or time control (CON). HT participants underwent 30 one-hour hot tub sessions over 8\u201310 wk, while CON participants completed all testing but did not undergo heat therapy. Before (Pre), at the mid-point (Mid), and following (Post) 8\u201310 wk of heat therapy, metabolic health was assessed using a 2-h oral glucose tolerance test, a subcutaneous abdominal fat biopsy (Pre-Post only), and other blood markers relating to metabolic function. HT participants exhibited improved fasting glucose (Pre: 105\u2009\u00b1\u20093, Post: 89\u2009\u00b1\u20095mg\/dl; P = 0.001), glucose area under the curve (AUC) (Pre: 18,698\u2009\u00b1\u20091,045, Post: 16,987\u2009\u00b1\u20091,017 mg\u00b7dl<jats:sup>\u22121<\/jats:sup>\u00b7min<jats:sup>\u22121<\/jats:sup>; P = 0.028) and insulin AUC (Pre: 126,924\u2009\u00b1\u200911,730, Post: 91,233\u2009\u00b1\u200914,429 IU l<jats:sup>\u22121<\/jats:sup>\u00b7min<jats:sup>\u22121<\/jats:sup>; P = 0.012). Adipocyte insulin signaling (p-AKT at Ser-473 with 1.2 nM insulin) increased in HT (Pre: 0.29\u2009\u00b1\u20090.14, Post: 0.93\u2009\u00b1\u20090.29 AU; P = 0.021). Additionally, serum testosterone declined in HT participants (Pre: 51\u2009\u00b1\u20097, Post: 34\u2009\u00b1\u20094 ng\/dl; P = 0.033). No parameters changed over time in CON, and no change in BMI was observed in either group. HT substantially improved metabolic risk profile in obese women with PCOS. 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