10% of us live with PCOS but not many of us know that exercise can impact on how severe our symptoms can be. Slow, soothing yoga can help to reduce inflammation, calm the mind and help lower certain hormones, as writer Robyn Schaffer explores.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, with the NHS suggesting that as many as one in 10 might have it. Despite how common it is, however, relatively little is known about PCOS and how best to manage it – including exercising to soothe symptoms.
PCOS is caused by an imbalance of reproductive hormones in the body, which can result in things like missed or irregular periods, the development of cysts on the ovaries and even infertility. It causes your ovaries to produce an excess of male hormones (androgens), and so some of the more visible symptoms of PCOS include things like excess hair growth (for example, on the face and chin), acne, weight gain and skin discolouration. “These symptoms can cause stress, anxiety and even depression,” says Dr Tania Adib, a consultant gynaecologist and resident gynaecologist at Callaly. Dr Adib explains that this stress can contribute to a “vicious cycle” by prompting the production of ACTH, a hormone that stimulates the secretion of the stress hormone, cortisol. “PCOS is generally a state of insulin resistance,” Dr Adib adds. “And cortisol doesn’t help with this. It can make people even more insulin resistant and worsen the symptoms of PCOS.”
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How can exercise help?
Managing cortisol levels is an essential part of living with PCOS. For the most part, this can be done by making changes to your lifestyle and there’s particularly good evidence to show that exercise can help, according to Dr Adib. She says: “In addition to increasing your metabolic rate, managing your weight and elevating your mood, (the right kind of exercise) drives down those hormones and helps reduce cortisol levels.”
Low-impact exercises like yoga, in particular, can be effective. In a recent study, participants with PCOS who did a one-hour yoga class three times a week for three months found their testosterone levels reduced by 29%. Dr Nitu Bajekal, a gynaecologist with over 35 years’ experience in women’s health, adds: “Yoga is good for PCOS because anxiety, depression and mood disorders are a big feature and yoga forces you to focus on your breath and being present, which can decrease that anxiety. Prolonged, high-intensity exercise can cause a spike in cortisol and you want to bring your levels down, not up.”
So, while it might not be a great idea to dive straight into a sweaty power vinyasa class, the good news is that there are a handful of gentle yoga poses that can help with some of the symptoms of PCOS and you can try them just about anywhere.
7 yoga poses for PCOS
1. Cat-cow (marjariasana)
Cat-cow is a staple in most yoga classes. “It’s brilliant for spine mobilisation,” says Louise Premilla, a yoga teacher who specialises in teaching yoga to people with long-term health conditions. “It’s helpful for PCOS because it increases blood flow and circulation in the pelvic region. It’s also a way to link the mind and body as you have to focus on matching your breath to your movement.”
- Get into a tabletop position on your hands and knees. Keep your hands directly underneath your shoulders, your palms flat on the ground and push away from the floor. Your knees should be hip-width apart.
- Look straight ahead. As you inhale, raise your chin, tilt your head up and arch your back so your navel is pointing down to the floor and your tailbone is raised.
- As you exhale, drop your chin to your chest and arch your back up as far as you can, creating a dome shape.
- Continue slowly for up to one minute.
- If you have any knee pain, place a towel or blanket underneath them for added support.
- If you have any discomfort in your wrists, make a fist instead and place your knuckles on the floor. This will keep your wrists in line with your elbows and shoulders.
2. Folded butterfly (baddha konasana uttanasana)
This is another pose that increases blood flow to the pelvic region while also releasing tension. “We often hold tension in our hips,” Louise says. “Because this is a hip opener and you’re getting that external rotation, it promotes more openness and relaxation.”
- Come to a seated position on the floor. Bring the soles of your feet together and your heels out in front of you so your legs create a diamond shape, and your knees fall out to the side.
- As you inhale, sit up tall and straighten your back as much as you can.
- As you exhale, fold forwards from the hips, keeping your back as straight as possible. You can reach your arms out in front of you, placing your hands on the floor, or hold onto your ankles. Stay here for a few breaths.
- As you inhale, come to sit up straight again and repeat up to 10 times.
- Sit on a towel or blanket to support the hips and give the spine extra height.
- You can also place a yoga block or something similar under your knees for extra support.
3. Seated spinal twist (ardha matsyendrasana)
“This will help you focus and be present because you have to concentrate on lifting up and drawing the core in,” Louise says.
