{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:07:50Z","timestamp":1788898070588,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Depressive symptoms are highly prevalent among women with polycystic ovary syndrome (PCOS), with previous studies suggesting a substantially elevated burden of depression and depressive symptoms in this population compared with women without PCOS, exacerbating the metabolic and reproductive burden of the disorder. Although exercise is recommended as a core component of PCOS management, its specific effects on depressive outcomes in this population remain unclear because evidence from randomised controlled trials has not been comprehensively and quantitatively synthesised.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the efficacy of exercise interventions in reducing depressive symptoms among women with PCOS and to explore whether intervention characteristics may moderate treatment effects.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic review and meta-analysis of randomised controlled trials was conducted. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random- or fixed-effects model as appropriate. Pre-specified subgroup analyses examined exercise type, intervention format, weekly frequency, and programme duration. But were considered exploratory because of the limited number of included studies, Sensitivity analyses and publication bias assessments were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Seven trials met the inclusion criteria. Exercise interventions significantly reduced depressive symptoms compared with controls (SMD\u202f=\u202f\u22120.75, 95% CI \u22120.96 to \u22120.55). In exploratory subgroup analyses, resistance exercise and interventions with higher weekly frequency or longer duration showed numerically larger effect estimates; however, between-subgroup differences were not statistically significant. Sensitivity analyses showed that the pooled effect estimate was not materially altered by sequential study removal, and no significant publication bias was detected.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Structured exercise may be a promising non-pharmacological strategy for reducing depressive symptoms in women with PCOS. However, the findings should be interpreted cautiously in light of the small number of trials and limited sample sizes. Further high-quality trials are required to determine optimal exercise prescriptions and long-term psychological benefits.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n The protocol was registered on\n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42022375480<\/jats:ext-link>\n (CRD420261285288).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1802184","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:37:17Z","timestamp":1776055037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Exercise-based interventions for depression in women with polycystic ovary syndrome: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yi","family":"Zheng","sequence":"first","affiliation":[{"name":"Capital University of Physical Education and Sports, Martial Arts and Performance Academy","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Physical Education Department, Xiamen University Tan Kah Kee College","place":["Zhangzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"ref1","article-title":"Depression","volume":"169","author":"Lucassen","year":"2025","journal-title":"Ned Tijdschr Geneeskd"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/s1098-3597(99)90021-2","article-title":"Clinical aspects of depression","volume":"1","author":"Kennedy","year":"1999","journal-title":"Clin Cornerstone"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"120387","DOI":"10.1016\/j.jad.2025.120387","article-title":"Tracking positive emotions in the course of adult depression: A systematic scoping review of longitudinal studies","volume":"393","author":"Dupuis-Lesavre","year":"2026","journal-title":"J Affect Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1300\/J005v35n02_01","article-title":"Introduction: women, depression, and the struggle for control over the evaluation of self-worth","volume":"35","author":"Horvath","year":"2008","journal-title":"J Prev Interv Community"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1017\/S2045796015000748","article-title":"The efficacy and acceptability of psychological interventions for depression: where we are now and where we are going","volume":"25","author":"Hollon","year":"2016","journal-title":"Epidemiol Psychiatr Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.cnur.2018.04.008","article-title":"Polycystic ovary syndrome","volume":"53","author":"Meier","year":"2018","journal-title":"Nurs Clin North Am"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.fertnstert.2016.05.003","article-title":"Criteria, prevalence, and phenotypes of polycystic ovary syndrome","volume":"106","author":"Lizneva","year":"2016","journal-title":"Fertil Steril"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.ecl.2013.10.003","article-title":"Polycystic ovary syndrome","volume":"43","author":"Nandi","year":"2014","journal-title":"Endocrinol Metab Clin N Am"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s11920-017-0834-2","article-title":"Depression and anxiety in polycystic ovary syndrome: etiology and treatment","volume":"19","author":"Cooney","year":"2017","journal-title":"Curr Psychiatry Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1399580","DOI":"10.3389\/fendo.2024.1399580","article-title":"Depression, anxiety and self-esteem in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis","volume":"15","author":"Li","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil