Breathwork for PCOS: Techniques to Lower Cortisol

Breathwork is a simple and free way to manage PCOS symptoms by lowering cortisol, the stress hormone that worsens hormonal imbalances, insulin resistance, and other PCOS-related issues. Women with PCOS often experience higher stress, anxiety, and depression, which can create a cycle of worsening symptoms. Breathwork helps break this cycle by activating the body’s natural relaxation response, improving hormonal balance, and reducing stress.

Key Benefits of Breathwork for PCOS:

Lowers Cortisol: Reduces stress and improves hormonal balance.
Improves Insulin Resistance: Helps manage weight and blood sugar levels.
Supports Mental Health: Reduces anxiety, depression, and improves sleep.
Accessible and Easy: Requires no equipment and only a few minutes daily.

Effective Techniques:

Deep Belly Breathing: Relaxes muscles, reduces anxiety, and boosts oxygen levels.
4-7-8 Method: Quick stress relief and better sleep.
Alternate Nostril Breathing: Balances hormones and calms the mind.
Kapal Bhati Breathing: Energizes and supports weight and metabolic health.

Start with just 5–10 minutes daily to see noticeable improvements in stress and PCOS symptoms. Pair breathwork with other treatments like exercise, mindfulness, and a balanced diet for the best results.

3 Effective Pranayama Practices For PCOD & PCOS| Yoga With Archana Alur | Pranayama Yoga |

How Cortisol Affects PCOS

Cortisol plays a major role in PCOS, disrupting hormonal balance and worsening insulin resistance - a condition that affects 60–80% of women with PCOS.

Cortisol's Impact on Hormone Balance

When cortisol levels stay elevated, they throw off the delicate hormonal balance that women with PCOS work hard to maintain. High insulin levels interact with the hypothalamic-pituitary-adrenal (HPA) axis, creating a vicious cycle of increasing cortisol and insulin. Elevated cortisol can also boost androgen levels, which triggers several hallmark PCOS symptoms:

Hirsutism: Unwanted facial and body hair growth may become more noticeable.
Hair thinning: Scalp hair loss can worsen, compounding PCOS-related hair issues.
Acne: Increased androgen activity often leads to more severe skin problems.

On top of this, high cortisol levels interfere with reproductive hormones like progesterone, testosterone, and estrogen, which can disrupt menstrual cycles. Weight management becomes even more challenging as cortisol encourages fat storage around the midsection. Studies reveal that women with PCOS may have a BMI that's 20.9% higher and carry up to 144.9% more visceral fat compared to women without PCOS.

These hormonal imbalances create a feedback loop where stress amplifies PCOS symptoms, making it harder to break free from the cycle.

How Stress Worsens PCOS

Stress and PCOS often feed into each other, forming a cycle that's hard to escape. Chronic stress keeps cortisol levels elevated, which, in turn, worsens PCOS symptoms.

One major issue is how elevated cortisol disrupts sleep. High nighttime cortisol can disturb sleep patterns, leading to insomnia and chronic fatigue. Poor sleep then increases stress levels, creating a downward spiral.

Cortisol also contributes to anxiety, depression, and inflammation, which further aggravates insulin resistance. Interestingly, research suggests that women with PCOS who show neurotic or psychotic personality traits may have even higher cortisol levels than those with more stable personality profiles.

Breaking this stress-cortisol-PCOS cycle requires a multifaceted approach that addresses both the physical and emotional aspects of the condition. One effective tool is breathwork, which helps calm the nervous system and reduce stress.

How Breathwork Reduces Cortisol Levels

Breathwork is a powerful way to break the stress-cortisol cycle, which can exacerbate PCOS symptoms. By practicing controlled breathing, you're essentially calming your nervous system, which directly influences cortisol production.

How Breathing Techniques Calm the Nervous System

Your breathing patterns act like signals to your brain, letting it know whether you're safe or under threat. Slow, deep breathing activates the vagus nerve, a key connection between your brain and the systems responsible for relaxation. This activation shifts your body into the parasympathetic "rest and digest" mode, triggering changes like lower blood pressure, slower heart rate, reduced stress hormone levels, and even a boost to your immune system.

