What Exercise is Best for PCOS: Cardio vs Weight Training?

Wondering what type of exercise is best for PCOS? Cardio and weight training are two popular forms of exercise. Many women want to know if they should follow cardio only workouts or weight training for PCOS.

I frequently get asked questions like “If I lift weights, won’t I get bulky?”, “My goal is to lose weight, so isn’t cardio best?”.

In this post, you will find out whether cardio or weight training is best for PCOS. We will first look at the differences between these exercises, the benefits for PCOS and which you should favour as your PCOS exercise.

So, if you want to learn the truth about these popular forms of exercise and finally find a workout you can stick to, keep reading. The answer may surprise you!

Let us begin.

What’s the difference: Cardio vs Weight Training?

As I am sure you aware, there is a clear difference between these two exercises. The difference is how the body get its energy.

Let me explain.

Cardio, short for cardiovascular training or conditioning, is a form of aerobic exercise. Aerobic refers to the use of oxygen to fuel your muscles. Cardio or aerobic exercises include running, cycling, swimming and brisk walking.

Weight training, a.k.a resistance training, is an anaerobic exercise. During this form of exercise, oxygen is not present to break down glucose in the body. Weight training involves lifting weights to build muscle, strength or endurance. Weight training includes free weights like dumbbells, barbells, kettlebells, weighted machines, medicine balls and resistance bands.

Now, let’s look at some of the benefits of cardio and weight training for PCOS.

Benefits of Cardio

There are two types of cardio, high-intensity interval training (HIIT) and low-intensity steady-state training (LISST). Currently, there are not many studies on HIIT for PCOS. However, the few studies conducted in this area are encouraging.

HIIT Improves Insulin Resistance

Insulin resistance affects around 70% of women with PCOS. It is a condition where the cells in the body have become unresponsive to the effects of insulin. As a result, there is a build-up of sugar in the bloodstream.

A systematic review and meta-analysis of seven randomized controlled trials found that HIIT alone is effective for reducing HOMA-IR and BMI in women with PCOS, The training intensity was performed between 90% and 95% of the maximum heart rate, three times a week, for at least 10 weeks. Studies with longer duration are limited.

The intense intervals require plenty of glucose. As a result of the significant release, there are drastic changes to glucose levels in your muscle cells, in turn, making insulin active again during the recovery period. Insulin transports glucose back into the muscles to replenish them.

In other words, undertaking high-intensity interval training increases insulin sensitivity through expending glucose and then allowing blood glucose to enter the muscle cells. HIIT is, therefore, an effective way to improve blood sugar levels and insulin resistance.

More calories burned during your workout

Cardio is a popular tool because you burn more calories during your cardio workout vs. weight training. Emphasis on during your workout. However, the amount of calories burnt varies on the intensity of the workout, your weight, age and workout duration.

You Burn Additional Calories After Doing a HIIT Workout

One of the reasons for HIIT’s popularity is Excess Post Exercise Oxygen Consumption (EPOC). EPOC is just a fancy way of saying the additional calories you burn after your workout is complete.

So here’s the thing.

Because HIIT is so intense, you create an oxygen debt. The body needs to take in oxygen post-workout to return its systems to the point of homeostasis. So the body will burn a few extra calories to restore its processes to a normal level.

Now, for those intrigued and wondering how many additional calories you will burn, the answer is: An additional 6-15% of total calories burned.

You now know the benefits of cardio for PCOS. Let’s take a look at the amazing benefits weight training has to offer.

Weight Training

Reduces Insulin Resistance

As I mentioned, one of the problems women with PCOS struggle with is blood sugar imbalances and high insulin levels. Researchers found that each 10% increase in muscle was associated with an 11% relative reduction in the risk of insulin resistance.

When we contract our muscles during exercise, we increase the rate of glucose uptake. This means glucose transport is activated, independent of insulin, through muscle contraction. Regularly using our muscles allows the glucose in the bloodstream to be used as energy and helps the cells become more sensitive to insulin. 

Lowers Testosterone Levels

High male hormones, like testosterone, are a symptom of PCOS. A study found weight training can lower testosterone levels in women with PCOS.

Researchers looked at the effect of a 16-week resistance training program would have on the quality of life of PCOS women. The results show that after 16 weeks, their testosterone levels significantly reduced.

The studies finding may have come as a shock to you because many women believe lifting weights will cause their testosterone levels to increase. But as you can see, it has the opposite effect.

 Helps to Increase Metabolism

Weight gain and difficulty losing weight is a common PCOS symptom. Researchers found PCOS women, particularly those who suffer from insulin-resistant PCOS, have a lower Basal Metabolic Rate (BMR). BMR is the number of calories your body burns at rest, e.g., breathing, sleeping, sitting.

One way to increase your BMR is to build muscle. Muscle is more metabolically active than fat. Meaning muscle burns more calories while your body is at rest. I know, amazing!

Reduces the Risk of Depression

Women with PCOS have higher rates of depression. But researchers have found this form of exercise significantly reduced the risk of depression.

The theory behind why weight training reduces the risk of depression is that it can change the brain’s structure and function. But also because it can trigger the release of mood-enhancing chemicals such as endorphins.

Now, of course, mood and treating depression is more complicated than just lifting weights. But the results from the study suggest resistance training can be a powerful tool that can help boost mood and support our mental health.

