When it comes to movement and PCOS (now also called PMOS), finding the right balance is key.
Both too much and too little exercise can worsen PCOS symptoms.
In this article, we’ll cover how to work out if you are over or under exercising as well as the best form of exercise for PCOS.
A PMOS/PCOS workout plan you can use this week
Here is a week built from the principles below. If exercise is new to you, do half of it and build from there.
- Two 20-minute strength or bodyweight sessions, on days that are not back to back.
- A 30-minute walk on most other days, at a pace where you could still hold a conversation.
- One full rest day, and a second if your sleep or energy asks for it.
Strength training for PMOS/PCOS: your two sessions
My own 14-minute bodyweight sequence is further down. If you would rather lift, do 8 to 12 repetitions of each exercise, two or three times through, and add weight or a repetition when it starts to feel easy. Session A: squats, push-ups on your knees, a row, a plank hold. Session B: lunges, a hip hinge (stand tall, push your hips back and fold forward with a flat back), a shoulder press, a side plank. Warm up and cool down with a few minutes of easy movement.
If you are pregnant or have recently had a baby, get the plan cleared with your doctor or physiotherapist first.
Are you overdoing exercise?
Over exercising can be harmful for all root causes of PCOS/PMOS.
An interesting study found that moderately-high to high intensity exercise (such as a spin or HIIT class) increased cortisol levels, whereas low intensity exercise lowered cortisol[1].
Higher cortisol levels trigger your adrenal glands to release excess DHEAS which in turn increase the symptoms of PCOS like acne, hair changes, and irregular cycles.
For the 80% of Cysters with Insulin-Resistant PCOS, this is an issue because high cortisol levels trigger your body to release glucose into your bloodstream.
If, like many of us, you spend the majority of your day sitting at a desk, this extra glucose isn’t used by your muscles.
Having too much glucose sitting in your blood is dangerous, so your body increases its production of insulin to bring the levels down.
Over time, this can worsen insulin resistance as well as increase inflammation.
So how do you know if you are overdoing exercise?
Look at how quickly you recover after finishing a workout or session.
You should recover and feel more energized within 30 minutes.
If you feel more fatigued, this is a sign that you overdid it.
When one of my clients, Sammi, first came to see me she proudly announced that she worked out so intensely that she would collapse on the couch or need to take a nap afterward.
Exercising to fatigue is not a sign of a “good” workout and is not sustainable.
The other telltale sign is changes to your sleep.
If you notice you take longer than 20 minutes to fall asleep at night, wake frequently through-out the night, or wake up feeling unrefreshed even after enough hours in bed, this is a sign that your stress hormones may be out of whack.
Try reducing the intensity of your exercise for a few days whilst keeping your other habits similar to observe if your workouts might be impacting your sleep.
Is HIIT bad for PCOS or cortisol?
No. For most of us it is one of the most useful ways to train, as long as you recover from it.
A single HIIT session raises cortisol for about an hour, and in pooled trials of healthy participants those levels came back to baseline within a day[2]. That is the normal shape of a response to hard work.
The exception is Adrenal PCOS with very high stress levels: skip HIIT for now, or keep it under ten minutes while your stress hormones recover. And whatever your type, if you do not feel more energised within 30 minutes of a session, it was too hard for you that day.
Are you getting enough exercise?
Getting some form of movement into your week is important for improving insulin resistance, lowering inflammation, and keeping stress hormones at bay.
Current exercise guidance for PCOS recommends 150 to 300 minutes a week of moderate intensity physical activity, or 75 to 150 minutes of vigorous intensity, or an equivalent combination, plus muscle strengthening activities on two non-consecutive days a week[3].
This could be a 15-minute walk to and from your car or the train station each work day, plus some simple squats and lunges twice a week at home.
If exercise is new for you, start small and build from there.
The “best” exercise for PMOS/PCOS
Despite what you might have heard from influencers, there is no one “perfect” exercise for PCOS.
The best exercise plan for you is the one you actually enjoy and will keep on doing.
Remember that to control your PCOS symptoms, you will need to follow the PCOS Repair principles for the rest of your life, not just a few weeks.
We are creating sustainable habits that you can stick with, instead of just another fad you can’t sustain.
Taking the time to experiment with different forms of movement is important in determining what works for you.
If you are open to different types of exercise and would like to maximize your results, I have found my clients have great results with a combination of HIIT or strength-based exercises plus low intensity movement.
This might look like two or three 20-minute HIIT/body-weight sessions per week, plus a 30-minute walk or cycle most days.
It might be more or less than this based on your root cause, your current fitness level, and your schedule.
For Adrenal PCOS with very high stress levels, you might like to skip HIIT sessions for now, or keep them to under ten minutes while your stress hormones recover.
HIIT exercise involves short bursts of high intensity exercise, lasting around one to four minutes, followed by a short period of recovery.
A total HIIT workout, including a warmup and cooldown usually lasts around 20-25 minutes and can be completed from home, a park, or even a spare meeting room in the office.
Many of my busy clients find that squeezing in a short HIIT session at a time that works for them is much more doable than trying to make a class at the gym or committing to a long walk or run.
It can be a great way to give you a quick burst of energy to break up your day.
You can follow a guided workout video or create a simple series of exercises using your own bodyweight.
It doesn’t have to be complicated or fancy.
For example, you could complete one minute each of squats, pushups on your knees, jogging on the spot, and a plank hold with a 30-second rest in between each exercise, and repeated twice.
With a minute of warming up and cooling down on either side, this whole sequence would take just 14 minutes but would increase your heart rate, boost your metabolism, and get lots of different muscle groups firing.
