By: Dr. Jillian Sarno Teta
Many ladies with PCOS don’t realize that they are inadvertently worsening or locking in their PCOS symptoms with their exercise routines. The hallmarks of PCOS – androgen imbalance, insulin resistance and metabolic dysfunction stemming from shifts in brain signaling – are greatly influenced by the hormonal impacts of exercise, for better or for worse.
While there are many aspects to PCOS management, in this blog we will specifically explore the role of exercise.
Everyone knows exercise is important, right? Maybe 😉 The subtlety of how we exercise is extremely important, particularly when it comes to hormonal imbalance, and most particularly, when it comes to the influence of stress hormones on reproductive hormones and insulin sensitivity.
In other blogs, the disruption of brain chemistry and stress signaling, and how that negatively impacts insulin and androgen production and function, is discussed in depth. HERE, HERE, HERE, and HERE For today, there are but three things to think about: something to increase, something to decrease, and something to play with.
Sometimes, it is possible to exercise yourself into PCOS. In fact, we often see this in our clinic with female endurance athletes. The reverse is also true, you can use exercise to back out of it as well.
Over exercising, not taking enough rest, or utilizing too much medium intensity, medium-to-long duration exercise is a surefire way to increase the amount of stress hormones in your body. Jogging for more than 30-40 minutes, hour long aerobics, spin classes, massive bike riding excursions and similar increase your resting levels of cortisol and adrenaline.
Left unchecked and unopposed, these hormones are free to go on and disrupt the balance between your brain, your adrenals, your pancreas and your ovaries. This worsens a major contributing factor of PCOS, and the effect is most enhanced in women who do a lot of cardio.
The good news is, that if exercise can make things worse for us, it can also be used to make things better.
Three things to do:
Go for your morning walk.
Take a stroll, each morning or most mornings. Whether it is 5 minutes or an hour, it doesn’t much matter, to start. As you walk, notice what is immediately in front of you. Engage your senses. Feel the air and the sun on your skin, on your face. Listen to the birds or bugs or cars or people. Look at the grass or the woods or the pavement or the flowers or your hands on the dog you are walking with or whatever happens to be right there. Adopt an easy pace. Stroll as if you’d like to smell the flowers.
When your mind gallops away, as it inevitably will, bring your awareness back to what is right in front of you.
This is walking meditation. This is how we slow down time exactly to the present moment – not projecting into the future, not ruminating about the past – here, now, in reality in the truest sense.
By engaging your senses (I call it sense drenching), you fully inhabit yourself.
Several years ago, I did the 9-day School for the Work, hosted by Byron Katie. It was here I learned of the transformative power of a meditative walk. Each morning, Katie would have us walk, and offered similar instructions to us: notice what is in front of you.
This week and a half was an in-depth look inward at many of my own dysfunctional belief and thought patterns, the many tricky ways I stressed myself out. Through the walks, I was able to notice these themes and see them for what they were – lies, untruths, stories I had bought into, patterns unconsciously adopted, deflections of responsibility, etc. If one can see a thing for what it is, without defense or justification or excuse or without catching ourselves on our emotional hooks, the emotional charge is reduced. What do you think that does to your levels of cortisol and other stress hormones?
The daily walk is not all woo-hoo hippie mumbo-jumbo. Research demonstrates the stress-reducing, cortisol-blunting benefits of walking, particularly in nature. The Japanese even have a name that sounds wonderful: Shinrin yoku, translated to “forest bathing.” Doesn’t that sound lovely?
Reduce medium intensity, medium-to-long duration cardio.
I understand that many women are reluctant to give up any of their cardio. Many use this form of exercise for the endorphin hit, and many use it to maintain their waistline. The benefits of cardio are undeniable – but in a woman with PCOS, they are more than offset by the worsening of the hormonal imbalance that generates and maintains symptoms.
To start, shave off one session per week. Replace it with a walk, a restorative yoga session, or a mindful movement/breathing practice like tai chi or qi gong. Replace it with a weight training session, downtime, or time spent doing something that you love.
After two weeks, eliminate another session. Continue on this schedule until you are at one or zero sessions weekly.
Consider changing your exercise routine.
Your body is amazingly adept at getting acclimated to the types and volumes of physical work you subject it to. This acclimatization can also reinforce dysfunctional hormonal signaling. Thus, to best keep your metabolism responsive by keeping it on its toes, you will want to swap up your exercise every month to month and a half.
If you’ve been doing short exercise sessions with lots of hybrid movements, swap to slower, longer, more body-builder style workouts. If you’ve been doing lots of CrossFit or MetCon (metabolic conditioning) workouts, cycle into body part splits.
Weight training provides a sink for blood sugar, improves insulin sensitivity, can favorably alter body composition and shape, and should be a cornerstone of exercise for women with PCOS.
Small changes, applied with time and consistency, can reap large benefit. By increasing long, slow movement like walking, decreasing medium to long term aerobic exercise, and tweaking your routine to keep your metabolism on its toes, you are helping to balance your hormones at a global level – through the nervous system.
Want more help with PCOS management?
Check out Metabolic Effect’s PCOS Program.