Metabolic, androgenic, and physical activity profiles in women aged over 40 years with polycystic ovary syndrome: A comparative analysis using UK Biobank data

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women, linked to metabolic, hormonal, and psychological issues. Management typically involves lifestyle changes, including increased physical activity and reduced sedentary behaviour. Objectives: To compare the health profiles and behaviours of women with and without PCOS. Design: This study analysed data from the UK Biobank, which is a prospective cohort study. Methods: Women with PCOS in the UK Biobank were identified, while age- and body mass index (BMI)-matched controls were randomly selected. Data on factors associated with PCOS severity and self-reported lifestyle behaviours were analysed. Group differences were tested for significance, and participants were categorised by health behaviours to assess morbidity risk. Results: The study included 319 women with PCOS (mean age: 43.9 years) and 638 in each control group. Significant differences ( p < 0.05) were observed in anthropometric (e.g. body weight, BMI, waist and hip circumference, and body fat), cardio-metabolic (e.g. blood pressure, triglycerides, and glycated haemoglobin), and androgenic (e.g. sex hormone-binding globulin) indices. Differences were most pronounced between PCOS and age-matched controls but remained when BMI was also considered. Women with PCOS engaged in less vigorous physical activity and had higher screen time and sedentary behaviours. Those with the lowest physical activity and highest sedentary time had the worst health profiles and highest morbidity risk, regardless of group. Conclusion: Women with PCOS exhibit poorer health despite only slight lifestyle differences. Across all participants, lower physical activity and higher sedentary behaviour were linked to increased health risks. Further research is needed to clarify causal relationships between lifestyle factors and PCOS.