BACKGROUND: Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder in women of reproductive ages which will lead to infertility. This study is aimed to determine changes in levels of hyperandrogenism, hirsutism and menstrual regulation after a period of aquatic high intensity interval training (AHIIT) in women with PCOS. METHODS: Thirty patients with PCOS having age between 20 and 35 and body mass index (BMI) >= 30 kg/m2 in obstetrics and gynaecology clinics in Isfahan were selected based on Rotterdam Diagnostic Criteria. They were randomly divided into experimental (AHIIT plus metformin, N = 15) and control groups (metformin, N = 15). The exercises were done for 12 weeks, three sessions of 20 minutes. Metformin (1,500 mg) was taken daily for 3 consecutive days for 12 weeks. Kolmogorov-Smirnov test, t-test, Covariance and Wilcoxon were applied (p value < 0.05). RESULTS: After 12 weeks, no significant difference was observed in waist-to-hip ratio (WHR), but in AHIIT, the BMI and fat mass significantly decreased and levels of follicle-stimulating hormone (FSH), free testosterone (FT) and sex hormone binding globulin (SHBG) increased compared to control group (p < 0.05). While levels of improvement of total testosterone (TT), dehydroepiandrosterone sulphate (DHEAS), FT, luteinising hormone (LH) and free androgen index (FAI) were not significant between the two groups (p > 0.05). Furthermore, there was a significant decrease in homeostatic assessment of insulin resistance (HOMA-IR) and hirsutism severity in experimental group (p < 0.05). In both groups, the order of menstrual cycles improved significantly (p < 0.05). CONCLUSIONS: Doing AHIIT besides drug therapy can be effective for PCOS patients.

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