Debunking Myths About Exercise and PCOS
Misinformation about health is widespread, including advice on polycystic ovary syndrome (PCOS). A common myth is that high-intensity exercise, such as HIIT or running, is bad for PCOS. This statement is based on the oversimplified idea that high-intensity exercise increases cortisol, which in turn worsens insulin resistance—the main underlying driver of PCOS.
The Truth About Exercise and PCOS
This misconception has spread widely on social media, leading some patients to avoid all aerobic exercise, thinking it was harmful for PCOS. However, moderate to high-intensity exercise is one of the best therapeutic interventions for improving insulin resistance, which is why it is prescribed for PCOS, type 2 diabetes, and metabolic liver disease.
Understanding Cortisol and Exercise
Cortisol levels do increase during exercise to prevent hypoglycemia, which is a normal functional response. However, cortisol levels rapidly drop after exercise. Regular exercise also has a net effect of decreasing inflammation and diversifying the gut microbiome, both of which are beneficial for PCOS.
Mental Health Benefits
PCOS is associated with approximately twice the rate of depression and anxiety compared to the general population. Regular moderate to high-intensity exercise improves mental health, particularly depressive symptoms, which is crucial for managing patients with PCOS.
Anecdotal Evidence and Misdiagnosis
Some people on social media claim their PCOS improved with decreased exercise. Anecdotes are difficult to draw evidence from due to multiple confounding factors such as diet and sleep. However, it is possible that some individuals were incorrectly diagnosed with PCOS when they actually had functional hypothalamic amenorrhea, which might explain why reducing high-intensity exercise helped them.
HIIT vs. MISS for PCOS
The debate between high-intensity interval training (HIIT) and moderate-intensity steady-state (MISS) exercise for PCOS is ongoing. A 2021 review favored MISS for improving insulin resistance and other metabolic outcomes. However, the HIIT group in the study exercised less (124 minutes per week vs. 170 minutes in the MISS group) and had other study design issues. This highlights the importance of reading the entire study, not just the abstract.
Exercise Recommendations
Monash PCOS recommends following national guidelines of 150 minutes of moderate to vigorous exercise per week, along with two strength training sessions. Ultimately, the best exercise is the one you enjoy and can stick with consistently. Remember, something is always better than nothing! ❤️