Impact of Intermittent Fasting on Reproductive Markers in PCOS
DOI:
https://doi.org/10.51985/Keywords:
Hyperandrogenism; Insulin resistance; Intermittent fasting; Polycystic ovary syndrome; Time-restricted feedingAbstract
Objective: To evaluate the effect of a six-week time-restricted feeding (TRF) regimen on anthropometric, metabolic, and reproductive hormonal parameters in women with polycystic ovary syndrome (PCOS).
Study Design and Setting: Retrospective observational study conducted at Medical Teaching Institute Bacha Khan Medical College and Mardan Medical Complex, Mardan Pakistan.
Methodology: A total of 63 women diagnosed with PCOS according to Rotterdam criteria who completed a six-week TRF dietary regimen (8-hour feeding window from 1:00 p.m. to 9:00 p.m.) were included. Anthropometric measurements and laboratory parameters were recorded before and after the intervention. Variables assessed included body mass index (BMI), waist-to-hip ratio (WHR), insulin resistance using HOMA-IR, androgen profile (free androgen index, testosterone, SHBG), gonadotropins (LH and FSH), and ovarian reserve markers (estradiol and AMH). Paired t-tests were applied and p < 0.05 was considered statistically significant.
Results: Significant reductions were observed in BMI, WHR, HOMA-IR, fasting insulin, and free androgen index. Total and free testosterone levels decreased, while SHBG levels increased significantly. LH levels declined and FSH levels increased, improving the LH/FSH ratio. Estradiol levels increased whereas AMH levels showed a modest decline. Clinical improvement was observed in ovulatory function (60.4%), menstrual regularity (60.9%), and hyperandrogenism (63.6%). TRF showed high adherence (82.5%) with minimal side effects.
Conclusion: Time-restricted feeding appears to be a safe and effective lifestyle intervention for improving metabolic and reproductive hormonal parameters in women with PCOS. Further randomized controlled trials with longer follow-up are required.
References
1. Maqbool M, Dar MA, Gani I, Geer MI. Insulin Resistance
and Polycystic ovary Syndrome: A Review. J Drug Deliv
Ther. 2019 Feb 15;9(1-s):433–6. doi:10.22270/jddt.v9i1-
s.2275
2. Shang Y, Zhou H, Hu M, Feng H. Effect of Diet on Insulin
Resistance in Polycystic Ovary Syndrome. J Clin Endocrinol
Metab. 2020 Oct 1;105(10):3346–60. doi:10.1210/clinem/
dgaa425
3. Cooney LG, Dokras A. Cardiometabolic Risk in Polycystic
Ovary Syndrome. Endocrinol Metab Clin North Am. 2021
Mar;50(1):83–95. doi:10.1016/j.ecl.2020.11.001
4. Chiofalo B, Laganà AS, Palmara V, Granese R, Corrado G,
Mancini E, et al. Fasting as possible complementary approach
for polycystic ovary syndrome: Hope or hype? Med
Hypotheses. 2017 Aug;105:1–3. doi:10.1016/j.mehy.2017.
06.013
5. Barber TM, Franks S. Obesity and polycystic ovary syndrome.
Clin Endocrinol (Oxf). 2021 Oct;95(4):531–41. doi:10.
1111/cen.14421
6. Wong JMW, Gallagher M, Gooding H, Feldman HA, Gordon
CM, Ludwig DS, et al. A randomized pilot study of dietary
treatments for polycystic ovary syndrome in adolescents.
Pediatr Obes. 2016 Jun;11(3):210–20. doi:10.1111/ijpo.12047
7. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran
L, et al. Recommendations from the international evidencebased guideline for the assessment and management of
polycystic ovary syndrome. Fertil Steril. 2018 Aug;110(3):
364–79. doi:10.1016/j.fertnstert.2018.05.004
8. Azadi-Yazdi M, Karimi-Zarchi M, Salehi-Abargouei A,
Fallahzadeh H, Nadjarzadeh A. Effects of Dietary Approach
to Stop Hypertension diet on androgens, antioxidant status
and body composition in overweight and obese women with
polycystic ovary syndrome: a randomised controlled trial. J
Hum Nutr Diet. 2017 Jun;30(3):275–83. doi:10.1111/jhn.12433
9. Esfahanian F, Zamani MM, Heshmat R, Moini Nia F. Effect
of M etformin compared with hypocaloric diet on serum C
-reactive protein level and insulin resistance in obese and
overweight women with polycystic ovary syndrome. J Obstet
Gynaecol Res. 2013 Apr;39(4):806–13. doi:10.1111/j.1447-
0756.2012.02051.x
10. Yang J, Liang J, Xu J, Lin T, Ye Q, Lin Q, et al. The impact
of dietary interventions on polycystic ovary syndrome patients
with a BMI =25 kg/m2 : A systematic review and metaanalysis of randomized controlled trials. Reprod Med Biol.
