If you have PCOS, you’ve probably heard a lot of conflicting advice about exercise. Focus on strength training but don’t lift too heavy. Do more cardio but don’t make it be intense. Walking is best. Try HIIT. Or whatever you do, don’t do HIIT because it will spike your cortisol and make your PCOS worse. Confused yet?
One of the reasons I wanted to write this post is because I see so much fear mongering around exercise and PCOS. I’ve seen women stop doing workouts they love because they’ve been told they’re “bad” for PCOS, or force themselves to do a type of exercise they don’t even enjoy because they’ve heard it’s better for their hormones. And that’s frustrating, especially when the science doesn’t necessarily support these blanket rules.
Exercise has always been an important part of managing PCOS, but we haven’t had great evidence showing whether one type is actually better than another. In fact, the 2023 International Evidence Based PCOS Guideline concluded that there wasn’t enough evidence to recommend one specific type or intensity of exercise over another.
But we’re starting to learn more. While we still can’t crown one exercise the winner, research is giving us a better idea of the benefits different types and intensities of exercise may offer. So in this post, I want to show you what the research says, clear up some of the confusion and help you figure out what makes sense for your PCOS exercise plan.
Prefer to watch? In this video, I break down what the research says about the best types of exercise for PCOS/PMOS.
Why Exercise Matters for PCOS, Even If You Don’t Lose Weight
When most people think about exercise and PCOS, weight loss may be the first thing that comes to mind. But focusing only on the scale misses many of the benefits.
Regular exercise can help:
- Improve insulin sensitivity (which is a biggie!)
- Lower blood sugar
- Improve cardiovascular fitness and heart health
- Build and maintain muscle
- Improve body composition
- Support mood and mental health
- Support better sleep
- Maintain strong bones
- Improve overall health and quality of life
And you don’t necessarily need to lose weight to benefit. That’s one reason I encourage my clients to think beyond calories burned. Exercise is doing a lot behind the scenes that you may not see when you step on the scale. So if weight loss isn’t the best way to judge whether exercise is “working,” what type should you be doing? That’s where the newer research gets interesting.
Not sure what type of exercise makes sense for your PCOS? I can help you sort through the conflicting advice and find an approach that works for you. Learn more about working with me.
What Does the Latest Research Say About Exercise for PCOS?
PCOS research has historically been underfunded, so I’m always excited to see new studies come out, especially on a topic as controversial as exercise.
And lately, we’ve gotten some interesting ones. Several systematic reviews and meta analyses published in 2025 and 2026 have compared different types and intensities of exercise in women with PCOS.
Before we get into what they found, here’s a quick refresher on the different types of exercise you’ll see mentioned:
1. Aerobic exercise (cardio): Walking, jogging, cycling, swimming and other activities that increase your heart rate.
-Moderate intensity exercise: You’re breathing harder but can still carry on a conversation.
-Vigorous intensity exercise: You’re breathing much harder and talking becomes difficult.
2. Resistance or strength training: Lifting weights, using machines, resistance bands or your own body weight to challenge your muscles.
3. HIIT (high intensity interval training): Short bursts of high intensity exercise alternated with easier recovery periods. An example could be a spin class where you have a minute of high intensity spinning followed by a minute of lower intensity.
4. Mind body exercise: Activities such as yoga and Tai Chi that combine movement with breathing, balance and mindfulness.
So, did researchers find one clear winner? Not really (not a shocker!) Instead, we’re learning that different types of exercise may have different strengths.
Cardio vs. Strength Training: Is One Better for PCOS?
If you spend any time on social media, you may have gotten the impression that strength training is the exercise to do if you have PCOS, while cardio should take a back seat. While I’m a strong proponent of strength training for PCOS, the research doesn’t tell us to ditch cardio and just lift weights.
Resistance training can help build and preserve muscle, improve body composition and support metabolic health. Some research in women with PCOS has also found improvements in insulin resistance and androgen levels, although we have fewer resistance training studies and the findings aren’t as consistent. And muscle itself matters when we’re talking about insulin resistance because skeletal muscle is a major site for glucose disposal.
But cardio deserves a place in your exercise plan too. Aerobic exercise has some of the strongest evidence for improving metabolic health in women with PCOS. In one recent analysis of 23 randomized controlled trials involving nearly 1,200 women, moderate intensity continuous exercise performed particularly well for improving insulin resistance.
And you don’t necessarily have to choose one or the other. A 2026 analysis found that combining aerobic and resistance exercise performed particularly well for lowering triglycerides and LDL cholesterol.
So rather than thinking cardio or strength training, I prefer to think cardio and strength training.