Steril"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"028","DOI":"10.1055\/s-0038-1667312","article-title":"Large-scale evidence-based guideline development engaging the international PCOS community","volume":"36","author":"Misso","year":"2018","journal-title":"Semin Reprod Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e075847","DOI":"10.1136\/bmj-2023-075847","article-title":"Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials","volume":"384","author":"Noetel","year":"2024","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.neubiorev.2019.09.040","article-title":"Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity","volume":"107","author":"Kandola","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/cen.13795","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"89","author":"Teede","year":"2018","journal-title":"Clin Endocrinol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/978-981-15-1792-1_8","article-title":"Exercise and polycystic ovary syndrome","volume":"1228","author":"Woodward","year":"2020","journal-title":"Adv Exp Med Biol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13643-019-0962-3","article-title":"Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis","volume":"8","author":"Kite","year":"2019","journal-title":"Syst Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/j.jad.2019.11.025","article-title":"The effects of aerobic physical exercises on body image among women with polycystic ovary syndrome","volume":"262","author":"Kogure","year":"2020","journal-title":"J Affect Disord"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/1472-6882-13-131","article-title":"Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial","volume":"13","author":"Stener-Victorin","year":"2013","journal-title":"BMC Complement Altern Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1812","DOI":"10.1016\/j.fertnstert.2009.11.001","article-title":"Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome","volume":"94","author":"Thomson","year":"2010","journal-title":"Fertil Steril"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12905-016-0292-8","article-title":"Perceived exercise barriers are reduced and benefits are improved with lifestyle modification in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial","volume":"16","author":"Thomson","year":"2016","journal-title":"BMC Womens Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2626","DOI":"10.1016\/s0735-1097(25)03110-9","article-title":"Effect of high-intensity interval training and moderate-intensity continuous training on the cardiometabolic profile and psychological outcomes in patients with polycystic ovary syndrome: a systematic review and META analysis","volume":"85","author":"Kaushik","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e186861","DOI":"10.1001\/jamanetworkopen.2018.6861","article-title":"Efficacy of regular exercise during pregnancy on the prevention of postpartum depression: the PAMELA randomized clinical trial","volume":"2","author":"Coll","year":"2019","journal-title":"JAMA Netw Open"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/sms.12581","article-title":"Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases","volume":"25","author":"Pedersen","year":"2015","journal-title":"Scand J Med Sci Sports"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1093\/humupd\/dmae008","article-title":"Comparative efficacy of exercise, diet and\/or pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity: a systematic review and network meta-analysis","volume":"30","author":"Ruiz-Gonz\u00e1lez","year":"2024","journal-title":"Hum Reprod Update"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12902-022-01208-y","article-title":"Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity","volume":"23","author":"Cowan","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e70520","DOI":"10.1111\/cns.70520","article-title":"The relationship between different components and levels of physical exercise, depressive symptoms, inhibitory control, and possible cognitive neural mechanisms in college students","volume":"31","author":"Li","year":"2025","journal-title":"CNS Neurosci Ther"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.2174\/1871527313666141130203245","article-title":"Effects of physical exercise on depressive symptoms and biomarkers in depression","volume":"13","author":"Archer","year":"2014","journal-title":"CNS Neurol Disord Drug Targets"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jpsychires.2016.01.012","article-title":"Electroconvulsive therapy (ECT) and aerobic exercise training (AET) increased plasma BDNF and ameliorated depressive symptoms in patients suffering from major depressive disorder","volume":"76","author":"Salehi","year":"2016","journal-title":"J Psychiatr Res"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.2147\/NDT.S247599","article-title":"Protective effects of spirulina platensis, voluntary exercise and environmental interventions against adolescent stress-induced anxiety and depressive-like symptoms, oxidative stress and alterations of BDNF and 5HT-3 receptors of the prefrontal cortex in female rats","volume":"16","author":"Moradi-Kor","year":"2020","journal-title":"Neuropsychiatr Dis Treat"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1802184\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:37:30Z","timestamp":1776055050000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1802184\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2026.1802184"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1802184","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"1802184"}}