Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome.

PURPOSE: To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). METHODS: Twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. RESULTS: The exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from "good" to "fairly good" (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions. CONCLUSIONS: Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.

Affect-regulated exercise: an alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome.

OBJECTIVE: Affect-regulated exercise ("ARE") is an alternative approach to guide exercise intensity based on feeling of pleasure. The aim of this study was to analyze if overweight/obese women with polycystic ovary syndrome (PCOS) meet the American College of Sports Medicine (ACSM) recommendation regarding to exercise intensity to improve health status during a single bout of "ARE". METHODS: A sample of 14 overweight/obese women with PCOS (18-34 years) performed a single bout of "ARE" (40 min of aerobic exercise on outdoor track). The Feeling Scale (FS) was used to guide "ARE" intensity/pace maintaining an affective valence between "good" and "very good" during all time. Heart rate (HR), speed, % of HR at first and second ventilatory threshold (VT1 and VT2) and time spent at moderate (64-76% of HR(max)) and vigorous (77-95% of HR(max)) intensity during "ARE" were measured with a global positioning system (GPS) device. RESULTS: Volunteers exercised at 73% (68-78%) of HR(max), 5.8 (5.2-6.2) km/h, 93.4% of HR at VT1 (89.3-98.2) and 80.5% of HR at VT2 (75.3-84.6) and spent >80% of time at moderate intensity. CONCLUSIONS: Overweight/obese women with PCOS met the ACSM recommendation regarding exercise intensity to improve health status when exercised between "good" and "very good" of FS. Thus, "ARE" may be an interesting approach to be used in clinical practice regarding to exercise prescription and/or physical activity advice.

[Heart rate variability as a method of assessing the autonomic nervous system in polycystic ovary syndrome]. / Variabilidade da frequência cardíaca como método de avaliação do sistema nervoso autônomo na síndrome dos ovários policísticos.

Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with several cardiometabolic risk factors, such as central obesity, insulin resistance, type 2 diabetes, metabolic syndrome, and hypertension. These factors are associated with adrenergic overactivity, which is an important prognostic factor for the development of cardiovascular disorders. Given the common cardiometabolic disturbances occurring in PCOS women, over the last years studies have investigated the cardiac autonomic control of these patients, mainly based on heart rate variability (HRV). Thus, in this review, we will discuss the recent findings of the studies that investigated the HRV of women with PCOS, as well as noninvasive methods of analysis of autonomic control starting from basic indexes related to this methodology.

[Quality of clinical studies published in the RBGO over one decade (1999-2009): methodological and ethical aspects and statistical procedures]. / Qualidade dos estudos clínicos publicados na RBGO ao longo de uma década (1999-2009): aspectos metodológicos, éticos e procedimentos estatísticos.

PURPOSE: To evaluate the methodological and statistical design evolution of the publications in the Brazilian Journal of Gynecology and Obstetrics (RBGO) from resolution 196/96. METHODS: A review of 133 articles published in 1999 (65) and 2009 (68) was performed by two independent reviewers with training in clinical epidemiology and methodology of scientific research. We included all original clinical articles, case and series reports and excluded editorials, letters to the editor, systematic reviews, experimental studies, opinion articles, besides abstracts of theses and dissertations. Characteristics related to the methodological quality of the studies were analyzed in each article using a checklist that evaluated two criteria: methodological aspects and statistical procedures. We used descriptive statistics and the χ2 test for comparison of the two years. RESULTS: There was a difference between 1999 and 2009 regarding the study and statistical design, with more accuracy in the procedures and the use of more robust tests between 1999 and 2009. CONCLUSIONS: In RBGO, we observed an evolution in the methods of published articles and a more in-depth use of the statistical analyses, with more sophisticated tests such as regression and multilevel analyses, which are essential techniques for the knowledge and planning of health interventions, leading to fewer interpretation errors.

[Quality of life and psychosocial aspects of polycystic ovary syndrome: a quali-quantitative approach]. / Qualidade de vida e aspectos psicossociais da síndrome dos ovários policísticos: um estudo quali-quantitativo.