Where Does HIIT Fit In?
HIIT, or high intensity interval training, alternates short bursts of vigorous exercise with periods of recovery. And if you have PCOS, you’ve probably heard that you should avoid HIIT because it causes cortisol spikes.
One of my clients loved spinning and felt great doing it. But after hearing that high intensity exercise could spike cortisol and make PCOS worse, she stopped and switched to walking. The problem was, she found walking boring and eventually started exercising less. She hadn’t stopped spinning because it made her feel bad. She stopped because she was afraid it was bad for her PCOS.
So, is HIIT actually bad for PCOS?
The research doesn’t suggest that it is. Several analyses have found that HIIT can improve cardiovascular fitness, insulin levels and other markers of metabolic health in women with PCOS.
But does that mean HIIT is better than moderate intensity exercise? Not necessarily. A 2021 systematic review and meta analysis comparing the two actually found more consistent benefits with moderate intensity exercise. More recent research has found benefits from HIIT as well, particularly for cardiovascular fitness, fasting insulin and LDL cholesterol.
The takeaway? You don’t need to choose HIIT because you’ve heard it’s the “best” exercise for PCOS. If you enjoy it, great. If you hate it, there’s no reason to force yourself through it. Both HIIT and moderate intensity exercise can have benefits.
But what about the big concern that HIIT spikes cortisol? Let’s look at that next.
Does HIIT Raise Cortisol in Women With PCOS?
This is one of the biggest concerns I hear about HIIT and PCOS: Won’t intense exercise spike my cortisol and make my PCOS worse?
Here’s where we need to distinguish between a temporary rise in cortisol and chronically elevated cortisol. Cortisol normally increases in response to vigorous exercise. That’s a normal part of your body’s response to exercise, not necessarily a sign that something harmful is happening.
The problem is that we really don’t have much research looking at cortisol responses to exercise specifically in women with PCOS. Most exercise studies focus on outcomes such as insulin resistance, body composition, cardiovascular fitness, cholesterol and androgen levels. Even the recent large reviews comparing different types of exercise generally did not evaluate cortisol as an outcome. We need more studies specifically examining both the short term cortisol response to different types of exercise and what happens to resting cortisol levels over time in women with PCOS.
That said, we do have one small randomized controlled trial that actually measured cortisol in women with PCOS doing HIIT. Twenty eight women with PCOS participated in the study. Their average BMI was about 30, and half were assigned to HIIT three times a week for eight weeks. In addition to improvements in insulin, insulin resistance, body fat, visceral fat, LDL cholesterol and cardiovascular fitness, resting cortisol levels actually decreased after eight weeks of HIIT.
Does this mean HIIT lowers cortisol if you have PCOS? No. This was one small study, and we need much more research before making that claim. But at the very least, the evidence we have doesn’t support blanket recommendations that women with PCOS should avoid HIIT because it will chronically raise cortisol.
As always, pay attention to how exercise makes you feel. If intense workouts leave you exhausted, interfere with sleep or simply make you miserable, choose something else. But if you enjoy HIIT and feel good doing it, having PCOS alone isn’t a reason to stop.
Don’t Underestimate Walking
With all this talk about HIIT, vigorous exercise and strength training, let’s not overlook one of the simplest forms of exercise: walking. Walking is one of my favorite ways to get more movement into the day. It’s accessible to most people, free and easy to fit into your day. It’s also a great place to start if you haven’t been exercising regularly or if you’re not ready for more intense workouts. Walking can also be a good option if joint pain or previous injuries make higher impact exercise uncomfortable. You can adjust your pace, duration and terrain based on what feels good for your body.
And yes, walking can help with blood sugar and insulin resistance. In women with PCOS, aerobic exercise has been shown to improve insulin resistance even without significant weight loss. We also have a large body of research outside of PCOS showing that walking can improve glucose control.
A few reasons I’m such a fan of walking:
- It’s great for beginners or anyone getting back into exercise.
- It’s generally easier on the joints than higher impact activities.
- You don’t need special equipment or a gym.
- You can fit short walks into your day rather than finding time for one long workout.
- Walking after meals can help reduce postmeal blood sugar.
- Breaking up prolonged sitting with brief walking breaks can improve glucose and insulin responses.
- It’s easy to adjust the pace and duration to your fitness level.
One of my favorite ways to use walking is after meals. And you don’t necessarily need one long walk to get benefits. If you don’t have 30 or 45 minutes to exercise, don’t automatically write the day off. Take a 10 minute walk after lunch. Walk for 10 minutes after dinner. Take a few short walking breaks during your workday. It all adds up.