"A lot of these techniques are about teaching people to slow down and move into the parasympathetic branch of the nervous system, which is our rest and digest state. Breathwork is obviously a powerful tool to do this." – Jamie Clements, Expert breathwork coach and founder of The Breath Space

Breathing patterns also have a direct impact on the parts of your brain that regulate emotions and behavior. Interestingly, 80% of the vagus nerve's fibers send signals from your body to your brain, showing just how much your breathing can influence your mental state.

Techniques like diaphragmatic breathing - where you breathe deeply into your abdomen - enhance oxygen intake while slowing your breathing rate. This rhythmic approach activates the parasympathetic nervous system, easing the "fight or flight" response. The results? A slower heart rate, lower blood pressure, and reduced muscle tension. These benefits aren't just theoretical; research consistently supports breathwork as an effective stress-relief method.

Research on Breathwork Benefits for PCOS

Studies back up the idea that breathwork can significantly lower cortisol and improve stress responses in women with PCOS. A review published in Scientific Reports highlighted breathwork's potential to improve stress management and mental health. One study even found that breathing techniques were more effective than mindfulness meditation for reducing stress, improving mood, and regulating the nervous system.

This is especially relevant for women with PCOS, as they often experience stress-response issues and low heart-rate variability (HRV) due to chronic stress and anxiety. Slow breathing has been shown to increase HRV by enhancing parasympathetic activity and balancing the autonomic nervous system.

In one study, participants with hypertension practiced 2:1 breathing - where exhalation is twice as long as inhalation - for 10–14 minutes daily over three months. The results showed a significant reduction in stress markers. While the study focused on blood pressure, the cortisol-lowering effects of such techniques are highly applicable to PCOS management.

Additionally, slow breathing can synchronize brain waves, improving communication between different brain regions. This enhanced neural connectivity helps regulate the hypothalamic-pituitary-adrenal (HPA) axis, which often becomes overactive in PCOS, driving excessive cortisol production.

For women managing PCOS, these findings highlight breathwork as a simple, accessible tool. The beauty of breathwork lies in its ease: slowing your breathing rate is one of the most effective ways to calm your stress response. It's a practical and convenient addition to other PCOS treatments, offering a natural way to support your overall health.

Breathwork Techniques for PCOS Management

Now that we’ve covered how breathwork can help calm your nervous system and lower cortisol levels, let’s look at some specific techniques you can start practicing today. These methods are particularly helpful for managing PCOS because they focus on reducing stress, supporting hormonal balance, and improving overall well-being. They’re practical tools you can incorporate into daily life to complement the strategies we’ve already discussed.

Deep Belly Breathing

Deep belly breathing, or diaphragmatic breathing, helps relax your muscles and stimulates the vagus nerve, which plays a key role in stress reduction. It also boosts oxygen levels in your body, helping to ease anxiety and promote a sense of calm.

"Deep breathing, also known as belly breathing or diaphragmatic breathing, promotes relaxation, reduces stress, and increases body awareness."

How to practice deep belly breathing:

Sit or lie down in a comfortable position.
Place one hand on your chest and the other on your belly to feel your breath.
Inhale deeply through your nose, letting your belly rise as your lungs fill with air.
Exhale slowly through your mouth, allowing your belly to return to its natural position.
Repeat for 5–10 minutes daily, gradually increasing the duration as you get more comfortable.

Research backs this technique. For instance, a study found that combining aerobic exercise with deep breathing and mindfulness led to a 30.29% drop in cortisol levels and a 14.54% reduction in fasting blood sugar for women with type 2 diabetes.

Next, let’s explore the 4-7-8 Breathing Method for quick stress relief.

4-7-8 Breathing Method

The 4-7-8 breathing method is a simple yet effective way to manage sudden stress and improve sleep. It involves specific timing for inhaling, holding your breath, and exhaling:

Inhale through your nose for 4 seconds.
Hold your breath for 7 seconds.
Exhale through your mouth for 8 seconds.

This technique increases oxygen delivery to key organs and raises carbon dioxide levels, which helps calm the mind. The extended exhale activates the parasympathetic nervous system, slowing your heart rate and promoting relaxation.

"This technique is extremely effective for anxiety because it combats the two areas where anxiety can be held: cognitively as well as somatically [in the body]." – Jillian Brandmaier, Therapist

How to practice the 4-7-8 method:

Find a quiet, comfortable spot to sit or lie down.
Exhale completely through your mouth, making a whooshing sound.
Close your mouth and inhale quietly through your nose for a count of 4.
Hold your breath for a count of 7.
Exhale forcefully through your mouth for a count of 8, making the same whooshing sound.
Start with four cycles twice a day, gradually increasing to eight cycles as you become more comfortable.

