The first PCOS article was about what you should eat to get your hormones under control – and now we’re going to talk about exercise. That’s because exercise, or rather the right kind of exercise for women with PCOS, is incredibly important.

As I mentioned in Part 1, it’s a good idea for PCOS sufferers to learn how to manage stress and, among other things, find their own ideal carbohydrate intake – not by cutting out carbs altogether but by finding what works and doesn’t cause them to go into a food coma or feel drained of energy with a strong craving for sweets.

When it comes to exercise, remember that all exercise puts stress on the body, exercise breaks down muscle, burns stored fat and increases insulin sensitivity – so proper rest and good nutrition are required to repair the body from this kind of stress. Exercise can cause stress, but it can also help you cope with stress, such as by increasing the amount of the feel-good hormone endorphin. Certain types of workouts cause more stress than others, and too much exercise or an unbalanced exercise programme can exacerbate PCOS symptoms.

Lots of women with PCOS (including thin women with PCOS) are insulin resistant. Chronic high insulin levels force the ovaries to increase testosterone production. Elevated levels of testosterone can disrupt the menstrual cycle, and cause acne and excess body hair. Exercise, especially strength training, increases insulin sensitivity in both healthy women and women with PCOS. So, your goal in terms of exercise and diet should be to lower your blood sugar and cortisol levels. And, given that depression is associated with PCOS, endorphins can help you with that too.

You could even say that PCOS is less about a woman’s ovaries and more about insulin resistance. And since insulin resistance is the main problem in PCOS cases, increasing insulin sensitivity can help you manage your weight and potentially improve your ability to get pregnant.

Why exercise at all?

Famous Swedish nutritionist and author Fredrik Paulún says:

‘When you eat carbohydrates (or protein for that matter), insulin is released from the pancreas into the bloodstream. The insulin circulates in the blood until it reaches the muscles. Muscles have receptors that detect insulin. When insulin sends a signal to the muscles, immediately after a meal, they absorb the nutrients in the blood and use them. The muscles mainly absorb carbohydrates (which become glycogen) and amino acids (which become muscle). However, fat cells also have receptors that detect insulin. In these cells, the fat is absorbed and stored as body fat instead. Insulin sensitivity refers to the sensitivity of muscle insulin receptors. If they are sensitive, they easily sense the presence of insulin in the blood, and we experience increased glycogen storage and muscle building. Furthermore, the pancreas does not need to release as much insulin, so fat storage is reduced too. A person with high insulin sensitivity will get much better results from exercise than a person whose insulin sensitivity is low. The results are more muscles, less body fat and better endurance. Increased insulin sensitivity can be achieved by exercising regularly, eating slow carbohydrates with a low to medium GI value, eating the right types of fat and not eating too much fat. The best sources of fat for this purpose are fish and seafood.’

In other words: insulin lowers blood sugar more with physical activity than without it, especially if you exercise large muscle groups (think basic exercises). By increasing insulin sensitivity, muscles can absorb more glucose using less insulin. This also helps you to store less fat and keep the fat-burning process going.

How can strength training help women with PCOS?

To be clear, although strength training can help PCOS, it can’t cure it. You can’t sweat out PCOS through exercise. Too much exercise can actually aggravate symptoms. If you feel that you are ‘doing all the work, eating properly and exercising’ and you’re not seeing results – the problem may simply be that you are exercising too much.

When your body doesn’t get enough rest, you can experience conditions like chronic joint and muscle pain, aches and pains that won’t go away, lack of results, loss of energy and brain fog. Frequent colds can also be the result of too much exercise and too little rest. Constantly striving to burn calories at all costs is one approach, but working with your body, following its cues and adapting your workouts accordingly will give you so much more.

The muscle you gain from weight training is ‘living’ tissue – so the more muscle you have, the more fat you burn.

A couple of tips for the road

Avoid any kind of running where you run frequently and for tens of miles per week or aerobics/step classes etc. These activities raise cortisol levels. Focus instead on strength training, gentle walks and yoga. These activities lower cortisol levels.

A week of exercise might look like this:

✅ Strength training 3 days/week

✅ Daily walks of 45–60 mins (or combine with yoga)

✅ HIIT 1 day/week, for max. 20 mins.

Photo iStockphoto

References, sources
Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study