Does exercise help PCOS?

In this article:

• Exercise for PCOS
• Types of exercise
• Modifications for PCOS
• The bottom line

In this article

• Exercise for PCOS
• Types of exercise
• Modifications for PCOS
• The bottom line

Polycystic ovary syndrome, also called polycystic ovarian syndrome or PCOS, is a common hormonal disorder affecting 7%-10% of women of reproductive age. This women’s health condition is the most common cause of female infertility. It is characterized by irregular menstrual cycles, hyperandrogenism (excess male sex hormones), hirsutism (excessive hair growth), acne, obesity, and polycystic ovaries (enlarged ovaries containing numerous small cysts).

Individuals with PCOS are at increased risk of metabolic syndrome, a cluster of conditions that make them more susceptible to Type 2 diabetes, cardiovascular disease, and stroke. Maintaining a healthy lifestyle that includes regular exercise plays a crucial role in preventing metabolic syndrome and managing PCOS symptoms—often along with medication. But what type of exercise routine works best? Read on for expert-approved exercise interventions to manage the condition.

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PCOS and exercise

Lifestyle modifications like diet and exercise are essential to treating PCOS, says G. Thomas Ruiz, MD, a board-certified OB-GYN and Lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Why? Regular physical activity helps manage PCOS symptoms and the cluster of conditions referred to as metabolic syndrome, including high blood sugar, excess body fat, and high blood pressure (hypertension). Exercise is beneficial for PCOS in the following ways:

Reduces risk of metabolic syndrome

PCOS places women at increased risk of metabolic syndrome, a group of conditions including insulin resistance, excess stomach fat, and high blood pressure, which predisposes women to develop Type 2 diabetes and heart disease. Working out reduces your risk of developing diabetes, hypertension, and high cholesterol—and can also improve insulin resistance and help you attain a healthy body weight.

Improves insulin sensitivity

Insulin resistance occurs when your body needs more insulin to lower blood glucose levels effectively, and it often goes hand-in-hand with PCOS. When your blood sugar is too high, it can make the ovaries produce more androgens (male sex hormones like testosterone), leading to symptoms like irregular menstrual cycles, acne, and hirsutism, Dr. Ruiz says.

According to the American Diabetes Association, physical exercise enhances the body’s ability to use insulin for up to 24 hours. A 2017 research review found that incorporating moderate-intensity aerobic exercise for at least 30 min three to five days per week improved insulin sensitivity and glycemic control. In women with PCOS, consistent exercise can lower blood sugar levels, restore insulin sensitivity, and reduce the risk of Type 2 diabetes.

Reduces excess weight

Exercise helps reduce body mass index (BMI) in two ways: it helps create a calorie deficit, which is essential for weight loss, and it helps build muscle mass, which improves metabolism to promote fat burning. What’s more, weight loss can balance hormone levels, helping to regulate the menstrual cycle and improve insulin resistance.

Weight gain around the abdomen, common among women with PCOS, can worsen insulin resistance, Dr. Ruiz explains. “It’s common for overweight patients to experience menstrual irregularity and hormonal imbalances,” says Jennifer Wu, MD, a board-certified OB-GYN at Northwell Health’s Lenox Hill Hospital in New York.

A 2020 systematic review and meta-analysis concluded that high-intensity aerobic exercise was the most effective in BMI reduction and insulin resistance in women with PCOS. The best results were experienced by those who followed healthy diets in conjunction with a vigorous exercise protocol totaling 120 minutes weekly.

Alleviates PCOS symptoms

A recent research review concluded that regular exercise improved reproductive health functions among women with PCOS, including menstrual regularity, ovulation, and hormonal balance. Research has also found that exercise reduces stress and improves psychological well-being by releasing endorphins; therefore, it may contribute to reduced anxiety and depression, which are common among those with PCOS.

Promotes better sleep

Regular physical activity can improve sleep quality, often compromised by PCOS. For example, it’s common for women with PCOS to have sleep problems like insomnia, daytime sleepiness, obstructive sleep apnea (OSA), and restless legs syndrome. What’s more, PCOS-related conditions like diabetes, depression, and obesity can compound sleep issues.

Resistance training may be particularly helpful in improving PCOS-related sleep issues. A recent clinical trial of 24 women with PCOS between the ages of 25 and 40 evaluated the effect of a strength training routine performed three times weekly. At the end of four weeks, the exercisers experienced statistically significant improvements in sleep quality compared to the control group. Even so, larger-scale studies are needed to validate these results.

Reduces androgen levels

PCOS is characterized by high androgen levels, responsible for symptoms like acne and oily skin, changes in breast size and body shape, male-pattern hair growth (on the face, chin, and abdomen), and irregular or absent menstruation. Exercise may help by lowering androgen levels.

According to a recent systematic review investigating the role of exercise on hormone levels in women with PCOS, vigorous aerobic training, high-intensity interval training (HIIT), strength training, and yoga are the most effective.

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What type of exercise is best for PCOS?

When it comes to the best exercise for PCOS, Dr. Wu says many forms are beneficial.

• Cardio exercises like running, cycling, or swimming help burn calories and improve cardiovascular health.
• Strength training helps build muscle mass and can increase metabolism.
• HIIT, which combines short bursts of high-intensity physical activity with lower-intensity phases, can improve insulin sensitivity and contribute to fat loss.
• Yoga can help lower androgen levels and improve symptoms of anxiety and depression.

Different types of exercise may help to target different PCOS symptoms. For example, strength training may help with sleep, while HIIT exercises can help reduce weight, insulin resistance, and androgen levels.

Tailoring your exercise routine for PCOS management

Balancing cardio with strength training is ideal for managing PCOS, so be sure to incorporate both types of exercise into your routine, says Dr. Ruiz. The Centers for Disease Control and Prevention recommend at least 150 minutes of moderate-intensity aerobic exercise per week, plus strength training at least twice a week for optimal health. Dr. Ruiz says this is a good starting point but emphasizes that most patients can benefit from more activity.

To start and maintain a consistent exercise routine, follow these tips:

• Set realistic goals, gradually increasing workout duration and intensity.
• Find activities you enjoy to make exercise feel less like a chore.
• Schedule workouts at convenient times, or incorporate multiple movement breaks into your day.

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The bottom line

Exercise can improve many PCOS symptoms and associated conditions. Still, a holistic approach combining physical activity with a balanced diet and lifestyle changes is essential for effective PCOS management.

Dr. Ruiz points out that medication is also an essential component of PCOS treatment, so be sure to see a healthcare provider for medical advice at the first sign of symptoms. The condition is managed best with early diagnosis and treatment.