For long-term hormonal balance, Alternate Nostril Breathing is another technique worth trying.

Alternate Nostril Breathing

Known in yoga as Nadi Shodhana Pranayama, alternate nostril breathing is great for balancing hormones. It helps calm the mind, relieve stress, and regulate natural cycles, which is especially beneficial for managing PCOS symptoms.

How to practice alternate nostril breathing:

Sit comfortably with your back straight.
Use your right thumb to close your right nostril and inhale slowly through your left nostril for a count of 4.
Close your left nostril with your ring finger while releasing your right nostril.
Exhale through your right nostril for a count of 4.
Inhale through the right nostril, close it with your thumb, and release your left nostril.
Exhale through the left nostril. This completes one cycle.
Start with 5–10 cycles and work up to 10–15 minutes, maintaining a steady, comfortable rhythm.

Finally, Kapal Bhati Breathing offers an energizing approach to managing PCOS.

Kapal Bhati Breathing

Kapal Bhati, or "skull shining breath", is an invigorating breathing technique that can help manage weight, blood sugar, and stress - key areas often affected by PCOS. While it’s not a cure, it can provide relief from many symptoms.

This method boosts blood circulation to essential organs, supports glandular function, and combats oxidative stress. Studies suggest it can help reduce abdominal fat and improve overall metabolic health.

"Kapalabhati pranayama tones the abdominal muscles and reduces abdominal fat"

How to practice Kapal Bhati breathing:

Sit comfortably with your spine straight and hands resting on your knees.
Take a deep breath in, then forcefully exhale through your nose by contracting your abdominal muscles. Let the inhalation happen naturally as you relax.
Start with 20–30 rapid exhalations, then take a deep breath, hold it for a few seconds, and exhale slowly. This counts as one round.
Begin with 3–5 rounds, gradually increasing as your stamina improves.

Important: Avoid practicing Kapal Bhati if you’re pregnant, menstruating, or have high blood pressure or heart conditions. Always listen to your body and start slowly.

Kapal Bhati also helps regulate the brain-pancreas-endocrine pathway, which can be helpful for managing insulin resistance and weight issues often linked to PCOS.

Even dedicating just 10–15 minutes a day to these practices can make a noticeable difference in managing PCOS symptoms and boosting your overall wellness. Pair these techniques with other lifestyle changes for a more comprehensive approach to PCOS management.

At Oana Health, we’re here to support you with tailored, science-backed plans that address the delicate connection between stress and hormonal health. Breathwork can be a valuable part of your journey.

sbb-itb-6dba428

Adding Breathwork to Your Daily Schedule

Now that we've covered several breathwork techniques, the next step is to weave them into your daily routine. The good news? It doesn’t require a huge time commitment. Even carving out 3–5 minutes for intentional breathing can make a noticeable difference in managing PCOS symptoms and lowering cortisol levels. The trick is to choose methods that align with your schedule and lifestyle.

"You don't always have time to work out or go to a yoga class, but working with the breath provides high impact benefits. You could spend three minutes and experience a pretty drastic shift in how you feel physically, mentally, and emotionally." - Madisson Singleton, New York City–based yoga teacher

Start small - just 2–3 minutes per session - and gradually increase the time as it becomes a regular habit. To stay consistent, try setting reminders on your calendar or placing visual cues around your home or workspace.

Morning Breathing for a Calm Start

Kick off your day with breathwork to set a peaceful and focused tone. Morning breathing exercises can help lower cortisol levels and reduce stress, creating a solid foundation for the hours ahead. Deep belly breathing is especially effective in the morning - it strengthens your lungs and eases anxiety. Find a quiet spot, sit comfortably, and dedicate 5–10 minutes to this practice before diving into your daily tasks.

You might also try alternate nostril breathing, a technique shown to improve blood pressure, heart rate, and overall lung capacity, according to a 2011 study. To make it part of your routine, pair it with morning rituals like brushing your teeth or sipping your coffee.

Midday Breathing for Stress Relief

By midday, stress can creep in from work deadlines, errands, or general busyness. This is the perfect time to pause for a quick breathwork session to stay grounded and avoid stress build-up. The 4–7–8 breathing technique is a great option - it’s simple, effective, and can be done anywhere, whether you’re at your desk or taking a short break in your car.

