Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed by SIAHMSR medical team.

Physical exercise to manage PCOS [polycystic ovarian syndrome]

What is Polycystic ovarian syndrome [PCOS]?

  It is a disorder of female reproductive system involving a group of hormones in women and is characterized by lack of ovulation, irregular menstruation, hair loss from scalp, excessive body hair growth, acne & comedones on face with or without obesity.

PCOS may affect ovulation [egg release from ovary during mid cycle of menstruation]  and is associated with high levels of male  hormones. 

PCOS may leads to infertility in women. Genetic factors as well as environmental factors such as sedentary life style, lack of physical activity, over eating, obesity lead to PCOS.

Insulin resistance is a key factor associated with the severity of PCOS .The insulin hormone in the blood fails to remove glucose from blood and cells fail to take up glucose from blood. This state is known as insulin resistance. blood sugar as well as blood insulin hormone remain elevated in this condition. Insulin resistance is the hallmark of PCOS. This may lead to complications later in life.

Women having PCOS may develop complications such as type 2 diabetes, gestational diabetes [ during pregnancy ], high cholesterol and hypertension [ high blood pressure] enhancing their risk for cardiovascular diseases like heart attack and stroke.

Women with PCOS are at a two to eight times greater risk of developing impaired glucose tolerance and type 2 diabetes mellitus compared to women without PCOS.

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 Reduction of BMI [Body mass Index]  –Does it help PCOS management ?

 PCOS is often associated with high body mass index [BMI].High body mass index is the  characteristic of obesity. Women having PCOS are often obese, although PCOS can occur in lean women also.

The goal in PCOS management should be reduction of high BMI.

Vigorous physical exercise helps to reduce the body mass index. Diet also has crucial role in achieving the target of optimum BMI.

Benefits of exercise in PCOS

•        It helps to reduce body weight

•        Improves insulin resistance  prevents related complications.

•        Reduces belly fat

Physical exercise  to prevent complications of PCOS- Research based information

  Exercise training has consistently been found to help women with PCOS. However, earlier the research studies used in the formation of the guidelines were not adequate to provide exercise prescription for the management of PCOS.There was uncertainty about suitable intensity, duration, and modality of exercise, and the interaction between exercise and diet.

 A Systematic Review and Meta-Analysis published in 2020 seems to be helpful to understand about exercise plans in depth. Results from various research study analysis  suggest that vigorous intensity exercise may have the greatest impact on cardiorespiratory fitness, body composition, and insulin resistance in women having PCOS.

A minimum of 120 min of vigorous intensity per week is needed to provide favorable results for women with PCOS.

  According to a study done in 2016 Compared with moderate exercisers and inactive women, the vigorous exercisers had lower  body mass index [BMI] and lower insulin resistance, higher levels of high-density lipoprotein [good cholesterol] and sex hormone-binding globulin; and a reduced prevalence of the metabolic syndrome [2].

These research study outcome is applicable to PCOS also.Therefore vigorous exercise is recommended in women with severe PCOS symptoms and high insulin resistance.

It is important to evaluate the general state of health & fitness of vital organs before starting vigorous exercise.

    There is clear-cut evidence that exercise reduces cardiovascular disease risk factors in women with PCOS, preventing heart attack and stroke. This is achieved by improved insulin sensitivity and reduction in the high insulin hormone level in blood found in PCOS [3].

Can physical exercise improve mental health problems in women with PCOS?

PCOS is also associated with mental health issues in some women. Exercise improves psychological well-being in women with PCOS [3].

 Physical exercise guidelines for PCOS suggest at least 150 min of physical activity per week [3].

Can physical activity improve sleep related issues in women with PCOS?

Sleep apnea or difficulty in breathing while sleeping, snoring, and sleeplessness are very common in women with PCOS. Regular exercise also can improve sleep in women with PCOS.

Types of exercises helpful for women having PCOS

Cardio work outs are helpful in PCOS. This group of aerobic workouts can include fast walking, bicycling, dancing etc. these are exercises which increases your heart rate and heart health. These exercises can be practiced regularly by all women having no serious other diseases.

·       High intensity interval training [ HIIT]

Workouts that combine high-intensity exercise bursts with rest periods are known as HIIT. HIIT is any form of exercise that consists of a short burst of intense exercise that precedes a period of rest or low intensity exercise.

The period of intense exercise can vary from less than 45 seconds to a few minutes. People then rest or do gentle exercise for a similar time frame before repeating the sequence. Total time period of this work out is mostly15–20 minutes, but it provides a wide range of benefits. It can improve cardiovascular health. Burpees, tuck leaps, and mountain climbers are examples. These exercises are suggested to reduce high body mass index in women.

·       Mind body exercises

These include relaxation as well as strength improving exercises which help to reduce stress. Yoga, Pilates, and tai chi are examples of mind-body workouts that can not only burn calories but also lower stress levels associated with PCOS.

·       Strength training

Weights, resistance bands, or your body weight are frequently used in strength training exercises, which focus on muscle building. There are different levels of intensity for strength trainings. Begin with low weights.

Try to do strength exercises for all of your major muscle groups at least 2 days per week, but don’t exercise the same muscle group on any 2 days in a row.

This is associated with advantages and disadvantages, depending on how you do it.  Moderate strength exercise benefits include lowered blood pressure, better metabolic function, and improved bone strength.

A few examples include:

                Overhead arm curl

o   Arm curls

o   Wall push-ups

o   Lifting your body weight

o   Using a resistance band

·       Aerobics

Endurance exercises or aerobic exercises improve the health of your heart, lungs, and circulatory system. They also prevent many diseases that are common in older adults such as diabetes, colon and breast cancers, heart disease, and others.

This type of exercise is usually rhythmic and repetitive.

In aerobics when you participate in a continuous activity that increases your heart rate, your cells use oxygen to produce energy.

Aerobic exercises help proper oxygenation of the body cells.

Moderate aerobic exercise interventions ≥3 months in duration, with a frequency of 3/week for at least 30-min, may have favorable effects on various cardio metabolic risk factors in women with PCOS preventing heart related issues[4].

Brisk walking, cycling ,swimming etc. are examples.

  All these exercises listed here are useful for reducing the impact of PCOS on women’s health, preventing cardiovascular complications, diabetes and infertility through reduction of insulin resistance.

Summary

In women with severe PCOS symptoms and complications such as infertility, high blood glucose levels etc. strength training or high intensity exercises  do help .However it should be practiced under the guidance and instructions from a healthcare provider after excluding serious health problems to heart, lung and vital organs. All women , including those who are obese and having risk of PCOS due to positive family history may practice moderate intensity exercises such as aerobics, brisk walking etc.

written by dr.sanjana vb[ copyright]

References

1.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358428/

2.    https://pubmed.ncbi.nlm.nih.gov/26551442/

3.     https://pubmed.ncbi.nlm.nih.gov/32342454/

4.    https://link.springer.com/article/10.1007/s40200-019-00425-y

5.    https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability#:~:text=Most%20people%20tend%20to%20focus,Each%20one%20has%20different%20benefits.

6.    https://www.medicalnewstoday.com/articles/327474#benefits