Picture of Female ovaries.

Polycystic Ovary Syndrome (PCOS): The Best Exercise Tips

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Polycystic Ovary Syndrome (PCOS), is a condition that can affect a woman’s hormone levels. This can often result in ovarian cysts, irregular menstrual periods, and hair on the face and body. In someone with PCOS, higher-than-normal amounts of male hormones are produced and can cause the body to skip periods and increase the difficulty of getting pregnant.

PCOS Incidence?

PCOS affects women during their childbearing years (~15-44yrs) and can affect between 2.2-26.7% of women in this age group. 1

PCOS is a “syndrome,” or a group of symptoms and has 3 main charateristics:

  • Cysts in the ovaries
  • Higher than normal levels of male hormones
  • Irregular or skipped periods

What are the Symptoms?

There are a variety of common symptoms for PCOS but some of the main symptoms include:

  • Irregular Periods – a lack of ovulation can prevent the uterine lining from shedding every month.
  • Heavy Bleeding – because of the reduced amount of uterine lining shedding, the lining can build up over longer periods of time and cause heavier than normal periods.
  • Hair Growth – more than 70% of women with PCOS grow hair on their face and body – this excess hair growth is called hirsutism.
  • Acne – male hormones can contribute to making the skin oilier than normal.
  • Weight Gain – up to 80% of women with PCOS struggle with excessive weight gain.
  • Male Pattern Baldness – hair on the scalp can get thinner and fall out.
  • Darkening of the Skin – dark patches of skin can form.
  • Headaches – hormone changes can trigger headaches in some women

How Can Exercise Help With PCOS Management?

Exercise is an effective tool for the treatment and management of PCOS symptoms as well as the reduction of other comorbidities developing.

Insulin Action and Reducing the Risk of Diabetes: Regular physical activity enhances insulin sensitivity and glucose uptake by muscles, significantly lowering blood sugar levels and reducing the risk of type 2 diabetes (Colberg et al., 2016). 2

Weight Gain Prevention: Exercise increases energy expenditure and boosts metabolism, helping to prevent weight gain and obesity, key factors in reducing diabetes risk (Swift et al., 2014). 3

Emotional Wellbeing: Physical activity stimulates the release of endorphins and neurotransmitters like serotonin, which improve mood and reduce symptoms of depression and anxiety (Craft & Perna, 2004). 4

Energy Levels, Motivation, and Self-Confidence: Regular exercise improves cardiovascular efficiency and mitochondrial function, leading to higher energy levels, enhanced motivation, and increased self-confidence (Puetz, Flowers, & O’Connor, 2008). 5

Period Regularity: Exercise helps regulate hormonal balance and reduces insulin resistance, which can lead to more regular menstrual cycles (Goodman et al., 2014). 6

Fertility: By lowering insulin resistance and reducing body fat, regular physical activity can improve ovulatory function and fertility, particularly in women with PCOS (Thomson et al., 2010). 7

Fitness, Muscle Endurance, and Strength: Resistance and aerobic training increase muscle mass, strength, and cardiovascular endurance, enhancing overall physical fitness and performance (Garber et al., 2011). 8

What Type of Exercise is Best?

Aerobic Exercise

The evidence investigating the effects of aerobic exercise relating to improved reproductive function in people with PCOS is limited in nature. There are only a few small studies that have been conducted with small sample sizes, and relatively short durations. Therefore, there is low-certainty of evidence that exercise alone can produce changes in reproductive hormones/reproductive capability of individuals with PCOS

However, the benefits of aerobic exercise on body composition, cardiovascular fitness and management of other comorbidity is positive. There is a moderate-certainty of evidence that exercise alone can have a positive effect on body composition.

Women who want to maintain their health and an ideal weight should aim for:

  • 150 minutes of moderate intensity activity per week
  • or 75 minutes per week of vigorous intensity exercise

Women who need to improve their health or promote weight loss should aim for:

  • 300 minutes per week of moderate intensity activity per week
  • or 150 minutes per week of vigorous intensity exercise per week

Resistance Training

Strength training for PCOS can be a great form of exercise. Strength training has numerous benefits including reducing insulin resistance. Many PCOS symptoms are related to insulin resistance resulting in uncontrollable appetite, cravings, exhaustion, abnormal hormones, and difficulty losing weight.

One of the body’s major consumers of glucose are the muscle cells. When strength training, the body is encouraged to rebuild and grow new muscle cells. This in turn provides a greater density of cells for absorption of glucose in the body and better management of blood sugar levels.

In addition, the post-exercise effect causes an increase in insulin-sensitivity. Increased sensitivity decreases the requirement of the pancreas to release high levels of insulin.

Furthermore, strength training can cause a reduction in the male hormones that are higher in those with PCOS (androgens). These hormones are often involved increased facial hair, belly obesity, hair loss and acne. Strength training regularly can help lower androgen levels and maintain these symptoms.

Summary

In conclusion, PCOS, affecting a significant percentage of women during their childbearing years, manifests through a variety of challenging symptoms such as irregular periods, weight gain, hirsutism, and more. Effective management of PCOS symptoms can be significantly aided by regular exercise. Aerobic exercise enhances cardiovascular fitness, aids weight management, and improves overall health, while resistance training helps in reducing insulin resistance and managing symptoms related to elevated male hormones. By integrating both types of exercise into their routines, women with PCOS can achieve better hormonal balance, improved fertility, enhanced mood, and greater physical fitness, thus leading a healthier, more balanced life.

References

  1. https://www.intechopen.com/chapters/48078
  2. Colberg, S. R., et al. (2016). Physical activity/exercise and diabetes: A position statement of the ADA. Diabetes Care, 39(11), 2065-2079.
  3. Swift, D. L., et al. (2014). The role of exercise in weight loss and maintenance. Prog Cardiovasc Dis, 56(4), 441-447.
  4. Craft, L. L., & Perna, F. M. (2004). The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry, 6(3), 104-111.
  5. Puetz, T. W., et al. (2008). Effect of aerobic exercise on energy and fatigue. Psychother Psychosom, 77(3), 167-174.
  6. Goodman, N. F., et al. (2014). AACE guidelines for hyperandrogenic disorders. Endocr Pract, 17(Suppl 2), 1-53.
  7. Thomson, R. L., et al. (2010). Effect of diet and exercise on reproductive function in overweight women with PCOS. J Clin Endocrinol Metab, 93(9), 3373-3380.
  8. Garber, C. E., et al. (2011). Guidance for prescribing exercise. Med Sci Sports Exerc, 43(7), 1334-1359.
  9. Dos Santos, I.K. et al. (2020) The effect of exercise as an intervention for women with polycystic ovary syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220722/ (Accessed: 12 June 2024).
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