Guest Post by Despina Pavlou.

 
 
We all know exercise is important for our PCOS and overall health. However, you probably didn’t know that the type of exercise you are undertaking may be doing you more harm than good. Along with good nutrition, exercise is also a key component when trying to manage your PCOS.
 
If you have ever asked yourself, why am I not losing weight or why isn’t my PCOS improving, I am eating well and exercising, what is going on? A possible reason is that the type of exercise you are doing is not helping your hormones and in turn your PCOS.
 

Not One Type of PCOS

 
There is not one type of PCOS and therefore there is no best or standardised exercise program that can be given. Furthermore, we are all different, our bodies are not the same. So what works for one person, may not work for you.
 
As a result of the different types of PCOS, you have to undertake the exercise that takes into consideration your type of PCOS.
 

Insulin Resistant PCOS

 
Insulin Resistant PCOS is the most common type of PCOS. It is estimated that 70% of women with PCOS also suffer from insulin resistance (1).
 
Insulin is a hormone made in the pancreas, one of insulin’s many roles is to keep blood sugar levels under control. Cells in the body will burn glucose for fuel, but will also be sent to the liver.
 
Insulin is a like a key, it unlocks the door to allow glucose to enter the cells to be used as energy. However, if you are insulin resistant, insulin (the key), is faulty. Which means the cells have become resistant to the effects of insulin and instead of the glucose being used as energy, it builds up in the blood and gets stored as fat. Insulin resistance is when the cells in the body have trouble absorbing glucose in the blood and as a result, there is a build-up of sugar.
 
A high level of insulin causes the ovary to produce excess amounts of testosterone. This, in turn, causes PCOS symptoms, such as infertility, irregular periods, hair loss and acne.
 

Best Exercise for Insulin Resistant PCOS?

 
Countless studies have found both Resistance Training and High-Intensity Interval Training (HIIT) to be the best forms of exercise for this type of PCOS.
 

What is Resistance Training?

 
Resistance training is any exercise that causes the muscles to contract, in turn resulting in increased muscle mass, strength and endurance. You probably read that and thought, well this isn’t for me. A lot of women believe that weight training causes you to look ‘bulky’, however, this isn’t true. While women with PCOS do have an elevated level of testosterone, it is still not enough to build muscle like men.
 

The Benefits of Resistance Training for PCOS

 
If I still have not put your mind at rest and got you pumped and excited to lift some heavy weights, these benefits will.
 

Reduces insulin resistance

 
While any type of training is great for insulin resistance, studies have found that having more muscle increases your overall demand for energy. A study found that each 10% increase in muscle was associated with an 11% relative reduction in insulin resistance (2).
 
Research suggests that muscle mass can effectively increase glucose storage, facilitate glucose clearance from the circulation, and reduce the amount of insulin required to maintain a normal glucose tolerance (3).
 

Reduces testosterone

 
Research has found that resistance training can help lower levels of testosterone in women with PCOS (4). As a result of the reduction of insulin this, in turn, helps to lower testosterone levels.
 

High-Intensity Interval Training

 
High-Intensity Interval Training (HIIT) is the second form of exercise that research has identified as being beneficial for insulin resistance. HIIT is a vigorous form of exercise, which involves full bursts of energy along with a short or active recovery period.
 

An Example of HIIT Workout

 
HIIT sessions often last for 25 minutes or less:

• 3 minutes of warm-up
• 10 sprints of 60 seconds, with 60 seconds of recovery
• 2 minutes of cool down

 
Researchers found that HIIT completed over the course of 10 weeks improved insulin resistance. A further study examining the effects of HIIT on women with insulin resistance and PCOS found that after 12 weeks of HIIT cardio, undertaken three times a week resulted in a reduction in waist and hip circumference (5).
 
High-intensity interval training increases insulin sensitivity as a result of the body expending glucose and then allowing blood glucose to enter the muscle cells. This, in turn, helps to lower the risk of developing diabetes.
 

Your HIIT Workout

 
There is no best HIIT workout, simply ensure you choose a workout that uses a range of muscles, such as sprints, rowing, boxing. Furthermore, most importantly, when it comes to creating your HIIT workout your initial fitness and experience is important. Therefore, if you are a beginner it is important to start off slow and gradually increase the intensity, duration and sets.
 

