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- Polycystic Ovary Syndrome (PCOS) affects 6–13% of women of reproductive age in the U.S., but up to 70% remain undiagnosed.
- Common symptoms include irregular periods, high androgen levels, insulin resistance (75–95% of cases), and weight challenges (40–80% of cases).
- Strength training can improve insulin sensitivity, lower testosterone, reduce inflammation, and help manage weight.
- Studies show that resistance training reduces androgen levels, improves glucose metabolism, and decreases anxiety by nearly 50%.
- Experts recommend combining strength training (2x/week) with aerobic activity (150–300 minutes moderate or 75–150 minutes vigorous weekly).
Quick Comparison of Exercise Benefits for PCOS
| Exercise Type | Primary Benefits | Hormonal Effects | Metabolic Impact |
|---|---|---|---|
| Strength Training | Builds muscle, improves body composition | Lowers testosterone, boosts SHBG | Improves insulin sensitivity by 11% |
| Aerobic Exercise | Enhances cardiovascular health | Reduces BMI, lowers AMH | Improves glucose uptake |
| HIIT | Efficiently boosts fitness | Lowers fasting insulin and HOMA-IR | Reduces fat mass and improves VO2 max |
Start slow, stay consistent, and combine strength training with aerobic exercise for the best results. Pairing exercise with medical care, like telehealth services, can further enhance PCOS management.
PCOS Basics and Exercise Benefits
What Is PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal condition that affects around 5 million women of reproductive age in the United States. It places a financial strain on the healthcare system, with diagnosis and treatment costing approximately $4 billion annually. The disorder is typically defined by three key symptoms: irregular menstrual cycles, elevated androgen levels, and polycystic ovaries. These symptoms can vary widely, often disrupting daily life.
Many women with PCOS experience excessive hair growth, and 40% to 80% face challenges with weight management. Additionally, insulin resistance and high androgen levels are common, contributing to issues like acne, male-pattern hair loss, and unwanted facial hair. Without proper care, PCOS can lead to serious health risks, including type 2 diabetes, cardiovascular issues, high blood pressure, and uterine cancer. Mental health is also a concern - women with PCOS are at least three times more likely to experience depression or anxiety compared to those without the condition. Given these challenges, exercise becomes a key tool in managing PCOS.
How Exercise Helps PCOS
Exercise plays a crucial role in addressing the imbalances caused by PCOS. One of its most important benefits is improving insulin sensitivity. Since insulin resistance impacts about 75% of lean women with PCOS and up to 95% of women with PCOS who are overweight, regular physical activity is vital. Exercise helps muscles absorb glucose more efficiently, reducing the body's need for insulin and breaking the cycle of high insulin levels that worsen symptoms.
Physical activity also boosts levels of sex hormone-binding globulin (SHBG), which lowers the activity of testosterone. Additionally, exercise aids in managing weight by targeting central fat and reducing the risk of cardiovascular disease - even if significant weight loss doesn’t occur. Mental health benefits are another major plus: consistent exercise can alleviate symptoms of depression and anxiety.
Strength Training vs Cardio Exercise
Both strength training and cardio exercises offer unique advantages for managing PCOS. Cardio, for instance, enhances heart health and burns calories. Vigorous aerobic activity has been shown to effectively reduce BMI and improve insulin resistance.
On the other hand, strength training focuses on building muscle and improving overall metabolic health. Research shows that resistance training is particularly effective in reducing the Free Androgen Index, which measures testosterone levels. Beyond hormone regulation, it enhances insulin sensitivity, supports better glucose metabolism, increases resting metabolic rate, and decreases body fat. With more muscle mass, the body becomes more efficient at using glucose, offering long-term metabolic improvements.
Experts recommend that women with PCOS incorporate muscle-strengthening exercises at least two non-consecutive days per week. This should be paired with 150 to 300 minutes of moderate-intensity aerobic activity or 75 to 150 minutes of vigorous-intensity aerobic exercise each week. To maximize benefits for insulin sensitivity, exercising daily - or at least every other day - is highly encouraged.
Research Findings: Strength Training for PCOS
Main Results from Recent Studies
Recent studies have shed light on the positive impact of strength training for women managing PCOS. One notable 16-week study revealed that resistance training led to marked reductions in testosterone levels, while a 10% increase in muscle mass was linked to an 11% decrease in the risk of insulin resistance.
Combining resistance training with endurance exercises also showed promising results, significantly lowering both total testosterone levels and the Free Androgen Index (FAI). Since the FAI measures active testosterone circulating in the body, this reduction is particularly relevant for managing PCOS symptoms.
