Mechanisms and Target Parameters in Relation to Polycystic Ovary Syndrome and Physical
Exercise: Focus on the Master Triad of Hormonal Changes, Oxidative Stress, and Inflammation
Polycystic ovary syndrome (PCOS) is a common endocrine disorder among females of reproductive
age with heterogeneous prevalence. It is well known that female reproductive competence
depends on the dynamic regulation of the hypothalamic–pituitary–gonadal (HPG) axis;
therefore, disruption of this highly regulated system leads to fertility problems.
Among disruptors, both oxidative stress and inflammation contribute to an increased
LH-FSH ratio and a consequent hyperandrogenism. Shifts in this bidirectional interplay
between the neuroendocrine system and oxidative/inflammatory homeostasis result in
the accumulation of reactive oxygen/nitrogen species and inflammatory markers as well
as alterations in antioxidant defense mechanisms. Evidence shows that lifestyle changes,
including regular physical exercise, are recognized as the most effective first-line
management to reduce the severity of PCOS symptoms. The aim of our narrative review
is to provide insights into the mechanisms and target factors of PCOS-related hormonal
changes, oxidative/antioxidant homeostasis, and inflammation, and to discuss the effects
of exercise, which takes into account various factors, in relation to PCOS. A better
understanding of the PCOS-associated hormonal changes, oxidative and inflammatory
circuits, as well as exercise-induced mechanisms of action on those targets may improve
the quality of life of women with PCOS.