Adrenal PCOS

 
Androgens are not only produced by the ovary, it is estimated that 20-30% of women with PCOS have adrenal androgen excess (6).
 
In todays busy and fast-paced society, stress is experienced every day, whether it be from work, relationships or simply sitting in traffic. Stress levels are often not elevated the same way they would have been triggered during the time of our ancestors.
 
Cortisol, one of the primary stress hormones, is released by the adrenal glands. The stress hormone is triggered as a result of the fight-or-flight response. Stress or fear causes the body to automatically respond to ensure survival from any threat.
 
During the fight-or-flight response, cortisol increases blood sugar (the source of energy needed to survive) and shuts down anything within the body that is unnecessary, such as reproductive functions. The surge in blood sugar caused by the increase in cortisol also leads to an increase in insulin.
 
Stress causes the adrenal glands to produce cortisol, adrenaline and norepinephrine, along with 3 androgen hormones; DHEA, testosterone and androstenedione. Research has also found that DHEA can be converted into Dihydrotestosterone (DHT), which is what causes hair loss and hair thinning in women with PCOS (7).
 

The Effects of Chronic Stress

 
Long-term stress can cause an increase in the release of androgens, but also cortisol resistance, leading to adrenal fatigue or “burnout”. This is where the cells become resistant to the effects of the hormone. Therefore, if the body becomes resistant to cortisol you will not have the energy you are meant to have, for example in the morning cortisol is high, which is what makes us wake up.
 

Exercise for Adrenal PCOS

 
If you are struggling with fatigue or you feel tired after training, you may have to adjust or cut down on your workouts and their intensity. Endurance and intense exercise cause the body to produce increased amounts of cortisol. Exercise intensities between 80% and 90% of VO2 max, cause elevated cortisol levels to be secreted (8). 

If you are someone who is looking to lose weight, this may sound counterproductive. However, what happens when you reduce your intensity and exercise is that the weight actually starts coming off, due a decrease in your cortisol levels. Therefore, do not panic, I am not telling you to completely put an end to all exercise.
 

Low-intensity exercise (40%) does not result in significant increases in cortisol levels. Instead, it reduces circulating cortisol levels (8). Therefore, aim to include more low-intensity exercise into your workout routine, such as walking, yoga, swimming.
 

Summary

 
There is not one type of PCOS and therefore it is important to know which type you have before you delve into a workout program as it may be doing you more harm than good. Resistance training and HIIT are two great exercises for women who suffer from insulin resistant PCOS, as a result of glucose expenditure. Whereas low-intensity exercise is more beneficial for women who suffer from adrenal PCOS, as cortisol levels do not increase significantly, compared to HIIT.

Sources

 
 
(1) Ovalle, F and Azziz, R. (2002). Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertility and Sterility. 77(6),1095-1105. Available from: https://www.sciencedirect.com/science/article/pii/S0015028202031114

(2) Srikanthan P, Karlamangla AS. (2011). Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey. The Journal of Clinical Endocrinology and Metabolism. 96(9):2898-903. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21778224

(3) Cuff, DJ., Meneilly, GS., Martin, A., Ignaszewski, A., Tildesley. HD., Frohlich, JJ. (2003). Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes. Diabetes Care Association Journal. Available from: http://care.diabetesjournals.org/content/26/11/2977 . 26(11): 2977-2982. [Accessed 11 February 2017].

(4) Miranda-Furtado, CL., Picchi Ramos, FK., GS Kogure, Santana-Lemos BA., Ferriani RA., Calado RT.,   dos Reis RM.(2016). A Nonrandomized Trial of Progressive Resistance Training Intervention in Women With Polycystic Ovary Syndrome and Its Implications in Telomere Content. Reproductive Sciences. Available from: http://journals.sagepub.com/doi/pdf/10.1177/1933719115611753 . 23(5) 644-654. [Accessed 10 February 2017].