"Consistently adhering to a good strength training program can, in the long term, help with hormone balance and the reversal of PCOS symptoms", says Despina Pavlou, PT and host of The PCOS Oracle podcast.
Strength training doesn’t just help physically - it has mental health benefits too. In one study, anxiety levels dropped from 44.1% at the start to 23.2% after 16 weeks of resistance training, representing a nearly 50% reduction in symptoms. This highlights how strength training can address both the physical and psychological challenges of PCOS.
Dr. Claire Pettitt, a PCOS dietitian and nutritionist, explains why these improvements occur:
"It may be because strength training promotes muscle growth, which may use more testosterone and so reduce the levels of testosterone in the blood".
Strength Training vs Cardio: Study Comparisons
Strength training’s benefits become even clearer when compared to other exercise types. While both strength training and cardio support PCOS management, they address different aspects of the condition. For example, vigorous aerobic exercise improves insulin measures, while resistance training targets androgen levels.
Here’s a breakdown of how different exercise types impact PCOS:
| Exercise Type | Primary Benefits | Hormonal Effects | Metabolic Impact |
|---|---|---|---|
| Strength Training | Builds muscle mass, improves body composition | Lowers Free Androgen Index, reduces testosterone | 10% muscle increase = 11% lower insulin resistance |
| Aerobic Exercise | Enhances cardiovascular fitness, burns calories | Increases glucose infusion rate, may lower AMH | Improves insulin sensitivity, reduces fasting insulin |
| HIIT | Efficiently boosts fitness | Decreases fasting insulin and HOMA-IR, may lower DHEA-S | Improves insulin resistance markers significantly |
A study by Almenning highlighted that strength training improves fat mass percentage, fat-free mass, free androgen index, anti-Mullerian hormone, and sex-hormone binding globulin. Meanwhile, HIIT showed benefits in fat mass, VO2 max, fasting insulin, and HDL cholesterol.
Ellie Jordan, a holistic health coach, emphasizes the metabolic benefits of resistance training:
"Specifically, strength training is a great way to make our cells more responsive to insulin and improve weight management – which is so crucial in a condition like PCOS".
For women with low cardiorespiratory fitness, resistance training may be a more approachable starting point. However, experts agree that combining strength training with vigorous aerobic exercise and dietary guidance yields the most comprehensive results. Research supports the idea that integrating both exercise types can significantly improve insulin sensitivity and androgen levels.
These findings provide valuable insights into how strength training can directly address key PCOS markers.
The best exercise for PCOS
How Strength Training Works for PCOS
To understand why strength training is so effective for managing PCOS, it helps to dive into the science behind it. Strength training tackles several core issues tied to the condition, delivering benefits that go beyond just physical fitness.
Improving Insulin Sensitivity
One of the biggest challenges with PCOS is insulin resistance, which affects about 75% of lean women with the condition and up to 95% of women with obesity. Strength training helps combat this by changing how muscles handle glucose. When you perform resistance exercises, your muscles demand more energy, triggering GLUT4 translocation - a process that boosts glucose uptake in muscle cells.
Here’s the catch: the improvement in insulin sensitivity from strength training starts to fade around 72 hours after your last workout. That’s why staying consistent - working out daily or at least every other day - is so important. Over time, building muscle mass adds an extra layer of support. Bigger, healthier muscles act like glucose sponges, helping to regulate blood sugar levels more effectively. These metabolic shifts also set the stage for better hormonal balance.
Reducing Androgen Levels
PCOS often comes with elevated androgen levels, or hyperandrogenism, which impacts about 80% of women with the condition. Strength training can help here, too. It increases levels of sex hormone-binding globulin (SHBG), a protein that binds to testosterone and reduces its availability in the bloodstream. Since high insulin levels can suppress SHBG production, improving insulin sensitivity through strength training indirectly supports hormonal balance.
Body composition also plays a role. Resistance training reduces central fat and increases lean muscle mass, creating a more balanced hormonal environment. Studies suggest that strength training can improve androgen levels in women with PCOS. Experts recommend combining vigorous aerobic exercise with resistance training for the best results in managing insulin sensitivity and hormone regulation.
Lowering Inflammation and Stress
Strength training doesn’t just balance hormones - it also helps reduce inflammation and stress, two common issues in PCOS. Many people with the condition show elevated levels of inflammatory markers like C-reactive protein (CRP). Regular resistance training has been shown to lower these markers, improving overall metabolic health.
On top of that, strength training can be a stress reliever. It triggers the release of endorphins, those feel-good chemicals that boost your mood. Plus, as your body composition improves, you may feel more confident, which can further reduce stress.
