# Evaluation of Changes in Levels of Hyperandrogenism, Hirsutism and Menstrual Regulation After a Period of Aquatic High Intensity Interval Training in Women with Polycystic Ovary Syndrome

PMID: 31807257
Journal: International Journal of Preventive Medicine
Published: 2019-10-17
Authors: Samadi Z, Bambaeichi E, Valiani M, Shahshahan Z

## Question

Does aquatic HIIT plus metformin improve hyperandrogenism, hirsutism, menstrual regulation, insulin resistance, and body composition more than metformin alone in obese women with PCOS?

## Summary

In obese women with PCOS taking metformin, adding 12 weeks of aquatic HIIT improved BMI, fat mass, insulin resistance, some androgen-related markers, hirsutism, menstrual cycle timing, and VO2peak more than metformin alone. The study was small and did not report adverse-event details.

## Population

- Obese women with PCOS and insulin resistance
- Sample size: 30
- Age: 20 to 35 years
- Sex: Female
- Fitness level: Physically inactive for previous 3 months
- Health status: PCOS, BMI at least 30 kg/m2, insulin resistance

## Methodology

- Randomized clinical trial
- 12 weeks
- Aquatic exercise intervention for clinic-recruited women in Isfahan
- Randomized and controlled study design.

## Protocol

- AHIIT plus metformin.
- Modality: Aquatic HIIT.
- Work intervals: 20 s.
- Recovery: 10 s rest; 1 min between 4-min bouts.
- Sets or repetitions: 4 bouts of 8 intervals.
- Intensity: 80% to 95% HRmax.
- Session duration: 30 min including warm-up and cool-down.
- Frequency: 3 sessions/week.
- Program length: 12 weeks.
- Progression: Not reported.
- Metformin only.
- Modality: No regular exercise.
- Program length: 12 weeks.

## Outcomes

### HOMA-IR
Status: improved
AHIIT plus metformin reduced insulin resistance more than metformin alone.

Experimental 3.14 +/- 1.42 to 2.69 +/- 0.78; between-group p=0.010.

### Hirsutism
Status: improved
Hirsutism severity decreased substantially in the experimental group.

Ferriman-Gallwey 14.06 +/- 5.18 to 7.53 +/- 2.03; between-group p=0.000.

### Androgens
Status: mixed
FT, FSH, and SHBG improved versus control, but TT, DHEAS, FAI, and LH were not significantly different between groups.

Between-group p<0.05 for FT, FSH, SHBG; p>0.05 for TT, DHEAS, FAI, LH.

### Menstrual cycle
Status: improved
Menstrual cycle timing improved in both groups.

Experimental cycle days 69.33 +/- 20.24 to 47.80 +/- 13.38; control 66.73 +/- 19.72 to 56.93 +/- 17.54; within-group p=0.001.

## Practical Insights

- 20:10 aquatic intervals may be feasible as an adjunct in a clinical PCOS program.
- Claims should be limited to women with PCOS using metformin and pool-based training.
- Diet, motivation, and mental health were not controlled enough for strong behavioral translation.

## Limitations

- Small sample
- Clinical PCOS-only population
- Metformin co-intervention
- No daily energy intake assessment
- No psychological/motivation assessment
- No adverse-event detail

## Safety And Adherence

- No adverse-event reporting was found in the extracted NXML.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/31807257/) (pubmed)
- [DOI](https://doi.org/10.4103/ijpvm.IJPVM_360_18) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852193/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.