I get the same questions in my DMs all the time: “What is the BEST exercise for PCOS?”
My short answer: There isn’t one. PCOS isn’t one-size-fits-all.
The better question is “What is the best exercise for ME to support my body with PCOS?” And that depends on each individual.
There is much anxiety around exercise, especially for those with PCOS. I find two reasons for this. 1) Exercise is often viewed as a punishment, or something you must do to make up for what you ate. 2) There’s a lot of talk about certains types of exercise being bad for PCOS, relating to cortisol and inflammation (we’ll get to this).
Because of the first reason above, I like to use the word “movement” instead of exercise. It’s part of the perspective shift to focus more on flexibility, nourishment, and benefits beyond calorie burn, instead of rigidity, rules, and weight-centric approaches.
Now, let’s jump into the basics of movement and how they are helpful for those with PCOS.
Types of Movement
This blog will focus primarily on these three types of movement: cardio, strength training, and yoga.
Cardio-type movement generally refers to movement that increases the heart rate. Cardio can range from low to high intensity. An example of low-intensity cardio is simply walking, while high-intensity may include running, biking, high-intensity interval training (HIIT), endurance sports, and swimming.
Is cardio helpful for PCOS?
Both low-intensity and high-intensity cardio movement has shown to improve insulin resistance. HIIT exercise in particular has shown to improve insulin sensitivity. Additionally, walking after a meal may help lower postprandial blood sugar levels. At least 70% of those with PCOS have insulin resistance, meaning cardio-type movement may be beneficial.
However, it’s important to note that those with PCOS often have high cortisol levels and impaired stress response. High-intensity cardio, especially at a long duration, can increase stress and cortisol levels, and may contribute to inflammation. Because of this, those that have high stress or high cortisol may consider focusing more on strength training and/or low-intensity cardio.
Strength training refers to the building, toning, or strengthening of muscles through resistance. Strength training may be done using equipment, such as a machine, kettlebells, dumbbells, weighted balls, and resistance bands, or your own body weight.
Is strength training helpful for PCOS?
YES! Increasing muscle mass through strength training increases glucose uptake and improves insulin sensitivity, which can help improve insulin resistance in those with PCOS.
Strength training has also been shown to lower testosterone in women with PCOS. Testosterone is an androgen hormone, when in excess, can result in irregular periods, hirsutism, cystic acne, male-pattern baldness, and other symptoms associated with PCOS.
Those with PCOS may also find that they are able to build muscle mass a bit easier than those that don’t have PCOS. Don’t worry, this doesn’t mean you’ll be “buff” or “bulky”!
Yoga (and other types of restorative movement)
Yoga in particular has been studied in those with PCOS and shown to have great benefits. You may think about yoga as another form of stretching and strength training. It can be as relaxing or intense as you choose to make it.
Much of the benefit of yoga comes from the relaxation and ability to reduce stress. Yoga has been shown to reduce stress, cortisol, androgen levels, insulin resistance, and inflammation in those with PCOS, along with its benefits in mood and flexibility! These benefits have obvious impacts on PCOS symptoms!
A great way to learn yoga is to follow along with videos. There are actually yoga videos specific for PCOS. Check out Kendra at Live Fertile – YouTube. You may also check out Yoga with Adriene on YouTube. She has beginner and advanced levels with specific videos for certain parts of the body.
If you do not like the practice of yoga, you may choose similar restorative movement, like stretching, Pilates, barre, SoulCore, or whatever you prefer.
Other Benefits of Movement for PCOS
There are both physical and mental health benefits of movement with PCOS. As stated previously, women with PCOS can often experience higher rates of insulin resistance. This affects your body’s ability to use sugar from the blood for energy efficiently. Regular movement can help improve insulin resistance.
According to a study done by Shetty et al., (2017) movement can also help with inducing hormonal changes of testosterone and other hormones, as well as reducing inflammatory markers, and increasing immunity in those with PCOS.
Beyond physical benefits, movement can provide mental benefits as well. Movement may help you relieve stress, bond with friends or family, have a sense of accomplishment, be a way to enjoy nature or simply just to have fun. Stress is often a driver of PCOS symptoms, as it raises cortisol levels, increases androgens, contributes to nutrient deficiencies, and further inflammation. Movement may help to reduce stress and therefore, improve PCOS.
How do I know what’s the best exercise for my PCOS?
My first recommendation is to answer this: What movement would be most enjoyable and helpful for me? It’s important that you choose something that’s sustainable.
Second, it’s helpful to know what’s primarily driving your PCOS symptoms: insulin resistance, inflammation, stress, or a combo? Then see above to help you choose what types of activity would be best suited for you.
For example, if you have high cortisol or inflammation, you may want to choose less high-intensity activity and more strength training or restorative movement.
For most people, a combination of cardio, strength training, and restorative movement like yoga can be helpful.
If you’re feeling overly fatigued, stressed, or in pain, it may be time to re-evaluate your movement routine.
Your routine should help you NOURISH your body, and help you feel energized, lower stress, and improve your PCOS.
Where do I begin?
Let’s start today and just get moving! Even just 10 minutes of movement each day is helpful. The recommendation for movement is 150 minutes per week of moderate-intensity activity. You can slowly work up to 30 minutes five days per week, or however you’d like to split it up.
Strength training is recommended 2-3x per week, working different muscles each day.
Plan a routine to try and monitor how it feels.
An example routine may be 4 days per week alternating between 30 minutes walk on two day and 30 minutes strength training on 2 days.
Remember, you can always switch it up. Be flexible, try new types of movement and routines, and listen to your body to decide what feels best for you!
How do you know when it’s time to rest instead?
Are you fatigued? Have you barely slept? Has it been an emotional day for you? Or are you very sore from some of the other movements you have been doing throughout the week? If so, it might be time to rest instead.
I want you to be mindful of what your body is trying to tell you. Taking a day off is not something you should be ashamed of! Listening to your body is something you should be proud of!!
Finding joy in movement!
Find ways to move around without you having to think about it as “I have to do this”.
Use music to get you motivated or listen to a podcast. Bring a friend to chat with on a walk, or take your dog. Try a new class at your neighborhood gym or studio. Find a new YouTube channel. Pick up a new sport or outdoor activity. Find the joy!
Need more support building a movement routine that improves YOUR symptoms? As an ACSM Certified Exercise Physiologist and Registered Dietitian, I can help create a movement and nutrition plan that is right for you! Learn more about my 1:1 Peace with PCOS Pack here.
Shetty D, Chandrasekaran B, Singh AW, Oliverraj J. Exercise in polycystic ovarian syndrome: An evidence-based review. Saudi J Sports Med 2017;17:123-8
Written by: Katie Massman and Bo Brasseur