"Daily activity is important in glycemic control and vigorous aerobic exercise can help to also increase insulin sensitivity. Adding in some resistance training per week will also help as this increases metabolic activity which also improves insulin sensitivity." - Olivia Tyler, Personal Trainer and Fitness Manager
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Strength Training Guidelines for PCOS
Starting a strength training routine for PCOS doesn’t have to feel daunting. By following these evidence-based guidelines, you can balance hormones, improve insulin sensitivity, and build long-term fitness habits that support PCOS management.
Training Frequency and Intensity
For women with PCOS, incorporating strength exercises twice a week on non-consecutive days can help prevent weight gain and even support modest weight loss. Additionally, aim for 150–300 minutes of moderate aerobic exercise or 75–150 minutes of vigorous aerobic activity weekly. Alternating these with strength training sessions helps maintain metabolic health. If greater weight loss is your goal, consider increasing aerobic activity to 250 minutes per week at a moderate intensity or 150 minutes at a vigorous intensity.
For adolescents with PCOS, the recommendation is at least 60 minutes of moderate to vigorous physical activity daily, which should include muscle- and bone-strengthening exercises three times a week.
Incorporating a mix of exercise types can further enhance results.
Adding Other Types of Exercise
Strength training works best when paired with other forms of exercise. For example, a four-month study showed that combining aerobic and resistance exercises led to better menstrual regularity and reduced upper body fat. You can pair strength training with aerobic activities like walking or cycling and include flexibility-focused exercises like yoga or Pilates to aid recovery and reduce stress.
The key is to create a program that suits your preferences and lifestyle - there’s no one-size-fits-all approach.
Tips for Starting an Exercise Routine
When beginning a new exercise routine for PCOS, safety and sustainability are essential. Here are some practical tips to help you get started:
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Seek Professional Guidance
Consult with an exercise professional, such as a clinical exercise physiologist, who can assess your fitness level and create a tailored program using reliable screening tools. -
Start Slow and Build Gradually
Begin with low-impact activities like walking or yoga and slowly increase the intensity and duration of your workouts. As Illume Fertility advises:"Start slowly and do what you can. Don't overdo it or set sky-high expectations when you're just getting going. Building habits takes time!"
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Set Realistic Goals
Focus on consistency by setting achievable milestones, such as working out three times a week or completing a 10-minute routine. -
Prioritize Proper Form
Correct movement techniques are more important than lifting heavy weights. Proper form helps prevent injuries and maximizes the hormonal benefits of exercise. -
Warm Up and Cool Down
Dedicate 5–10 minutes to warming up with light cardio or dynamic stretches and finish each session with static stretches to promote recovery. Illume Fertility’s PCOS fitness routine suggests warm-up moves like walking in place, high knees, and jumping jacks, followed by exercises such as squats and arm circles, and ending with a proper cool down. -
Listen to Your Body
Pay attention to signs of fatigue or discomfort. Adjust your routine or take breaks as needed to ensure your program aligns with your body’s needs. -
Work with Your Healthcare Team
Collaborate with your healthcare providers to set realistic exercise goals that take your preferences and any limitations into account. This partnership can help you overcome barriers and stick to your routine long-term.
Telehealth Support for PCOS Management
Telehealth is transforming how Polycystic Ovary Syndrome (PCOS) is managed, especially when paired with strength training. By integrating lifestyle guidance and medical care into personalized plans, telehealth platforms make it easier than ever to access effective, evidence-based PCOS treatments.
Custom Treatment Plans
One of the key advantages of telehealth platforms is their ability to create tailored treatment plans that address specific PCOS symptoms, such as insulin resistance, weight management, hair loss, and unwanted facial hair. For example, Oana Health offers targeted solutions, like treatments for insulin resistance starting at $22/month and weight management plans beginning at $199/month. These plans are crafted by licensed medical professionals who consider each patient’s unique needs. Strength training recommendations can also be seamlessly incorporated alongside prescribed medications, ensuring a comprehensive approach to care.
Easy Access to Care
Telehealth eliminates many of the barriers associated with traditional healthcare, making it an ideal option for managing PCOS - an issue that affects an estimated 10–20% of women of reproductive age. With telehealth, patients can consult PCOS specialists from the comfort of their homes, avoiding challenges like scheduling conflicts, transportation issues, and long wait times. These platforms also provide prescription-based treatments with free shipping and offer regular follow-ups to monitor progress. This streamlined approach simplifies the management of multiple PCOS symptoms by consolidating care into a single, accessible platform. It also ensures that adjustments to both medical treatments and exercise routines can be made in a coordinated manner.