(5) Liza Haqq, Josh Denham, Gudrun Dieberg, Jim McFarlane, Neil Smart . (2016). Effects of high intensity interval training on insulin resistance in women with polycystic ovarian syndrome. University of New England. Available from: https://www.researchgate.net/publication/319154178_Effects_of_high_intensity_interval_training_on_insulin_resistance_in_women_with_polycystic_ovarian_syndrome

(6) Kumar, A., Woods, SK., Bartolucci, AA., Azziz, R. (2005). Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS). Clinical Endocrinology.62(6), 644–649. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2005.02256.x/full

(7) Androgen therapy in women. European Journal of Endocrinology. 1541-11. Available from: http://www.eje-online.org/content/154/1/1.full 

(8) Hill EE, Zack E, Battaglini C, Viru M, Viru A, Hackney AC. (2008). Exercise and circulating cortisol levels: the intensity threshold effect. Journal of Endocrinological Investigation. 31(7):587-91. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18787373

Despina Pavlou is the founder of PCOS and Nutrition and a certified personal trainer. She takes a holistic and evidence-based approach to both nutrition and training. She believes both diet and lifestyle modifications are an effective approach to managing PCOS and its symptoms.

On her website, you will find tips on how to treat PCOS with lifestyle, diet, and supplement changes, as well as recipes. You will also find a host of general health and wellness information.

Guest Post By: Kim Holmes, Personal Trainer and Founder of My Fit Coach
 

It’s no secret that exercise is good for us. As grown women, we’ve all heard the benefits about a stronger heart, decreased risk of diabetes, better mental health. The list goes on and on.  Any form of exercise is good.

As a Personal Trainer, I too want you to find a type of exercise that you love to do. However I AM a touch partial to one particular form of exercise.  It is my humble opinion that Strength Training is the single best type of exercise that ANY woman can do. I could go on and on with this one but for the sake of time, here’s my short list of benefits:

1)   Increased metabolism

2)   Decreased risk of injury

3)  Increased Strength

4)   Increased confidence with increased strength

5)   You’ll look a size smaller…can I get an amen?!!!

While ALL these reasons are great ones to hit the weights, today we’re going to focus specifically on the metabolic benefits of strength training. The truth is that lifting ALL THE HEAVY THINGS  will insanely boost your metabolism!

Did that get your attention?!

Let me say it again!
 

Strength Training boosts your metabolism! And Here’s how:

 
What if I told you there was a way to burn more calories every single day by simply sitting on the couch? Would you be in??? I sure would!

Performing regular strength training activities 2-3 times a week builds and maintains lean muscle mass.  By adding just 1lb of muscle to your frame, you increase your metabolism by approximately 35-50 extra calories a day. In addition to this, your body will be incinerating even more calories up to 40 minutes after you’ve put down the dumbbells.

It’s important to note that muscle mass decreases as we age and therefore, our metabolism starts to slow down.  This is a situation that we can prevent. It is never to early OR late to hit the weights.
 

Why Cardio alone isn’t gonna cut it…

 
For all my cardio lovers out there, I’m not asking you to stop especially if you love your daily run.  I get it!  I AM however suggesting that making a few small adjustments to your fitness routine could have a significant benefit to your health and weight loss efforts. If you’ve been struggling with weight loss but are still doing hours and hours of cardio each week, you may wanna listen up.

When you do long sweaty cardio sessions (think 60 minutes and up) your body releases extra cortisol, the hormone responsible for fat being stored right smack dab in your belly. In addition to this, too much cardio can actually break down your muscle mass thus decreasing your metabolism. This literally breaks my heart!

Muscle is metabolically active tissue. We want to increase our muscle mass and do everything we can to preserve it. This is where our good pal strength training comes in.
 

So what’s a girl to do about a workout?

 
I recommend starting with a full body strength training workout 2-3 times a week and 2-3 shorter interval based cardio sessions.

I train my Online clients with workouts ranging from 25-35 minutes and they still see amazing results when combined with a healthy eating plan. The reason it works is that they are increasing AND preserving their muscle mass (thus elevating their metabolism)

The other reason this works is because the workouts are shorter. By working out for shorter periods of time, you stress the body less, keep the excess cortisol monster at bay and keep those hormones in check.
 

