Effect of Electrical Muscle Stimulation on Psychosocial Well-being and Quality of Life in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial

Abstract

Background: Polycystic ovary syndrome (PCOS) carries a well-documented psychosocial toll that includes heightened rates of depression, anxiety, poor body image, and diminished quality of life (QoL). While lifestyle interventions are first-line recommendations, exercise adherence in this population remains critically low owing to fatigue, pain, and motivational barriers. Electrical muscle stimulation (EMS) offers an exercise-mimetic alternative, yet its influence on the psychosocial dimensions of PCOS has not previously been examined in a controlled trial.
Objective: To evaluate whether a 12-week supervised whole-body EMS programme improves health-related QoL (HRQoL), assessed by both generic (SF-36) and disease-specific (PCOSQ) instruments, relative to standard medical care alone.
Methods: Forty-two overweight/obese women (BMI > 24 kg/m²) aged 18–35 years with Rotterdam-confirmed PCOS were randomly allocated (1:1) to EMS (n = 21; 36 sessions, 3×/week, 12 weeks) or a control arm receiving standard care plus patient education (n = 21). The SF-36 and PCOSQ were administered at baseline, post-intervention, and 3-month follow-up. Between-group differences were analysed using the Mann–Whitney U test for change scores, analysis of covariance (ANCOVA) adjusted for baseline values, and linear mixed models. Effect sizes were reported as Cohen’s d.
Results: All 42 participants completed the trial. The EMS group demonstrated statistically significant and clinically meaningful improvements across every SF-36 domain and both summary components (all p < 0.001). PCS increased from 40.30 ± 3.26 to 51.39 ± 3.13 at follow-up; MCS rose from 36.55 ± 4.96 to 51.12 ± 4.81. PCOSQ Total scores climbed from 3.34 ± 0.37 to 5.39 ± 0.51 at follow-up (p < 0.001). Between-group Cohen’s d values ranged from 1.41 to 5.75, all exceeding the large-effect threshold. Gains persisted or continued at the 3-month follow-up. The control group remained essentially unchanged on all measures.
Conclusion: Structured EMS training yields substantial, durable enhancements in both generic and PCOS-specific QoL among overweight and obese women with PCOS. These findings position EMS as a viable adjunctive intervention capable of addressing the psychosocial burden of the syndrome within a biopsychosocial management framework.