Combining Exercise with Medical Treatment
Strength training plays a critical role in enhancing the effectiveness of medical treatments for PCOS. For instance, women taking medications like Metformin for insulin resistance can gain additional benefits when strength training is part of their routine. The insulin-sensitizing effects of exercise can complement medication, potentially leading to significant improvements in treatment outcomes. Telehealth platforms are designed to adapt treatment plans based on these improvements - healthcare providers can adjust medications as insulin sensitivity improves through exercise.
PCOS is also linked to higher risks of mental health challenges, including depression and anxiety. Recognizing this, many telehealth services include mental health support. Oana Health, for example, offers Bupropion XL for $25/month to help address these concerns. When combined with the mood-boosting effects of strength training, this dual approach can significantly enhance overall well-being. To further support patients, telehealth platforms often involve exercise professionals, such as clinical exercise physiologists, who assess physical capacity and provide tailored exercise plans that align with medical treatments. This comprehensive care model ensures that both physical and mental health are addressed effectively.
Conclusion: Strength Training Benefits for PCOS
Strength training provides valuable support for women managing PCOS. This condition comes with unique challenges, such as insulin resistance, which impacts up to 95% of women with obesity and 75% of lean women diagnosed with PCOS. Resistance training directly addresses these issues and offers a practical alternative to high-intensity cardio, which can feel daunting for many women.
One standout benefit of resistance training is its ability to increase muscle strength, even without significant changes in body composition. While HIIT may be more effective at reducing testosterone levels and body fat, strength training reliably enhances hormonal balance and metabolic health. However, research in this area is still evolving, with experts highlighting the need for more robust and well-designed studies:
"There is a striking lack of studies in this field and, despite the reported statistical significance for many outcomes, the documented magnitude of changes are small and the quality of the evidence questionable. This highlights an unmet need for rigorously designed/reported and sufficiently powered trials." - Chris Kite, Elizabeth Parkes, Suzan R. Taylor, Robert W. Davies, Lukasz Lagojda, James E. Brown, David R. Broom, Ioannis Kyrou, Harpal S. Randeva
To maximize the benefits of exercise, the most effective strategy combines strength training with comprehensive medical care. PCOS, which affects around 5–15% of women and often begins in adolescence, requires early and proactive management. Platforms like Oana Health make this approach more accessible by offering personalized treatments for insulin resistance starting at $22/month, paired with exercise guidance from licensed medical professionals.
Evidence suggests that combining vigorous aerobic exercise with resistance training can significantly improve insulin sensitivity and androgen levels. When paired with targeted medical treatments for symptoms like hair loss, unwanted facial hair, or mental health challenges, this holistic approach can lead to meaningful improvements in both physical and emotional well-being.
FAQs
How does strength training improve insulin sensitivity in women with PCOS?
Strength training can significantly enhance insulin sensitivity in women with PCOS by increasing muscle mass, which is essential for regulating blood sugar levels. More muscle means your body can process glucose more effectively, lowering the demand for insulin and addressing insulin resistance.
For women dealing with PCOS, this improvement can promote better hormonal balance, boost energy, and help manage symptoms such as weight gain and cravings. Adding regular strength training to your routine isn't just about fitness - it's a practical way to support metabolic health and feel better overall.
What’s the best way to balance strength training and cardio for managing PCOS symptoms?
When it comes to managing PCOS, incorporating a mix of 150–250 minutes of moderate to vigorous aerobic exercise each week alongside 2–3 strength training sessions can make a big difference. Strength training not only boosts insulin sensitivity but also helps maintain hormonal balance and supports muscle health. Meanwhile, cardio plays a key role in managing weight and improving heart health.
The key is to find a routine that suits your fitness level and personal goals. Start with activities you genuinely enjoy, and gradually build up from there. Before beginning any new exercise program, it’s always a good idea to check in with a healthcare professional to make sure it’s the right fit for your needs.
What should women with PCOS keep in mind when starting a strength training routine?
For women managing PCOS, starting strength training should be a gradual process. Jumping in too quickly can lead to overexertion, which might upset hormonal balance. Taking rest days is just as important as the workouts themselves, giving your body the time it needs to recover and avoid burnout.
To get the most out of your routine, consider combining strength training with moderate aerobic exercises and activities that help reduce stress, like yoga or meditation. These additions can provide a well-rounded approach to improving overall well-being.
And remember, before diving into any new fitness plan, it’s always smart to check in with a healthcare professional. They can help ensure your routine aligns with your personal health needs and goals.