Does walking need to be your only form of exercise? Ideally, no. Resistance training provides benefits that walking can’t, particularly when it comes to maintaining and building muscle and strength. And depending on your fitness level, adding some more vigorous activity can further improve cardiovascular fitness.
But don’t dismiss walking because it doesn’t feel intense enough. Whether you’re just starting out, dealing with joint issues, short on time or simply enjoy walking, it’s an excellent way to add more movement to your day.
What About Yoga for PCOS?
I’ve always been a huge fan of yoga for PCOS, and now it’s great to see more research backing up some of the benefits I’ve seen over the years.
A 2025 network meta analysis of 19 randomized controlled trials compared several types of exercise, including yoga, moderate intensity aerobic exercise, HIIT, resistance training and combined training. Among the exercise types studied, yoga ranked highest for improving insulin resistance and lowering total testosterone.
Pretty impressive for an exercise that sometimes gets dismissed as “just stretching.” But I wouldn’t call yoga the best exercise for PCOS just yet. Only three of the trials in this analysis involved yoga, and network meta analyses use both direct and indirect comparisons between exercise types. So while the findings are encouraging, we need more high quality research before saying yoga is superior to other forms of exercise.
Still, there are plenty of reasons to consider adding yoga to your routine. Depending on the type, yoga can incorporate strength, flexibility and balance, along with breathing, mindfulness and relaxation. And that’s one reason I’ve been recommending it to women with PCOS for years.
How Much Exercise Do You Actually Need?
Now that we’ve talked about what kinds of exercise may be beneficial for PCOS, let’s talk about how much you actually need.
The 2023 International Evidence Based PCOS Guideline recommends that adults with PCOS aim for:
- 150 to 300 minutes a week of moderate intensity aerobic activity, such as brisk walking, cycling or swimming
OR - 75 to 150 minutes a week of vigorous aerobic activity, such as running, faster cycling or more intense workouts
OR - A combination of moderate and vigorous activity
PLUS - Muscle strengthening activities on two nonconsecutive days each week
If weight loss or preventing weight regain is a goal, the recommendation increases to at least 250 minutes of moderate intensity activity or 150 minutes of vigorous activity per week, plus strength training.
But what does that look like in real life? These guidelines are helpful targets, but they aren’t always practical for everyone. Work, family responsibilities, joint issues, injuries, fatigue, access to a gym and simply finding the time can all get in the way.
I had a client who felt like if she couldn’t find 30 or 45 minutes for a workout, it wasn’t worth doing. And with her schedule, those longer workouts often didn’t happen. So we changed her approach. Instead of waiting for the perfect block of time, she started fitting in 10 minute walks when she could, often after meals. It felt much more doable, and she became much more consistent with exercise.
That’s something I want you to keep in mind when you see exercise guidelines. You don’t have to do it all at once, and you certainly don’t have to go from zero to 300 minutes a week. Start where you are. Maybe that’s a 10 minute walk after dinner. Maybe it’s two 15 minute strength workouts at home each week. As your fitness, strength and confidence improve, you can gradually do more.
The guidelines also emphasize limiting prolonged sedentary time, so movement outside of your formal workouts matters too. Think of these recommendations as goals to work toward, not numbers you have to hit for exercise to count.
So, What’s the Best Exercise for PCOS?
After looking at the latest research, I don’t think we can say there is one “best” exercise for PCOS. And that’s actually good news. You don’t need to force yourself to run, give up cardio because an influencer told you to lift weights, or start doing HIIT because one study ranked it highly for insulin levels.
Ideally, aim for a mix of aerobic exercise and strength training, and consider yoga or higher intensity exercise if you enjoy them. Different types of exercise offer different benefits, and there’s plenty of room to personalize your routine.
Most importantly, don’t get so caught up in finding the perfect PCOS workout that it keeps you from moving. Choose activities you enjoy, that make you feel good and that realistically fit into your life. Start where you are and build from there. And don’t feel pressured to immediately meet the exercise guidelines. Any increase in movement is a step in the right direction.
And a word of caution: avoid the “if a little is good, more must be better” mentality. For some people, too much exercise without adequate recovery can add to overall physical stress and may affect stress hormones, particularly when combined with inadequate fueling or other stressors. Ultimately, the “best” exercise is one that supports your health and that you’ll actually keep doing.
Need help figuring out what works best for your PCOS/PMOS? There is no one size fits all approach. I can help you create a personalized, evidence based plan that includes nutrition, exercise, supplements and other lifestyle strategies that fit your health, goals and life. Learn more about my PCOS/PMOS coaching programs.
References
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