When utilising holistic practices to manage a diagnosis of PCOS, healthy living comes at the very core. Alongside nutritional protocols, regular physical exercise is quickly prescribed to help with many of the associated side effects of the hormonal and metabolic condition. From insulin resistance, excess weight gain, hormonal imbalance and menstrual cycle irregularities to a heightened potential for anxiety and depression and an increased risk for long term complications such as Type 2 Diabetes, women with PCOS face a vast and differing array of physical and mental symptoms, which fortunately can be assisted through the tool that it is exercise.
Sustainable lifestyle changes and exercise implementation is important to manage and enhance symptoms including body composition, insulin sensitivity, cortisol management and hormonal balance, however there are a few home truths you need to know about working out when you have PCOS. Take it from this holistic PT who has been there, done that!
1. YOU CAN’T SWEAT OUT PCOS
Upon first leaving the doctor’s office with a diagnosis of PCOS, most women clutch to the very basic advice broadly offered by their GP – “keep active and exercise often”. While exercise is a practical tool that can help manage and indeed assist in reversing PCOS symptoms, it is important to know that it is not possible to “out-sweat” PCOS by ramping up your exercise patterns dramatically. There are various studies indicating that a modest amount of weight loss, roughly 5-10% of initial body weight, can have a positive impact on various symptoms [https://jeanhailes.org.au/health-a-z/pcos/weight-management-treatment], including a 50% reduction of insulin resistance, however it’s important to note that excessive exercise can indeed exacerbate your symptoms and hinder your progress. So, whilst you read over the following tips, keep this point at the forefront of your mind – move and exercise to assist your symptoms, but realise exercise alone is not a “cure”. Exercise should always support and nourish, not punish your body, mind and spirit.
2. ALIGN YOUR WORKOUTS TO YOUR SYMPTOMS
As a hormonal and metabolic condition that exists along a sliding scale, you will find there can be vast fluctuations in the presentation and severity of symptoms across the weeks, months and even years. You will also likely hear from many other women with PCOS, who will often be open in sharing their advice and what works best for them. Heed a warning though to be discerning in the advice you take on. The collective support is a great comfort, yet we are all uniquely individual so it is key to remember what works for someone else, may not work, nor be appropriate for your body in its current phase. Tuning into the most knowledgeable resource – yourself – is integral to assisting your personal management of PCOS at each stage experienced. By utilising all the information you can collate, be it from medical tests, practitioners reports or professional advice and by understanding your own symptoms, you can better use exercise as a tool to support your condition. Try to consistently check in with yourself to know where you are in your OWN process and consequently pace yourself accordingly to choose the type of workouts best suited to that current stage.
As a general guideline, if you are in an initial and acute phase with low energy, an overwhelmed nervous system and high inflammation, look for restorative, nourishing practices, such as Pilates or Yoga, with some additional low intensity movement such as walking or swimming – which will help restore the adrenal, hormonal balance while lowering levels of inflammation. Subsequently when you find your energy is picking up and symptoms are improving, adding in HIIT sessions and resistance training can be appropriate to reap the benefits for body composition, enhanced insulin sensitivity and metabolic health. Overall, finding a style of training that you enjoy, so that you adhere to it, whilst also finding formats that energise and uplift, helping you see results and progress over time, is the most important step in this process.
3. YOU NEED TO MAKE TIME TO MOVE ON THE DAILY
While research shows that any type of exercise can help PCOS symptoms, what is truly important, is implementing then maintaining regular consistency to ensure you are moving on the daily. To manage PCOS symptoms, it is recommended to include 150 minutes of exercise per week, with 90 minutes being moderate to high intensity. Spread across the week, that works out to around 25 minutes of movement per day, with one day of full rest – which seems much more manageable right? If you then make 3-4 of those sessions a higher intensity session, you’re on the path to a balanced workout schedule across the week. Of course, depending on your exercise background, existing fitness levels or body composition needs, this is a moving scale, but if you are just embarking on a workout regime, finding 25 minutes of movement daily, is a shift in the right direction.