2024 Jan;23(1):e12607. doi:10.1002/rmb2.12607
11. Mei S, Ding J, Wang K, Ni Z, Yu J. Mediterranean Diet
Combined With a Low-Carbohydrate Dietary Pattern in the
Treatment of Overweight Polycystic Ovary Syndrome Patients.
Front Nutr. 2022 Apr 4;9:876620. doi:10.3389/fnut.
2022.876620
12. Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects
of a ketogenic diet in overweight women with polycystic
ovary syndrome. J Transl Med. 2020 Dec;18(1):104. doi:10.
1186/s12967-020-02277-0
13. Cincione RI, Losavio F, Ciolli F, Valenzano A, Cibelli G,
Messina G, et al. Effects of Mixed of a Ketogenic Diet in
Overweight and Obese Women with Polycystic Ovary
Syndrome. Int J Environ Res Public Health. 2021 Nov
27;18(23):12490. doi:10.3390/ijerph182312490
14. Varady KA. Impact of intermittent fasting on glucose
homeostasis. Curr Opin Clin Nutr Metab Care. 2016
Jul;19(4):300–2. doi:10.1097/MCO.0000000000000291
15. Han Y, Lin B, Lu W, Wang X, Tang W, Tao X, et al. Timerestricted feeding improves metabolic and endocrine profiles
in mice with polycystic ovary syndrome. Front Endocrinol.
2022 Dec 16;13:1057376. doi:10.3389/fendo.2022.1057376
16. Li C, Xing C, Zhang J, Zhao H, Shi W, He B. Eight-hour
time-restricted feeding improves endocrine and metabolic
profiles in women with anovulatory polycystic ovary syndrome.
J Transl Med. 2021 Dec;19(1):148. doi:10.1186/s12967-021-
02817-2
17. Harvie MN, Pegington M, Mattson MP, Frystyk J, Dillon B,
Evans G, et al. The effects of intermittent or continuous energy
restriction on weight loss and metabolic disease risk markers:
a randomized trial in young overweight women. Int J Obes.
2011 May;35(5):714–27. doi:10.1038/ijo.2010.171
18. Diamanti-Kandarakis E, Dunaif A. Insulin Resistance and the
Polycystic Ovary Syndrome Revisited: An Update on
Mechanisms and Implications. Endocr Rev. 2012 Dec 1;33(6):
981–1030. doi:10.1210/er.2011-1034
19. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson
CM. Early Time-Restricted Feeding Improves Insulin
Sensitivity, Blood Pressure, and Oxidative Stress Even without
Weight Loss in Men with Prediabetes. Cell Metab. 2018
Jun;27(6):1212-1221.e3. doi:10.1016/j.cmet.2018.04.010
20. Biernacka-Bartnik A, Koce³ak P, Owczarek AJ, Chorêza PS,
Markuszewski L, Madej P, et al. The cut-off value for HOMAIR discriminating the insulin resistance based on the SHBG
level in women with polycystic ovary syndrome. Front Med.
2023 Mar 10;10:1100547. doi:10.3389/fmed.2023.1100547
21. Su P, Chen C, Sun Y. Physiopathology of polycystic ovary
syndrome in endocrinology, metabolism and inflammation.
J Ovarian Res. 2025 Feb 20;18(1):34. doi:10.1186/s13048-
025-01621-6
22. Joham AE, Norman RJ, Stener-Victorin E, Legro RS, Franks
S, Moran LJ, et al. Polycystic ovary syndrome. Lancet Diabetes
Endocrinol. 2022 Sep;10(9):668–80. doi:10.1016/S2213-
8587(22)00163-2
23. Chan K, Wong FS, Pearson JA. Circadian rhythms and
pancreas physiology: A review. Front Endocrinol. 2022 Aug
10;13:920261. doi:10.3389/fendo.2022.920261
24. Lowe DA, Wu N, Rohdin-Bibby L, Moore AH, Kelly N, Liu
YE, et al. Effects of Time-Restricted Eating on Weight Loss
and Other Metabo
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0
