Exercise for PCOS: What’s the Science?

Polycystic Ovary Syndrome (PCOS) is a common and devastating health issue. It affects 8–13% of all women of childbearing age, impacting not only their reproductive health, but also their metabolism and their mental wellbeing. PCOS is diagnosed if at least two of the following symptoms are present while other causes can be ruled out: irregular or missing ovulations, high levels of male hormones (so-called hyperandrogenism), and of course polycystic ovaries, visible via ultrasound. But it doesn’t stop there - PCOS also puts women at risk of having a higher insulin resistance, making it more likely they develop diabetes and thyroid issues and giving them a harder time maintaining their body weight. So, what can be done to treat it?

PCOS and Exercise

We all know that exercise is a great way to prevent disease. But did you know it’s particularly beneficial for women suffering from PCOS? A comprehensive review of recent research highlights the importance of exercise for improvements in hormone balance, overall health, and quality of life [1]. Guidelines have even been updated to suggest exercise, along with a healthy diet, as a primary treatment of PCOS! But what’s the best type of exercise for PCOS? How intense should it be? And for how long should you work out? Let’s have a look.

The Winning Formula

Here's the information you've been waiting for: vigorous intensity exercise, like for example a HIIT workout, resulted in the biggest improvement in the health parameters associated with PCOS! The more an activity gets your heart pumping and sweat dripping, the more impact it will have on your symptoms [2]. Here’s what counts most:

Cardiorespiratory Fitness: The more your VO2peak (your body’s ability to take in and use oxygen) goes up, the more your all-cause mortality risk goes down. It’s a clear marker of fitness that can be significantly improved through vigorous exercise [3].

Insulin Sensitivity: Regular activity can improve your insulin sensitivity, which will, in turn, lower your risk of developing diabetes - a common issue with PCOS [4].

Waist Circumference: Even without weight loss, vigorous exercise can help you to achieve what is called body recomposition - a shift from fat mass to lean mass. This can be measured as a decrease in abdominal fat, which in turn improves the severity of PCOS symptoms [5].

How Much Exercise Do You Need?

Consistency is key! The biggest improvements were seen with a minimum of 20 hours of exercise over the course of 10-12 weeks; That makes 120 minutes - or two hours - per week [1]. If that seems like too much for you right now, don’t worry! Even moving less than this is better than not moving at all. Slowly build your way up, incorporating short exercise sessions in your day, making it a sustainable and enjoyable routine that works for you. 

The Role of Resistance Training for PCOS

While it seems like aerobic and high intensity exercise is stealing the spotlight, resistance training has a special status. Lifting weights leads to the biggest positive changes in hyperandrogenism (the high levels of male hormones associated with PCOS), according to scientific data [6]. It will also greatly improve your lean muscle mass, which in turn elevates your metabolic health.

The Importance of Diet for PCOS

We all know that you can’t out-exercise a bad diet, and it’s the same in the context of PCOS management. Combining exercise with a balanced approach to nutrition will amplify the benefits. Focus on whole foods and getting enough protein and fibre daily. Swap processed carb sources for whole grains and starchy vegetables where possible and limit processed sugars and artificial sweeteners. This won’t only fuel your workouts, but also help you to prevent diabetes and feel better all round. 

Getting Help

Everyone is different - that goes for PCOS symptoms and their severity, but also your individual starting point when it comes to fitness and nutrition. Nobody is expecting you to become an expert overnight and adhere to a plan perfectly 24/7. That’s why, especially in the beginning of your journey, it can be a great idea to speak to healthcare professionals and coaches to help you tailor a plan that works for you and your lifestyle. They can also serve as accountability partners, making sure to keep you on track even when times get rough.

The Bottom Line

Exercise and diet hold the key to not just managing PCOS, but transforming your health. Making regular, vigorous exercise an enjoyable habit in your daily life can be the single most significant step towards being more in charge of your symptoms and your body!

Literature

[1] Patten RK, Boyle RA, Moholdt T, Kiel I, Hopkins WG, Harrison CL, Stepto NK. Exercise Interventions in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Physiol. 2020 Jul 7;11:606.

[2] Mohammadi S, Monazzami A, Alavimilani S. Effects of eight-week high-intensity interval training on some metabolic, hormonal and cardiovascular indices in women with PCOS: a randomized controlled trail. BMC Sports Sci Med Rehabil. 2023 Mar 29;15(1):47. 

[3] Patten RK, Bourke M, McIlvenna LC, Moreno-Asso A, Woessner MN, Stepto NK, Parker A. Longitudinal affective response to high-intensity interval training and moderate-intensity continuous training in overweight women with polycystic ovary syndrome: A randomised trial. Psychol Sport Exerc. 2023 Jan;64:102325.

[4] Covington JD, Tam CS, Pasarica M, Redman LM. Higher circulating leukocytes in women with PCOS is reversed by aerobic exercise. Biochimie. 2016 May;124:27-33. 

[5] Jurczewska J, Ostrowska J, Chełchowska M, Panczyk M, Rudnicka E, Kucharski M, Smolarczyk R, Szostak-Węgierek D. Abdominal Obesity in Women with Polycystic Ovary Syndrome and Its Relationship with Diet, Physical Activity and Insulin Resistance: A Pilot Study. Nutrients. 2023 Aug 20;15(16):3652.