From PCOS to PMOS: The Impact of Physical Activity, Diet, and Metabolic Health on the Course of Polyendocrine Metabolic Ovarian Syndrome

Abstract

Introduction: Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously called polycystic ovary syndrome (PCOS), is now recognized as a complex endocrine–metabolic disorder rather than a solely ovarian condition. Lifestyle modification is central to management, with growing focus on physical activity, nutrition, and long-term metabolic health. Aim: To summarize current evidence on the effects of physical activity, dietary interventions, and metabolic health on PMOS, and to highlight the importance of individualized lifestyle management. Material and methods: A narrative review was conducted using PubMed and Google Scholar publications from 2018 to 2026. The review included international guidelines, systematic reviews, meta-analyses, randomized controlled trials, and high-quality observational studies on lifestyle interventions in women with PMOS/PCOS. Results: Evidence shows that regular physical activity and individualized dietary interventions improve insulin sensitivity, body composition, lipid profile, and cardiometabolic health. Aerobic exercise has the strongest support for metabolic improvement, while resistance training and high-intensity interval training (HIIT) may offer additional benefits for some patients. Mediterranean, low-glycaemic index, and anti-inflammatory diets are linked to better metabolic and hormonal control. Notably, metabolic improvements can occur without significant weight loss, highlighting the importance of lifestyle quality over body weight alone. Conclusions: Lifestyle modification is the foundation of PMOS management. Individualized physical activity, high-quality dietary counseling, and regular metabolic monitoring should be integrated into multidisciplinary, patient-centered care to improve clinical outcomes and quality of life for women with PMOS.