woman exercising in pain

Exercise for PCOS: “How I learned to work out with polycystic ovary syndrome”

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Writer Katie Baskerville was diagnosed with PCOS (polycystic ovary syndrome) but learned how exercise could help her deal with symptoms such as bloating, inflammation and fatigue. 

In the UK, 1 in 10 women has Polycystic Ovaries Syndrome (PCOS), a condition affecting the ovaries in people assigned female at birth. From bloating and inflammation, to weight gain and fatigue – symptoms that can make exercise feel stressful.

It’s a catch twenty-two for many PCOS sufferers when it comes to working out. Exercise helps alleviate symptoms, but sufferers are often demotivated by flare-ups. The effects on mental health can be profoundly inhibiting too.

My journey with PCOS has been gruelling, to say the least. When I came off hormonal contraceptives in my mid-twenties, I began experiencing mild PCOS symptoms such as bloating, weight gain and joint pain. I found myself sapped of energy or tentatively caring for swollen joints. My friends and doctor would nod knowingly at me as I complained about my periods and sore joints, but I was never diagnosed. 

I knew that my body was suffering but it wasn’t until year later, in 2019, that I suffered a miscarriage and was finally diagnosed with having PCOS.

Difficult as it was, I was relieved to finally know what had been affecting my health. It took a moment to catch my breath but eventually, I found the strength to make life changes and began researching how I could better my lifestyle to counteract my symptoms.

I learned that for people with PCOS, having balance is everything. Ultimately, it’s about knowing when to move, how to be gentle and prioritising recovery and relaxation. Most importantly, that there’s no one-size-fits-all treatment for someone with PCOS.

“A mindful balance of mind and body, with a focus on breathing, is known to reduce the cortisol levels associated with stress, anxiety and depression,” says Claire Sparrow, pilates teacher trainer and pelvic health specialist.

Stress is a body-function disrupter. The brain, smart as it is, can’t tell the difference between physical stress and emotional stress. The adrenal gland goes into overdrive and keeps you in survival mode, which exacerbates internal inflammation, inhibits the immune system and can even damage brain cells. Medically this is known as ‘sympathetic state’, something Claire warns me about.

“Getting stuck in a sympathetic state is known to affect fertility, sleep, digestion, blood pressure and inflammation – so anything you can do to avoid this and be in your parasympathetic nervous system instead will give you a greater chance of reducing PCOS symptoms.”

Dr Kinza Younas, gynaecologist and reproductive medicine and fertility specialist, notes how important it is to focus exercise efforts around the central area. Having excessive weight around the core can disturb hormones and increase the risk of ‘Unopposed Estrogen Effect’.

“In PCOS, the hormones are disturbed. These disturbances increase the risk of diabetes, high cholesterol and heart disease. The condition also affects the metabolism of glucose. If not managed with a balanced diet and exercise, it can lead to a metabolic syndrome.”

To combat this, Dr Kinza recommends building stamina to increase strength and intensity. “It takes regular effort daily”, Dr Kinza tells me, “and the effort needs to be sustainable. Start slowly with 15 minutes of exercise and build up to 30 minutes.”

woman lying in bed in pain
Exercise for PCOS: Dr Kinza recommends building stamina to increase strength and intensity

EXERCISES THAT CAN HELP WITH PCOS

Yoga & pilates 

Try incorporating mellow practices such as pre-pilates or beginners yoga. Both involve gentle restorative movements that align your pelvis, mobilise your hips, spine and ribs, reduce pelvic pain, and improve breathing capacity and pelvic floor function.

“The pelvic floor muscles are important because they work with the abdominal muscles, deep back muscles and the diaphragm to create support for all the pelvic organs, including the all-important uterus,” Claire tells me. “If these become unsynchronised, it can affect the function of your pelvic floor, pelvic organs, circulation and hormones”

Plus, yoga can help to reduce bloating caused by PCOS. PCOS Fitness Coach Emma Krishnaswami explains, “The important thing with bloating is to stretch, twist, and elongate the abdominal muscles to get the blood flowing and trapped air moving, working with exercises that strengthen trunk control and then staying in stretching positions that release the core and pelvic muscles” 

HIIT + Weight Training

High-intensity exercises might feel counterintuitive, but Krishnaswami tells me that it’s all about understanding the body’s limits.

“The stress tolerance of this type of exercise varies from person to person,” she explains.

“You have to ask yourself if you can bear it emotionally and physically. If the exercises cause dread to the point of depression, the workout will do more harm than good.”

However, this doesn’t mean that HIIT needs to be abandoned. “Before you decide to scrap it, try modifying to simpler exercises, or doing it for less time. If it’s still unbearable, then replace it with simple, lightweight training,” Krishnaswami encourages. “The key is breath awareness. Don’t do it too often – once or twice a week is fine – and never for consecutive days.”

Stationary lunges, jump-free burpees and light resistance band punches are an excellent alternative to strengthening without high-impact. The key to a successful HIIT workout if you have PCOS, is to stretch before and after. Krishnaswamy recommends full-body foam rolling 2-3 times a week if joint pain persists.

Cardio

Cardio significantly improves circulation, breath capacity and helps prevent heart disease. However, overdoing it can lead to fatigue.

“You want to work at a pace that you can easily maintain for 30-60 minutes, and that gets your heart rate up. You should still be able to hold a conversation at this pace,” says Krishnaswami.

Swimming, cycling and walking are all excellent ways to practice low-impact cardio.

PREVENTING BURNOUT

“Practice mindset check-ins before and after your workouts,” suggests Krishnaswami. “Create mental space for ‘you’ time, an island away from the rest of your life. It will still be there when you’re done, but you can separate your stressors from your workouts to approach each movement with presence – and without ‘baggage’ weighing you down.”

Dr Kinza states that “we cannot fully escape stress, it’s a part of life. However, we can manage our susceptibility to its effects through regular exercise. Practising self-compassion is also key. Having PCOS is nobody’s fault. It’s not easy, but continuous hard work will pay off.”

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IMAGE: Getty 

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