So how do I start Strength Training???

 
Good news!

You really don’t need a lot to get started on a Strength Training Program.  You don’t have to have a lot of fancy equipment or even a gym membership for that matter.

Simply put, strength training or resistance training is the act of exercising your muscles using opposing force.  The opposing force can be dumbbells, barbells, resistance bands or even your own bodyweight. It doesn’t have to be fancy.  And the good news is that you can reap the benefits by strength training only 2-3 times a week.
 

In Fact you can do this ALL from your very own living room!

 
Exercises like squats, lunges, pushups, tricep dips and planks are a great way to get started and you don’t even have to leave your house. If you have some dumbbells you can add in some bicep curls and shoulder raises or tricep extensions to shake things up a bit.

If you’re not sure where to start, you can also work one on one with a Certified Personal Trainer or look at your local gyms Strength based fitness classes.  You can also check out Online Options like My Fit Coach’s Just Sweat Program to take the guesswork out of the whole thing.
 

Let’s get Going

 
Now that you know all the benefits of strength training and are pumped to get your metabolism firing on all four cylinders, let’s get this party started. Don’t make it too complicated. Just start where you’re at, stay consistent and the results will come in no time.

If you wanna get started RIGHT NOW (who can blame you?) you can download my FREE 5 Days to Fit Jumpstart Program and get instant access to 5 days of Home Workout Videos  and a energizing meal plan to help you boost your metabolism today.

These 30 minute (or less) videos teach you the correct strength training technique to decrease injury and maximize your muscle tone. Plus they’re fun AND short so they get the job done as quickly as possible.

Happy Metabolism boosting!
 
 

Kim Holmes is a Personal Trainer and the Owner of My Fit Coach. She helps busy Moms care for their bodies (and minds) through Online Fitness and Nutrition Programs. As a Mom of two young sons, she understands that you don’t have hours to spend at the gym. Her Online Programs are efficient, fun and most importantly, they make fitness fit into your REAL life.

I’m no stranger to struggles with weight loss. I first started dieting and exercising to change my weight when I was 16 years old, although if I had my way I likely would’ve started earlier- even though I was a slim girl, I never saw myself that way. Just because I was one or two pant sizes bigger than the other girls in my class, I thought I was huge. 

I also didn’t have good role models growing up- the women in my family were constantly hating on their bodies and always dieting. I thought that if I didn’t have a flat tummy, toned arms and a “thigh gap”, I was unworthy of being called “beautiful”.

Throughout the next several years, I dieted on an off basically all the time, usually by restricting my fat intake, lowering my calories and doing loads of cardio and attending bootcamp exercises classes at the local rec centre. 

It always worked temporarily, until I was in my early 20s and was diagnosed with PCOS. Calorie counting didn’t work, and when I went back to the treadmill, I gained even MORE weight. I couldn’t understand what the fuck was going on, and I felt like a failure. 

Although doctors and various “experts” over the last several decades have heavily promoted long cardio sessions and hardcore bootcamp classes as being the best for weight loss, this is a total MYTH, and a myth I’m super excited to BUST for you today. 

The Bad Science

First of all, let’s talk science. 

The thought process behind using cardio for weight loss centres around calorie expenditure. For instance, 1 pound of fat equals 3,500 calories. So, if you want to lose 1 pound per week, you need to burn an extra 500 calories per day according to this theory. 

Doctors and others may suggest that doing an hour on the treadmill, elliptical or stationary bike daily with some calorie restriction on your food will get you there. But what happens at the end of the week when you’ve burned all these calories and the scale still doesn’t budge?

Part of this has to do with heart rate. When you do cardio, it’s at a steady pace for the entire time. Generally, this is inefficient at burning fat, as variations in heart rate (like in High-Intensity Interval Training) become more effective partly by “keeping your body guessing” and putting yourself into that fat burning zone. 

Also, doing long, drawn out cardio often leaves us tired and hungry. So we eat more. Or, if we have the willpower to stick with the 1,200 calories a day we’ve chosen for our weight loss diet, we aren’t giving our bodies the proper fuel to recover from this exercise, which creates a mess in your body. We’ll talk about this more in the next section. 

