The Influence of Polyendocrine Metabolic Ovarian Syndrome on Training Adaptations and Athletic Performance

Abstract

Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously known as
Polycystic Ovary Syndrome (PCOS), is one of the most common endocrine disorders affecting
women of reproductive age. While regular physical activity is widely recognized as a
cornerstone of PMOS management, increasing evidence suggests that the syndrome itself may
influence training adaptations and athletic performance. The characteristic hormonal profile of
PMOS, particularly hyperandrogenism, may confer physiological advantages relevant to
athletic performance. Increased androgen concentrations have been linked to greater muscle
mass, enhanced strength and power production, improved oxygen transport capacity, and
favorable adaptations to training, which may contribute to superior athletic performance in
some women with PMOS.
Aim: The aim of this narrative review was to summarise and critically discuss the current
evidence regarding the relationship between PMOS, training adaptations, and athletic
performance.
Material and methods: A narrative review summarising and discussing evidence from
observational studies (including case-control and cohort studies), systematic reviews, and
meta-analyses published between 2015 and 2026, was conducted. The critical analysis focused
on the physiological effects of hyperandrogenism in PMOS, training adaptations, athletic
performance, and healthrelated factors influencing exercise capacity in women with PMOS.
Conclusions: PMOS appears to have both beneficial and detrimental effects on exercise
performance. While hyperandrogenism may confer certain physiological advantages,
metabolic and psychological challenges associated with the syndrome may limit athletic
potential. Further longitudinal and mechanistic studies are required to better understand the
influence of PMOS on training responses and to develop individualized exercise
recommendations for affected athletes.