Abstract
Polycystic ovary syndrome (PCOS) is a common, lifelong endocrine condition with interlinking reproductive, metabolic and psychological features. International guidelines make lifestyle modification, including weight management, a core first-line strategy. Yet women must sustain these changes amidst insulin resistance, appetite dysregulation and psychological distress, while facing weight stigma and a healthcare system that offers only brief, episodic care. The distance between what guidelines ask of patients and what clinics can realistically provide is the "care gap" this review takes as its starting point. The review considers whether mobile health (mHealth) applications and peer-led online communities can act as complementary "digital scaffolds" that extend self-management support between clinic visits. Drawing on PCOS-specific studies and the wider digital-health literature, it argues that mHealth tools supply behavioural scaffolding through symptom tracking, goal setting, personalised feedback, nudges and gamified prompts, and that these features are associated with short- to medium-term improvements in weight-related and psychological outcomes. Peer communities offer psychological scaffolding through validation, shared experiential knowledge and reduced isolation. Neither alone is sufficient; the most promising model combines both. These benefits are constrained by a quality gap between commercial wellness apps and evidence-based tools, the risk of reinforcing weight stigma, misinformation in poorly moderated communities, and digital inequities that may exclude the women who would benefit most. The review concludes that future digital PCOS interventions should prioritise clinical co-design, equitable access, psychological safety, robust moderation and long-term evaluation.