Your Body On Cardio and Bootcamps

To help you understand WHY these forms of exercise are inefficient for weight loss, you must understand HOW your body reacts when you participate in these activities. 

For the sake of simplicity, I’m going to use jogging as an example. 

You go out for a run, hoping to shed those pounds. You slowly work your way up to longer and longer distances. 

As you are running, a stress reaction starts in your body. Cortisol, your main stress hormone, is released. While this is a good thing if you’re literally running for your life, chronically high levels of cortisol (i.e.: from long distance running), tells your body to make and release more sugar into the blood so your body can make more energy. 

Higher levels of blood sugar is one of the simplest ways your body packs on the pounds. Plus, this leaves you feeling ravenous. The sugar and carb cravings will be yelling at you and guess what- you’ll likely eat and average of 100 more calories after you’re done than you burned off during the exercise!

Additionally, doing this type of exercise (or other cardio and bootcamps), causes your body to burn muscle instead of fat. Less lean muscle mass slows your metabolism, and it becomes even harder to burn those calories to get the weight off. Plus, you’ll become weaker, more tired and more irritable. And your hormones will start screaming at you. 

High levels of cortisol and imbalanced blood sugar mean hormonal hell. Your body steals building blocks (like pregnenolone and progesterone) to make more cortisol, leaving you deficient in progesterone. Low progesterone isn’t able to keep estrogen in check, so estrogen dominance can result. 

Estrogen dominance then starts a STORM in your body of weight gain- especially in the hips, thighs, belly and back- and moodiness, anxiety, depression and of course- bad periods. 

Many women with hormonal imbalances with estrogen dominance at the root (like PCOS, Endometriosis, PMS, and heavy, painful or irregular periods) feel the worst when they do cardio and bootcamps because it increases their symptoms- even if during the exercise they feel fabulous. 

You can read more about Estrogen Dominance to see if this hormonal imbalance is part of your inability to lose weight and improve your emotional state by clicking here. 

What Can Be Done Instead

So that’s all great- but what can you actually do to effectively burn fat without losing muscle and creating hormonal imbalances?

First, correct your hormonal imbalances with food. 

You cannot out-exercise a bad diet ladies.

It’s just not possible. No matter how long you stay on that treadmill or how many bootcamp classes you attend, if you’re scarfing down a bagel for breakfast and eating take out for dinner every night, the scale is going to climb. 

Second, switch your exercise to the fat-burning kind. The de-stressor kind. Think High-Intensity Interval Training for 20-30 minutes max, and some yoga to balance it out.

Causes of Low Energy

Hormonal Imbalance

Toxicity

Immune Deficiency

Dehydration

Anemia

Nutrient Deficiency

I want to make changes, and start exercising- but I’m SO TIRED.

How to do it

• Start Small
  • 1-3 days per week
  • 10-20 minutes duration
  • Low Intensity
    • Think walking, stretching, gentle yoga, recumbent stationary bike, MAYBE some bodyweight exercises like squats or using light weights (~2lbs) for small movements like bicep curls, calf raises, leg lifts, pelvic tilts and chest press. 
    • Keep your mind on your breath while exercising. Do not hold your breath, rather breathe with each movement.
• Check in with yourself over the process
  • Before: What kind of exercise does my body need today? You might have a hard time answering this one until you’ve tried several types/intensities of workouts. When did I eat last? Have I had some protein, fats and carbs to sustain my energy during my workout?
  • During: How am I feeling? Do I feel strong? Do I need water?
  • After: How am I feeling? Do I want to take a nap or am I energized for the next tasks of the day? Do I need water? Food?
  • Next day: Am I sore? How sore? How tired am I?
• BREATHE
  • Before exercise
  • During Exercise
  • After Exercise
  • . . .Always! 
  • Doing regular breathing exercises like meditation, the three-part breath, or alternate nostril breathing can help increase your lung capacity.
  • Not only this, the increased oxygen will go a long way to helping you feel more energized and ready for intense exercise.

Is your energy low? Do you know why? What holistic remedies have you used?