Introduction: Given the absence of a focused systematic review on the effects of low glycemic index diets on androgen status and the indication of this issue in several randomized clinical trials, the present study was conducted to investigate the effect of low glycemic index )GI( dietary regimens on androgen status in women with polycystic ovary syndrome (PCOS).

Methods: This study is a systematic review and meta-analysis conducted according to Cochrane guidelines and the PRISMA checklist. A literature search was conducted up to May 20, 2025, in international and Persian databases. The quality of studies was assessed using the Cochrane tool. Data analysis was performed using STATA and SPSS software applying random-effects models and heterogeneity tests (I², Q). Subgroup analysis, sensitivity, and publication bias were evaluated using Begg’s and Egger’s tests.

Results: Nine randomized clinical trial articles involving 482 participants were included; meta-analysis results showed that low glycemic index )GI( diets compared to high GI diets significantly reduced the insulin resistance index (Weighted Mean Difference [WMD]: -1.14; 95% CI: -0.75 to -1.29; P < 0.001), and total testosterone concentration (WMD: -0.25; 95% CI: -0.11 to -0.35; P < 0.001), whereas they did not produce a significant reduction in the free androgen index (WMD: -0.59; 95% CI: 0.36 to -1.59; P = 0.233).

Conclusion: Low glycemic index diets, especially with calorie restriction, can help improve metabolic and hormonal indices related to polycystic ovary syndrome.

Keywords: Low glycemic index, calorie restriction, polycystic ovary syndrome, androgen status