PCOS, exercise and what actually helps

Written By Dr Gab Gildea

PCOS (Polycystic Ovary Syndrome) affects around 1 in 10 women. Yet it’s still widely misunderstood and often reduced to “just a hormonal issue” or “just about fertility.”

In reality, PCOS is a whole-body condition that impacts metabolic, reproductive and mental health. And importantly, how you manage it matters.

This is a topic we will be discussing on the panel at the ‘Women’s Health and Exercise: What You Should Have Been Taught’ event on 30 March at Science of Fitness, Burleigh, Gold Coast.

So, what is PCOS?

PCOS is a hormonal condition diagnosed when at least two of the following are present:

  • Higher levels of androgens (often called “male hormones”)

  • Irregular or absent ovulation (which affects your cycle)

  • Polycystic ovaries on ultrasound

But the underlying driver for many women? Insulin resistance

This means your body doesn’t respond well to insulin (the hormone that helps regulate blood sugar), so it produces more of it. Over time, this can disrupt hormone balance and contribute to many of the symptoms associated with PCOS.

What does this actually mean for your health?

PCOS isn’t just about periods. It can show up in a few key ways:

Reproductive health: Irregular cycles, difficulty ovulating, and fertility challenges

Metabolic health: Higher risk of insulin resistance, type 2 diabetes, and cardiovascular disease

Skin & hair: Acne, excess hair growth, or hair thinning

Mental health: Higher rates of anxiety, depression, and body image concerns

So while symptoms can vary, the common thread is that PCOS affects more than one system in the body.

Where does exercise fit in?

Exercise is considered a first-line strategy in PCOS management, and for good reason.

1. It targets insulin resistance (the big one)

When you exercise, your muscles take up glucose (sugar) from the bloodstream more effectively.

This improves insulin sensitivity, which can help regulate hormones and reduce long-term health risks.

One important note: these benefits are short-lived (around 48–72 hours), which is why consistency matters more than intensity.

2. It supports hormone balance and cycle regularity

Exercise can indirectly improve hormone balance by:

  • Reducing high insulin levels

  • Increasing proteins that regulate testosterone in the blood

Even when hormone levels don’t dramatically change on paper, many women see improvements in ovulation and menstrual regularity

3. It improves metabolic and cardiovascular health

Exercise has been shown to:

  • Reduce waist circumference (a marker of visceral fat)

  • Improve insulin levels

  • Increase cardiovascular fitness

Even small improvements in fitness matter. A modest increase in aerobic fitness is linked to:
~13% lower risk of all-cause mortality
~15% lower cardiovascular disease risk

And importantly, these benefits can occur without significant weight loss.

4. It helps with mental health and quality of life

Women with PCOS are more likely to experience anxiety, depression and low self-esteem.

Exercise has been shown to:

  • Reduce symptoms of anxiety and depression

  • Improve body image

  • Enhance overall quality of life

And again, it’s not about perfection. It’s about regular, sustainable movement.

So… what should you actually be doing?

General guidelines recommend:

  • 150–300 minutes of moderate exercise per week (or 75–150 minutes vigorous)

  • Plus 2 strength sessions per week

But here’s the thing, PCOS isn’t one-size-fits-all. In saying that, neither is exercise for the general population. This is why Her Continuum is centred around individualised programming services.

Your symptoms, goals, fitness level and lifestyle all matter when it comes to what will actually work for you.

Where an Exercise Physiologist comes in

This is where working with an Accredited Exercise Physiologist (AEP) can make a big difference.

An AEP doesn’t just give you a generic program. We:

  • Assess your individual presentation (symptoms, fitness, medical history, goals)

  • Prescribe targeted exercise (type, intensity, volume, progression)

  • Support behaviour change so you can actually stay consistent

  • Work within a broader care team (GPs, dietitians, psychologists) when needed

Because while exercise is powerful, the real goal is making it work for you long-term.

The bottom line

PCOS is complex, but management doesn’t need to be overwhelming.

Exercise is one of the most effective tools we have to:
✔ Improve metabolic health
✔ Support hormones and cycles
✔ Enhance mental wellbeing

And when it’s tailored properly, it becomes something that supports your life, not adds stress to it.

Ready to get started?

If you want support applying this in a way that actually fits your body and lifestyle:

Work with me face-to-face: Book here
Prefer online support? Book an online consult here

Dr Gab Gildea