- Start seated with your legs stretched out in front of you. Bend your right leg so your knee points up to the sky and place the foot on the outside of the left knee.
- Bend and fold your left leg in front of the body so the heel touches the side of your right buttock, or keep the left leg extended in front of you.
- As you inhale, place your left arm against the outside of your right thigh, bringing your upper body towards the right thigh and twisting towards the right. Place your right hand on the floor behind you to support yourself.
- As you exhale in this position, twist further to face behind you. Use the left elbow to help you deepen the twist. Keep the spine as straight as possible.
- Stay here for a few breaths or, to come out the pose, slowly undo the twist on an inhale. Repeat twice on each side.
- For a less intense variation, use both hands to bring the bent knee towards your chest, hugging it in to help you twist round.
4. Boat (navasana)
“This requires core strength and concentration which will bring you into the present moment,” Louise says. Boat pose is also great for PCOS because it challenges the abs and spine, builds strength, helps maintain metabolism and relieves stress.
- Start seated with your knees bent and feet flat on the floor, hands beside your hips.
- Keeping your spine straight, lean back slightly and lift your feet, bringing your shins parallel to the floor.
- Then, lifting your chest and lengthening your torso, extend your arms forward in line with your shoulders.
- Balance on your sit bones, taking care not to let your lower back or chest collapse. Focus on keeping your breath smooth, slow and even.
- Stay in the pose for a few breaths before slowly releasing.
- Repeat twice more.
- Keep your hands on the floor while you lift your legs above the ground to assist with your balance.
5. Churning the mill (chakki chalanasana)
“This is another great hip opener,” Louise says. “It’s also good for linking breath to movement, your heart rate variability and relaxation response.”
- Sit on the ground with your legs spread out in front of you. Sit up straight, clasp your hands and outstretch your arms at shoulder height in front of you.
- As you inhale, start slowly moving your upper body to the front and right, making an imaginary circle with your body. Exhale as you move to the back and left.
- Repeat to the right up to 10 times before doing the same thing in the opposite direction. (Tip: Bend forward from the hips – not the back – and keep your legs as straight as possible)
- If you have any knee problems, place a rolled-up towel or blanket underneath them for extra support.
- Keep your hands on your hips as you rotate if holding them out in front of you causes any discomfort.
6. Cobra (bhujangasana)
“Cobra gives you a nice stretch in the abdominals,” Louise says. “You’re also building the back muscles and increasing relaxation in the muscles in the front of the body.”
- Lying on your front, place your palms flat on the ground directly underneath your shoulders. Hug your elbows into your sides.
- Looking down at the ground, keep your neck in a neutral position. As you inhale, lift your chest off the floor. Roll your shoulders back and keep your lower ribcage on the floor. Continue hugging your elbows into your sides and keep your gaze to the floor. Stay here for a few breaths or come straight down.
- Release to the floor as you exhale. Repeat up to 10 times.
If you’d like to take this further, try:
- Hovering your palms above the floor or
- Keeping the palms on the floor but straighten your arms out in front of you.
Both of these variations will create a more intense backbend and more of a challenge for your back muscles.
7. Bow (dhanurasana)
Bow helps stimulate energy flow in your internal organs. Louise says: “This is similar to cobra, but with the added quad stretch. Some people also like to rock backwards and forwards in bow which can add a massage dynamic to the posture.”
- Start by lying on your front with your arms alongside your torso. Bend your knees, bringing your heels as close as you can to your buttocks. Reach back with your hands to take hold of your ankles.
- Inhale and lift your heels away from your buttocks and at the same time lift your thighs away from the floor. This will pull your head and torso away from the floor too. Push your pelvis into the floor and draw the shoulders away from your ears. Look forward.
- Stay in the pose for up to 30 seconds, keeping your breath slow and steady, before releasing as you exhale.
- Repeat up to 5 times.
- If you aren’t able to reach your ankles, try placing a rolled-up towel or a blanket under your legs for an extra boost.
- A partner can also assist you by gently helping move your hands to your ankles.
- Alternatively, try lifting one leg at a time, keeping the opposite hand on the floor and using it to help you push your torso off the ground.
Keen to improve your form? Check out our How To library to see exactly how the experts do over 100 of the most common strength training exercises.