Another technique to consider is box breathing. This involves inhaling for 4 counts, holding for 4, exhaling for 4, and pausing for 4 counts. It’s a structured method that helps reset your stress response, even on hectic days.

"You're giving yourself a controlled environment where nothing is actually happening that you're stressed about. But you're purposely bringing your body up to that feeling so you can practice pulling yourself back down." - Lauren Schramm, breathwork coach and global Nike trainer

If you’re pressed for time and miss a full session, don’t worry. Even 30 seconds of mindful deep breathing can help calm your nervous system.

Evening Breathing for Better Sleep

As the day winds down, breathwork can help prepare your body for restful sleep. Good sleep is critical for hormone balance and managing PCOS, and an evening breathing routine can support both. Poor sleep can worsen insulin resistance and elevate cortisol, so finding ways to relax before bed is key.

Diaphragmatic breathing is a great choice for the evening. It activates the parasympathetic nervous system, promoting deep relaxation, and also stretches pelvic floor muscles, which can be particularly helpful for women with PCOS.

Resonant breathing is another effective option. Research from 2017 found that it enhances heart rate variability, stabilizes blood pressure, and boosts mood. To practice, aim for about five breaths per minute, keeping your inhales and exhales evenly timed.

Switching up your techniques can also keep things interesting. Some nights, you might prefer the simplicity of deep belly breathing, while on others, the rhythmic flow of alternate nostril breathing might feel more soothing.

Combining Breathwork with Other PCOS Treatments

Breathwork plays a key role in reducing cortisol levels, making it an excellent addition to other treatments for managing PCOS. By addressing stress - a factor often overlooked in traditional PCOS care - breathwork enhances the effectiveness of medical treatments, dietary adjustments, and exercise plans.

Research highlights a two-way relationship between PCOS and stress: PCOS can elevate stress levels, and in turn, stress can worsen PCOS symptoms. For the 80% of women with PCOS who experience insulin resistance, breathwork can complement treatments like metformin by improving the body’s stress response. If you’re working with a healthcare provider, it’s worth discussing how breathwork might integrate into your overall treatment plan. Services like Oana Health offer telehealth options that combine personalized PCOS care with stress-reduction strategies, including breathwork.

Building on the techniques mentioned earlier, pairing breathwork with other approaches can further support hormone balance and overall well-being.

Using Breathwork with Mindfulness and Meditation

Combining breathwork with mindfulness or meditation can effectively tackle the psychological challenges of PCOS. Women with PCOS often face higher levels of stress, anxiety, and depression compared to those without the condition. This combination addresses both mental and physical stressors.

For example, an 8-week mindfulness program was shown to reduce stress, depression, and anxiety while improving quality of life. Similarly, a study found that women practicing yoga and meditation for 90 minutes daily over six weeks experienced improvements in hirsutism and body measurements. Another 9-week program involving breathing techniques, body scanning, and chanting led to reduced pain and a better quality of life.

To get started, try 5–10 minutes of breathwork before transitioning into mindfulness or meditation. Controlled breathing can help calm your mind, making it easier to focus during meditation.

Breathwork Before and After Exercise

Incorporating breathwork into your exercise routine can amplify the metabolic benefits of physical activity, which is essential for managing PCOS. Exercise helps improve insulin sensitivity and supports weight management, but adding breathwork can take these benefits even further.

Before working out, spend 3–5 minutes practicing deep belly breathing or alternate nostril breathing to prepare your body for activity. After exercising, use diaphragmatic breathing to help your heart rate return to normal and reduce post-workout cortisol spikes. This approach not only aids recovery but also ensures you maximize the metabolic benefits of your workout. Research has shown that combining yoga with breathwork can improve metabolic outcomes in PCOS. Additionally, regular yoga and breathing practices have been linked to decreased testosterone levels and better androgen balance.

Breathwork and Mindful Eating

Stress often triggers unhealthy eating habits, particularly cravings for sugary or high-carb foods, which can worsen insulin resistance in women with PCOS. Combining breathwork with mindful eating practices can help break this cycle and promote a healthier relationship with food.