PURPOSE: To evaluate the quality of life of women with polycystic ovary syndrome (POS) and to learn about the experience of these women regarding the symptoms of their disease. METHODS: The study complementarily employed two methodological approaches - quantitative and qualitative ones. The quality of life of 213 women was evaluated (quantitative approach) using the SF-36 questionnaire. Of these, 109 had POS (Case Group: 26.8 ± 5.4 years of age) and 104 were healthy ( CONTROL GROUP: 23.9 ± 6.7 years of age). Data were analyzed statistically by the Student t-test, the chi-square test and the Pearson correlation test, with the level of significance set at 5%. Fifteen women with POS participated in the quantitative study and were interviewed using a semi-structured questionnaire. The qualitative data were analyzed by the technique of categorical thematic analysis. RESULTS: The women with POS showed impaired quality of life compared to Control (functional capacity: 76.5 ± 20.5 and 84.6 ± 15.9, respectively; physical aspects 56.4 ± 43.3 and 72.6 ± 33.3; general health status: 55.2 ± 21.0 and 62.5 ± 17.2; vitality: 49.6 ± 21.3 and 55.3 ± 21.3; social aspects: 55.3 ± 32.4 and 66.2 ± 26.7; emotional aspects: 34.2 ± 39.7 and 52.9 ± 38.2; mental health: 50.6 ± 22.8 and 59.2 ± 20.2). Regarding the qualitative data, thematic categorical analysis revealed that feelings of "abnormality", sadness, fear and anxiety were associated with the main symptoms of POS, i.e., hirsutism, menstrual irregularity, infertility and obesity. These symptoms affected the social, professional and marital life of these women. CONCLUSION: POS compromises the quality of life of affected women, causing them to feel that they are different from other women. Thus, women with POS do not simply require medical treatment regarding the reproductive, aesthetic and metabolic effects of the disease, but also need multiprofessional care.

Analysis of heart rate variability in polycystic ovary syndrome.

OBJECTIVE: To compare the modulation of heart rate in a group of volunteers with polycystic ovary syndrome (PCOS) to that of a group of healthy ovulatory women on the basis of R-R interval variability and analyze the relationships between heart rate variability (HRV) and other cardiovascular risk factors. METHODS: In a cross-sectional study, HRV and anthropometric, biochemical and hormonal parameters were measured in 23 women with PCOS and 23 age-matched controls. Mean outcomes measures: HRV indexes in the time (SDNN and rMSSD) and frequency domain (low frequency-LF and high frequency-HF). Differences between groups and correlation analysis were performed. RESULTS: Intergroup analysis showed significant differences (p < 0.05) between groups, with lower SDNN, rMSSD, LF and HF indexes in PCOS women when compared to the control group. There was significant negative correlation between BMI and SDNN, LF and HF, indicating a decrease in the autonomic modulation of heart rate with increasing weight. A negative correlation was also found between the high-sensitivity C-reactive protein level and the rMSSD index. CONCLUSION: Our results show that PCOS is associated with alterations in the autonomic modulation of heart rate, possibly due to the influence of weight gain.

[Lifestyle modifications in the polycystic ovary syndrome: role of physical exercise and importance of multidisciplinary approach]. / Modificações do estilo de vida na síndrome dos ovários policísticos: papel do exercício físico e importância da abordagem multidisciplinar.

The polycystic ovaries syndrome (POS) is a heterogeneous endocrinal disorder prevalent in 5 to 10% of women in reproductive age. In POS, there is an association with risk factors linked to the development of cardiovascular disease such as insulin resistance, dislipidemia, diabetes mellitus, arterial hypertension, endothelial dysfunction, central obesity, metabolic syndrome and chronic pro-inflammatory markers. Physical exercise practice together with nutritional guidance have been recommended as first rate strategies in the treatment of oligomenorrhea, hirsutism, infertility and obesity in POS women. This way, the objective of the present review was to analyze the specific role played by exercise and/or physical activity in changes of the body shape, in biochemical and hormonal plasmatic levels, and in the POS women's reproductive function.