ELECTRICAL MUSCLE STIMULATION AS A NON-PHARMACOLOGICAL STRATEGY FOR METABOLIC AND SOMATIC HEALTH IMPROVEMENT IN POLYCYSTIC OVARY SYNDROME: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic condition characterised by insulin resistance, dyslipidaemia, central adiposity, and hyperandrogenism. Although structured physical activity is the cornerstone of first-line management, adherence among affected women remains critically low. Electrical muscle stimulation (EMS) may replicate key metabolic effects of voluntary exercise while circumventing common adherence barriers, yet no randomised trial has assessed its impact on the full metabolic and somatic profile of PCOS. Objective: To determine whether a 12-week supervised whole-body EMS programme improves insulin resistance, glycaemic control, lipid profile, blood pressure, androgenic markers, and body composition in overweight/obese women with PCOS compared with standard medical care. Methods: Forty-two women (aged 18–35; BMI > 24 kg/m²) with Rotterdam-confirmed PCOS were randomly allocated (1:1) to EMS (n = 21; Russian current, 2500 Hz, 30-minute sessions, 3×/week, 12 weeks) or standard care control (n = 21). The primary outcome was HOMA-IR; secondary outcomes included fasting glucose, oral glucose tolerance test (OGTT), post-prandial glucose, lipid panel, blood pressure, serum testosterone, body weight, BMI, waist-hip ratio (WHR), and body fat percentage. Assessments occurred at baseline, post intervention, and 3-month follow-up. Between-group differences were evaluated by the Mann–Whitney U test, ANCOVA adjusted for baseline, and linear mixed models, with Bonferroni and Benjamini–Hochberg multiplicity correction. Results: All 42 participants completed the trial. The EMS group showed significant improvements across every outcome (all p < 0.001): HOMA-IR fell from 3.15 ± 0.81 to 2.20 ± 0.56 at follow-up (between-group d = −4.10); fasting glucose declined by 16.74 mg/dl; total cholesterol by 25.26 mg/dl; triglycerides by 31.40 mg/dl; LDL by 23.42 mg/dl; HDL rose by 8.38 mg/dl; body weight decreased by 6.40 kg; BMI by 2.67 kg/m²; WHR from 0.88 to 0.82; body fat from 34.86% to 30.90%; systolic/diastolic blood pressure by 12.47/7.33 mmHg; and testosterone from 0.66 to 0.45 ng/ml. All outcomes survived multiplicity correction, and benefits were sustained or continued at the 3-month follow-up. Conclusion: A 12-week EMS programme produced clinically meaningful, statistically robust, and durable improvements across the full spectrum of metabolic and somatic outcomes in overweight/obese women with PCOS. EMS warrants consideration as a feasible, non-pharmacological adjunct within comprehensive PCOS management. Psychosocial and quality-of-life findings from this cohort are reported in a companion paper.