Before meals, try this simple technique: inhale for 4 counts, hold briefly, and exhale for 6 counts. Repeat this three to five times to activate your body’s "rest and digest" mode, which supports proper digestion and nutrient absorption. As Coral Dabarera Edelson, MS, RD, notes:

"When we do this before we eat, we are more likely to chew more slowly and have more mindful awareness while eating".

Diaphragmatic breathing can also support the mind-gut connection, helping to manage digestive symptoms. If eating makes you anxious, a few minutes of breathing exercises beforehand can help. If you feel nauseated after meals, try these exercises afterward. However, avoid deep breathing during meals to prevent bloating or choking. Start by practicing diaphragmatic breathing for about 3 minutes, three to four times a day, until it becomes second nature. Once comfortable, integrate it into your mealtime routine. This practice can also heighten awareness of hunger, fullness, and cravings - key factors in managing PCOS symptoms tied to insulin resistance and weight management.

Conclusion: Using Breathwork for PCOS and Hormone Health

Breathwork provides a simple yet effective way to address PCOS symptoms by helping to reduce elevated cortisol levels. By engaging in proven techniques, you can tap into your body’s natural relaxation mechanisms, which may lead to noticeable improvements in hormonal balance.

Practicing breathwork regularly helps regulate the autonomic nervous system, shifting your body out of stress mode and into a calmer, rest-and-digest state. This shift can support healthier weight management, better blood sugar control, and improved hormonal function overall .

The key to success is consistency. Dedicating just 5–10 minutes a day - whether in the morning, during a midday pause, or as part of your evening routine - can lay the groundwork for long-term benefits. Over time, sticking to this practice can yield even greater outcomes.

When combined with medical care, breathwork becomes an even more powerful tool for managing PCOS. Many women find that integrating breathwork into their treatment plan enhances their overall approach to managing symptoms. Telehealth platforms like Oana Health offer personalized, science-based PCOS care, making it easier to combine stress management with medical treatment. Research shows that medication adherence improves by 45% with telehealth compared to traditional care alone, highlighting how an integrated approach can amplify results.

Experts emphasize the importance of accessible care:

"With telehealth, care is no longer optional - it's essential. For women with PCOS, it's the key to accessible, affordable, and effective treatment."

Breathwork is one of the most convenient tools at your disposal. Whether you’re tackling insulin resistance, managing weight, or coping with the emotional challenges of PCOS, intentional breathing offers a natural and affordable way to support hormonal balance. Start small, with just a few minutes of focused breathing each day, and gradually build a practice that supports your long-term health goals.

FAQs

How can breathwork help lower cortisol levels and support women with PCOS?

Breathwork techniques, like diaphragmatic breathing and other mindful practices, can play a key role in reducing cortisol levels. These methods work by activating the parasympathetic nervous system, which helps the body relax and counteracts stress. For women dealing with PCOS, managing cortisol is particularly important since high levels of this stress hormone can disrupt hormonal balance and intensify symptoms.

Engaging in deep, controlled breathing can contribute to better hormonal regulation, improved insulin sensitivity, and a reduction in stress-related effects on health. Adding breathwork to a daily routine is a straightforward and effective way to support overall health and manage PCOS symptoms.

Can breathwork help manage PCOS symptoms when combined with other treatments?

Yes, breathwork can play an important role in managing PCOS symptoms when combined with other treatments. Techniques such as diaphragmatic breathing and pranayama have been shown to reduce cortisol levels, which is crucial for balancing hormones - a major concern for women dealing with PCOS. By easing stress, breathwork not only encourages relaxation but may also boost the effectiveness of other therapeutic approaches.

On top of that, consistent breathwork practices can benefit pelvic health by addressing issues like pelvic pain or discomfort. When included as part of a holistic care plan, it supports overall well-being and tackles both the physical and emotional challenges of managing PCOS.

Are there any breathwork techniques women with PCOS should avoid or use cautiously?

Some breathwork practices might not be the best fit for women dealing with PCOS, particularly during times of fatigue, stress, or menstruation. Techniques like Holotropic breathing or rapid breathing exercises can be quite intense, potentially leading to discomfort or even worsening symptoms. Instead, opting for gentler approaches such as diaphragmatic breathing or the 4-7-8 method can help encourage relaxation and support hormonal balance.

Paying attention to how your body responds is key - adjust your practice as needed. And before diving into any new breathwork routine, it’s a good idea to check in with a healthcare provider to make sure it suits your individual health needs.