Contrary to popular belief, short HIIT-style workouts have been shown to be as effective at improving cardiovascular health and aerobic capacity as endurance-based cardio exercise (such as jogging or cycling)[4].
This style of movement also has the added benefit of increasing your muscle’s sensitivity to insulin, so is arguably more beneficial for women with PCOS.
A review of the trials that compared exercise types head to head in PCOS found HIIT and steady, moderate exercise gave comparable results for weight, metabolic and hormonal outcomes[5].
So if you know that you don’t enjoy HIIT workouts and love a longer jog, swim, or bike ride, then stick with it!
The best form of exercise for your PCOS is the one that you will stick with in the long run.
"So long as you feel energized afterward and aren’t noticing negative impacts on your sleep, keep up any form of movement that makes you feel good."
Bonus points if you can tie your exercise to something you look forward to such as a catchup walk with a friend or dancing to your favorite music.
Do I need to change the plan for my root cause?
Yes.
Adrenal PCOS: your stress hormones are already the problem, so the hard sessions come down until they recover, and walking and strength carry the week. Insulin-Resistant PCOS: strength work is doing something your body needs, so protect those two sessions first. Inflammatory and Post-Pill: moderate intensity, high consistency, while the rest of the protocol does its work.
If the adrenal picture is keeping you awake at night too, I created Calm + Sleep because I know what it's like to dread bedtime: ashwagandha with magnesium bisglycinate, chamomile, passionflower, tart cherry and L-theanine, two capsules about 30 minutes before bed. Leave it out if you are pregnant, breastfeeding or trying to conceive, and if you take a sleep aid, a sedative or another regular medicine, check with your pharmacist first.
My free root cause quiz tells you which one you are working with, and The PCOS Repair Protocol has the full plan for each.
Incidental movement for the win
Some of the best forms of exercise to lower cortisol and inflammation and improve insulin resistance are low-intensity exercises like walking, gentle swimming, gardening, and playing with your kids.
Aim to include as much of this in your day as possible. If you work at a desk, consider trialing a standing desk.
Organize walking meetings or catch ups with friends. Park further away.
Or take a walk around the block on your lunch break.
Let go of exercising to lose weight
For most of my life, I equated exercise with losing or maintaining my weight.
If your PCOS diagnosis was anything like the majority of Cysters I’ve met, you were probably told to “eat less and exercise more.”
You likely found that exercise wasn’t working, so you worked out harder and for longer, still with no results.
It’s no wonder working out has a negative connotation for so many Cysters.
It’s time to let the calories in, calories out equation go.
This doesn’t apply for PCOS.
When your root cause is ruling your body, it is almost impossible to lose weight, even when you are in a calorie deficit.
By working on lowering your insulin, cortisol, and inflammation, you’ll be able to move your body out of a place of danger and into one of safety.
Once your body systems are working in harmony again, you will find weight loss is far more achievable.
For a deep dive into weight loss in PCOS, the weight-loss chapter of The PCOS Repair Protocol takes you through it properly, and the audiobook carries a bonus chapter on it.
Can’t start exercising? Try these three tricks
Sometimes getting into a routine with regular exercise can be really hard, even when you know it is helpful for your PCOS.
Try these three simple tricks that have helped many of my clients:
Pack your bag the night before
It sounds trivial, but getting organized before going to bed at night can really help with motivation the next morning.
If you are going to a gym class, pack your bag so you can grab it and go before letting the excuses creep in.
If you exercise at home, lay your shoes and socks out next to your mat, fill a water bottle and decide on the routine you’ll follow so you can simply hit play and get started.
The five-minute rule
The five-minute rule is a technique used in cognitive behavioral therapy to help with procrastination.
You can use this in any area of your life where you struggle to get started, but it works particularly well with exercise.
If you just can’t start your workout because the idea of a full 20 minutes seems overwhelming, tell yourself you only have to commit to five.
Do just the first five minutes of a workout and then stop and assess.
Do you think you could do another five?
99% of the time, you’ll find that once you get going and the endorphins start flowing, you’ll be able to keep going.
If after the first five minutes you genuinely feel too tired to keep going, honor that.
Your body knows what’s best.
Exercise snacking
This technique works well if you genuinely don’t have time to exercise because of your schedule.
Instead of a formal exercise practice, try adding “snack sized” bursts of exercise throughout your day.
For example, while you are waiting for the kettle to boil, do ten squats.
While in the lift, do five calf raises (rise up from flat feet onto your toes and back down again).
When you’re on the phone, march on the spot or walk around the meeting room.
How to judge whether your PMOS/PCOS plan is working
Give it six weeks, then look at four things: how you feel 30 minutes after a session, how you sleep, whether your cycle is steadier, and whether the sessions are still happening. Weight goes last.
If every workout flattens you and your sleep is broken, pull the intensity back for a fortnight. If nothing moves after that, take it to your doctor, because persistent exhaustion has causes worth ruling out; my guide to PMOS/PCOS fatigue lists the tests to ask for.
References
- Hill 2008: Exercise and circulating cortisol levels: the intensity threshold effect
- Dote-Montero 2021: Acute effect of HIIT on testosterone and cortisol levels in healthy individuals: A systematic review and meta-analysis
- Sabag 2024: Exercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia
- Gaesser 2011: High-intensity interval training for health and fitness: can less be more?
- Colombo 2023: Comparison of selected exercise training modalities in the management of PCOS: A systematic review and meta-analysis to inform evidence-based guidelines
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