Is High Intensity Exercise Bad for PCOS?

If you have PCOS and spend any time on social media, you’ve probably heard the word “cortisol” quite a bit! You may also have heard you should avoid intense types of exercise as it can cause cortisol spikes and worsen PCOS. Yet other research says high intensity exercise has many benefits for PCOS. It’s confusing to say the least!  To learn more about cortisol and find out if high intensity exercise is bad for PCOS, read guest blog post by Tedi Nikova, RD.

What is cortisol?

Cortisol is nicknamed the “stress hormone”, as it is usually connected with our bodies stress response. It’s a steroid hormone produced by our adrenal glands in response to stress; the secretion of this hormone is controlled by the pituitary gland, located in our brain. Not only does cortisol help you deal with stress, research shows it plays a significant role in blood sugar control, metabolism, blood pressure regulation, assists with memory formation, and even supports the development of the fetus during pregnancy.

Now keep in mind that stress can come in many forms, including emotional, mental, or physical. Even sneaky things like eating too few calories, too little sleep or exercising too much can cause stress. It’s also important to make the distinction between short term and long term stress.

Chronic stress and PCOS

While short term stress isn’t dangerous (it can actually be a good thing!),  chronic stress can have many negative health effects, especially for people with PCOS. Here is an excerpt from Martha’s PCOS book (to be available fall 2021) “It can affect non-essential functions like reproduction, digestion, and optimal thyroid functioning. Research shows chronic high levels of cortisol can cause inflammation, disrupt sleep, and keep blood sugar elevated, which increases insulin resistance, increases the risk of heart attack, causes ongoing digestive issues, and more. Studies even suggest that people with PCOS may be more susceptible to stress as compared to people without PCOS. High levels of cortisol also influence weight gain around the mid-section. So, the last thing someone with PCOS wants is chronic high levels of cortisol! And if you have elevated levels of DHEAS, an adrenal androgen, you may be even more susceptible to stress.”

High intensity exercise and PCOS

Exercise acts as a stressor on the body, especially when it comes to high intensity exercise. High intensity cardio exercise can be described as a form of exercise that gets your heart rate up above 75% of your max heart rate (on average) for 10 minutes or more in duration. Two examples of high-intensity exercise include high intensity steady state training and high-intensity interval training (HIIT). HIIT involves alternating high-intensity exercise intervals with periods of lower-intensity intervals of active recovery.

So, does this mean you should avoid high intensity exercise if you have PCOS? It’s not as straight forward as you may think – and there are pros and cons!  It will depend upon the individual person, including how their hormones respond to the exercise, as well as other factors including overall conditioning and hydration status.

Let’s start with the positive.  Studies have shown HIIT in people with PCOS may reduce insulin resistance more than traditional endurance exercise. Other studies done in PCOS show vigorous exercise is most effect for improving insulin sensitivity. While not done in PCOS specifically, research also shows that HIIT training can elevate the metabolic rate for a longer period after you stop exercising, as compared to steady state exercise. So contrary to what you often read on social media, high intensity exercise can have many benefits for PCOS!

Potential downsides of high intensity exercise for PCOS

But high intensity exercise is not for everyone. PCOS is a hormonal condition. And anything that disrupts hormonal balance can have a negative impact on PCOS symptoms. So while exercise can have numerous health benefits, “overdoing” exercise can act as a chronic stressor. In addition to the negative effects previously listed, chronically high levels of cortisol can cause disruptions in the menstrual cycle.

Research suggests that moderate to high-intensity exercise may increase cortisol acutely (in the short term) – this means the spike in cortisol won’t have long term effects. Additionally, research shows that even low intensity exercise shows an increase in cortisol after 60 minutes. There is still no clarity regarding the effects of high-intensity training on rises of cortisol during the recovery period after exercise in trained and untrained individuals. Research shows that endurance athletes performing long periods of intense exercise have elevated long term cortisol. Note: the above studies mentioned were not done on people with PCOS, but they are the best we have.

General signs and symptoms of too much cortisol include:

• Weight gain, mostly around the mid-section
• Acne
• Severe fatigue
• Difficulty concentration
• High blood pressure
• Lack of sex drive
  
• Muscle weakness
• Insomnia
• Anxiety, depression, and irritability
• Osteoporosis
• For more signs and symptoms CLICK HERE

Of course, your best bet it to test, not guess, when it comes to cortisol. Very high levels of cortisol can indicate medical conditions such as Cushing’s disease.

Signs that you may be overdoing your workouts:
The trick here is to pay attention to how your body feels in response to exercise. Signs that you may be over-doing your exercise include:

• Needing longer periods of rest
• Trouble sleeping
• Losing motivation
• Getting frequent colds
• Stressing about your workout, remember all stress can spike your cortisol, feel like you NEED to do your workout
• Constant food cravings

The bottom line –  is high intensity exercise bad for PCOS? 

We are all unique individuals so you’ll have to listen to your body! For some people, intense exercise can dramatically improve insulin sensitivity and raise your metabolic rate. But for others it may cause more stress and worsen symptoms. Many of us already have chronic stress in our lives. As previously discussed, chronic stress can cause high levels of cortisol which can lead to blood sugar imbalances and diabetes, inflammation and worsened insulin resistance, weight gain and obesity and more. But there is no scientific evidence that intense exercise causes this reaction in everyone with PCOS. So the bottom line is that there is NO right answer to the question – it depends on the individual. So forget what you read on social media and listen to your body.

Tips to reduce exercise related cortisol

• Do not fear to change up your exercise routine to include higher intensity workouts
• Prioritize sleep and recovery time
• Focus on good nutrition and hydration pre and post workout
• Do NOT STRESS about your exercise routine!
• Practice mindful movement. Base your activity level on your bodies ques.
• Having a nighttime unwinding routine: Avoid stressors in the evening such as stressful work emails, intense tv, and stress provoking conversations.
• If you wish to include high intensity exercise in your program, also include weight training and lighter exercises (yoga, pilates) to help balance things out

How does intense exercise make you feel?

I’d like to thank Tedi Nikova for writing this blog post. Tedi is a Toronto based Registered Dietitian. She has a Master’s degree in Public Health, and a specialization in women’s health from The University of Toronto. Tedi has a passion, and commitment to help women feel confident, energized, and healthy in their own body, through nutrition therapy. Tedi’s areas of interest in nutrition therapy include women’s health conditions including PCOS, as well as clinical obesity.