4. BUT…MOVING OFTEN DOESN’T MEAN ‘WORKING OUT’ EVERY DAY
Though the general guideline to assist with PCOS is to move often, this certainly does not mean working out – in the traditional “go to the gym + smash out a HIIT session” sense – every day! The suggested 25 minutes of physical activity daily encouraged doesn’t have to be a gym session or workout class. It can be as simple as just getting yourself moving and fitting in some incidental fitness. Finding simple yet creative ways to move your body, regularly, can have a highly beneficial accumulative effect on your health and wellbeing. Be it walking to work, taking the stairs when you reach your train station, having a cheeky stretch during your lunch break or perhaps joining a social netball team, non-traditional formats of exercise will help you hit your movement quota quickly without even seeming that daunting!
5. FOCUS ON BALANCING DURATION + INTENSITY
I get it, when you’re on a mission to assist your healing process you just want to immediately do absolutely everything you can to get better, fast. But taking you back to point one – you cannot out sweat PCOS – and forcing rapid changes, especially by quickly increasing the duration and intensity of your exercise, is not a sustainable, long-term solution. When you’re informed exercise can help, realise that is not code for “go train for 2 hours a day” and be aware that extended durational exercise can indeed exacerbate symptoms.
Working out, especially at a high intensity, for over an hour can increase cortisol levels, which for PCOS women, is necessary to be avoided. For any high intensity workouts, such as HIIT training or cardio focused workouts, aim to limit the duration to 20-30 minutes. This will help you receive the benefits for insulin sensitivity, muscle growth and fat burning potential, without taxing the nervous system. If you just love endurance or are longing to train for an event, like a marathon, you need to be prepared to be in the process with a long-term, holistic goal in mind for your condition. First, focus on managing your current symptoms and/or reversing the syndrome, before you exacerbate symptoms with a heavy training load. Once you are on the path to healing, slowly begin increasing intensity whilst closely tracking how your body responds and pivoting as needed.
6. UTILISE RESISTANCE TRAINING FOR MORE THAN JUST #STRONGGIRLGOALS
We’ve seen a rise in the Strong not Skinny movement, but for women with PCOS, resistance training goes far beyond a hashtag. Not only does incorporating resistance training enhance metabolic health and body composition, through the progressive gain of lean muscle mass it can have additional positive impacts for the 70% of PCOS women who have Insulin Resistance. With insulin resistance and high levels of inflammation being a common marker for many women with PCOS, utilising exercise alongside a considered nutritional protocol is a key way in which to manage the symptom. Through strength training there is a resulting increase of muscle mass, which helps the uptake of glucose by the cells, thus enhancing insulin sensitivity, while simultaneously assisting in improved energy expenditure. Additionally, resistance training can help women feel empowered, track their progress and find functional strength to boost their everyday lives, outside the gym!
7. CHOOSE LOW + SLOW FOR LONG-TERM RESULTS
Inextricably linked to exercising for physical benefits, is exercising for stress reduction. Whilst our bodies are sophisticated machines, they cannot distinguish between a source of stress, so whether it is an actual threat to your livelihood, or just a high intensity sweat session, the body processes the stress in the same manner. This can have some pretty major kick on repercussions for PCOS ladies. So to combat the induced stress state but keep on moving, including low intensity workouts is a winning alternative. Low intensity movement, conducted at a steady state pace, can help decrease cortisol, lower inflammation levels and is overall great for reducing stress and anxiety. Whilst we know that for PCOS long durational exercise at high intensity isn’t recommended, when it comes to low intensity movement, this form of exercise can be highly beneficial without draining energy or placing excess tax on the body’s nervous system.
8. PRESS PAUSE WITH RESTORATIVE + RECOVERY BASED PRACTICES
Exercising for PCOS is important, but so too is rest and recovery. Our bodies are constantly fighting to find balance and homeostasis. When faced with a condition like PCOS, there is a constant juggle of numerous symptoms that require careful attention and care. Adding in too many other elements, even those, such as exercise, that are conducted with good intentions, can simply become too overwhelming for our many systems to comprehend. Taking time out to rest and recover is an integral part of the healing and management process of a complex condition such as PCOS. When looking at your week of workouts, make sure you are including practices that build and strengthen your connection to your body and spirit, such as Pilates, Yoga or Meditation, which further can help to combat stress and anxiety. Additionally, make sure you are taking ample days off to rest and recover, and assess your daily recovery patterns – are you getting enough sleep and adequately supporting yourself with hydration and nutrition? Remember, there’s a difference between resting and quitting, so allow yourself to pause so you can keep on going for long-term positive outcomes.