Strengthens Bones

Osteoporosis is not age-dependent. A study found PCOS women had lower bone mineral density than the healthy control group.

But get this: Weight training can protect your bones and reduce the risk of osteoporosis-related fractures.

To stimulate your bone osteoblasts (bone-building cells), you must expose them to a load that exceeds that experienced during daily living activities. Osteoblasts react to increased stress on the skeleton and hormonal changes. So lifting weights can help produce more bone cells.

Okay, so you now know the benefits of cardio and weight training for PCOS. But you may be wondering, well, which exercise is best?

Why I Choose Weight Training for PCOS

The reason for this is because it supports the metabolism. Excess/endurance cardio increases cortisol, suppresses the thyroid and slows down the metabolism.

Let me explain how.

When the heart gets pumping during exercise, the body burns glucose in the bloodstream for energy. Now, this supply only lasts for about 30-45 minutes. After that, your body needs to find a replacement to keep energy levels up. After about an hour of exercise, cortisol levels increase and stay elevated until you have finished your workout. Elevated cortisol is very catabolic. So once your glycogen stores are empty, it turns to stored fat and tissues like muscle and organs.

Cortisone, produced by stress, inhibits the thyroid gland. Low thyroid means less oxygen is needed, so this is a useful adaptation for increasing endurance. Endurance athletes have become adapted to this continuous stressed state.

In other words, the athletes’ bodies have become more efficient in using less energy to do the same work. When thyroid hormone production decreases, many metabolic processes like digestion, immune system, hormone production slow down to conserve energy.

But this isn’t to say I don’t believe cardio is beneficial. The truth is the best workout is the one you enjoy and can do regularly. I believe it is important to find a healthy balance, where you can combine both.

“But Won’t I Get Bulky?”

When you are diagnosed with PCOS, the advice is to eat less, exercise more and lose weight. Such standardized advice often causes newly diagnosed PCOS patients to fall into a rabbit hole of endless cardio and restrictive eating to lose weight in the hope that it will treat their PCOS.

Despite reading the great benefits of building muscle for PCOS, like improved insulin resistance, higher metabolic rate, lower testosterone and fat loss. It may still be difficult for you to jump out of that rabbit hole. You may be afraid to eat more food to build muscle and you fear getting bulky.

So, let me answer that frequently asked question of “Won’t I get bulky if I lift weights?”

The term ‘bulky’ simply means gaining a significant amount of muscle. The truth is, given you have PCOS, your testosterone levels may be higher than women who do not have PCOS and as such, you may find that you put on muscle a little easier. But building muscle does not happen overnight and by working with a personal trainer, you can transition to a maintenance plan once you have achieved the preferred level of lean mass.

However, a woman’s ability to get ‘bulky’ depends on multiple factors, regardless of her hormone levels, including her body type, the type of weight training she is doing, training frequency, previous training history, etc.

How much cardio and weights should you do per week?

This question is important because this is where many of us take exercise a little too far. We often think more exercise is better. Go hard or go home, right?

But that isn’t supportive of your hormones or PCOS.

Here’s the deal.

I suggest exercising for 30-45 minutes, 3-5 times a week. I recommend these ranges because, as I mentioned, prolonged workouts increase cortisol and slows down the metabolism.

Weight Training Programming

When building a workout routine for weight training, a general rule of thumb is 2 or 3 days a week of full-body exercises or 3 to 5 days of exercises separated by upper body/lower body or muscle group (legs, chest, back, shoulders, arms, etc.).

As a beginner, you can see great results from simply weight training 20 to 30 minutes, 2 times a week. Gradually increase the workout days, but do not exceed 4-5 days a week.

In summary

Weight training is a great form of exercise for women with PCOS. Lifting weights and building muscle can help reduce insulin resistance, testosterone and the risk of depression and strengthen bones.

However, cardio can also improve insulin resistance.

I recommend prioritizing weight training and limiting long cardio workouts to decrease cortisol, support the thyroid and boost the metabolism. The ideal amount of exercise is 30-45 minutes, 3-5 times a week, depending on your current health status, goals and lifestyle. Working out like this will provide you with optimal conditions for long term fat loss, lean muscle and a higher metabolism!

Source:

  • Santos IKd et al. (2021) Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE 16(1): e0245023.

Despina Pavlou is the founder of PCOS Oracle and a certified personal trainer. She takes a holistic and evidence-based approach to both nutrition and training. After being diagnosed with PCOS at the age of 18, she was forced to learn about PCOS and her body to overcome it. She believes both diet and lifestyle modifications are an effective approach to managing PCOS and its symptoms. Despina can be reached at despina@pcosoracle.com or @pcosoracle on Instagram, Facebook and Twitter.

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Comments (3)
  • Andrew john cassey

    April 28, 2021 at 12:04 pm

    It is a great explained of a article and quite helpfull too but is it bad if someone do both cardio and weights?

  • Angela Grassi

    April 28, 2021 at 4:59 pm

    No, in fact both are recommend!

  • Arvind Harit

    May 30, 2021 at 11:21 pm

    Sports/cardio/weight training are the best way to reduce stress and make our self healthy. When i was 20 i have many medical issues then doctor suggest me for some workout or sports. After 1 month of continuous practice my medical issues were released. This is the power of sports. Thankyou for sharing this information, subscribed your blog.

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