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HIIT (High-Intensity Interval Training) and Polycystic Ovarian Syndrome (PCOS) might seem like an unlikely pair for those focusing on hormonal balance. There’s some concern that HIIT could negatively impact hormone health, especially for those with PCOS, which is the most prevalent hormonal disorder among women of reproductive age. So, should women with PCOS steer clear of HIIT because it tends to raise cortisol levels? Is this type of workout suitable for everyone, particularly women dealing with hormonal conditions? Let’s explore these questions and more…..

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a metabolic condition in women where the body produces too many androgens, hormones similar to male sex hormones. This excess can lead to the formation of cysts on the ovaries.

You may experience symptoms such as:

  • Irregular or missed periods
  • Infertility or trouble getting pregnant
  • Acne
  • Excessive hair growth on your face and chin

To understand more, read our ‘What is PCOS?’ article

 

What is HIIT?

High-intensity interval training (HIIT) is a type of training that includes short periods of intense or maximal-effort exercise (typically around the 60-second mark), and short recovery periods.

Examples of HIIT:

  • Crossfit
  • Circuit training
  • Some gym glasses have HIIT elements

HIIT involves repeated exercises that are performed in quick bursts. These quick bursts of maximal work are followed by a shorter period of recovery, usually anywhere between 10-20 seconds. 

If you haven’t guessed already, HIIT workouts are very challenging!

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HIIT and PCOS: The hormonal impact

High-Intensity Interval Training (HIIT) is popular for how fast and effective it is, but it’s important to understand how it can affect you, especially with Polycystic Ovary Syndrome (PCOS). 

The high demands of HIIT inevitably lead to increased production of cortisol, a normal response to physical stress (exercise). However, for women with PCOS, the implications of this can be significant.

With your diagnosis of PCOS, you’re already suffering from hormonal imbalances.

If not applied correctly, HIIT can be problematic when it comes to maintaining or improving hormone balance.

Cortisol’s role in HIIT

During HIIT, your cortisol levels spike due to the intense bursts of activity followed by brief recovery periods. 

This constant high level of cortisol (especially multiple times a week or every day) may disrupt the delicate balance of female hormones such as estrogen and progesterone. 

These hormones are crucial for regulating your menstrual cycle. With PCOS, this is a struggle already. 

The impact of routine exposure to high cortisol

The body thrives on healthy routines and low-stress levels. For women with PCOS, prolonged exposure to heightened cortisol levels from continuous HIIT sessions can further disrupt the hormone balance they do have. 

Consistent exposure to high cortisol levels not only disrupts your progesterone and estrogen, but it also impacts other hormones (testosterone, melatonin, ghrelin, and more).

Whilst there is potential for HIIT to cause further disruption to your hormone balance and worsen your PCOS symptoms, this isn’t always the case.

 You absolutely can do HIIT and reap the rewards that it can offer.

In fact, there are some positives for women with PCOS doing HIIT.

Benefits of HIIT for women with PCOS

Improved Insulin Sensitivity

Research indicates that High-Intensity Interval Training (HIIT) can enhance insulin sensitivity, addressing a common challenge faced by women with PCOS.

Reduced Cardiovascular Risk

 PCOS increases the risk of cardiovascular diseases. Regular exercise, including HIIT, can help lower this risk!

Lower Testosterone Levels

A study revealed that HIIT is more effective at reducing testosterone levels in women with PCOS compared to strength training, potentially decreasing the severity of PCOS symptoms!

Effective Weight Loss

HIIT is renowned for its ability to produce significant weight loss results, which can be particularly beneficial for women with PCOS who struggle with obesity.

HIIT creates an oxygen debt in your muscles, which forces your body into something called ‘excess post-exercise oxygen consumption’. In simple terms, this means even after your workout, your body is still burning fat for a period of time. 

Improved Mood

HIIT workouts are pretty much guaranteed to give you that post workout boost! 

Any exercise you do produces a cortisol (stress) response; this is completely normal. When you overcome this, when finishing a workout, you will get a hit of endorphins. Endorphins are a hormone that helps combat cortisol and bring us back to a calm state. 

As hard as you push during a HIIT session, the greater you will feel afterward!

Potential Pitfalls of HIIT for women with PCOS

Further disrupting hormonal balance

One of the biggest concerns with regular HIIT for women with PCOS is the potential to cause further harm to your hormone health. 

Unfortunately, with a diagnosis of PCOS, your hormones aren’t functioning optimally as it is, and it is likely that your menstrual cycle isn’t regular or cyclic like you’d hope.

Adding HIIT into your routine does carry a risk of causing more irregularities to your menstrual cycle, or losing your period altogether. 

This is called amenorrhea.

Scientists and medical professionals do not understand the link between HIIT and amenorrhea yet, but they believe it has something to do with increased cortisol and testosterone levels.

With this in mind, you have to approach HIIT with caution.

Worsening PCOS symptoms

Disrupting your hormones will inevitably lead to worsening PCOS symptoms. 

It is impossible to tell how this will show up for you, but you will notice it over time.

  • Longer and even more irregular menstrual cycles
  • Worsening acne
  • More hair loss or thinning hairline
  • Trouble sleeping
  • Increased inflammation (PCOS moon face)
  • Weight gain
  • Low mood
  • More anxiety
  • Worsening depression

And more!

We don’t need to tell you of the extra challenges this may bring. Never mind the difficulty that this could add. You know better than anyone else. 

Despite the risks, the good news is, there is a way to add HIIT to your workout routine while minimising the impact on your hormones and PCOS… 

 

Minimising the impact of HIIT Training on PCOS

When you have PCOS and are considering HIIT, it’s important to focus on safety and protecting your long-term health.

If you’re feeling unsure about how to start, follow these tips to make sure you’re approaching HIIT in a way that keeps your hormone health in mind:

1. Make sure you are eating enough

One of the major challenges women face with HIIT training and hormone balance is not consuming enough or the right kind of nutrients to support their hormone health during workouts. You may have heard of hypothalamic amenorrhea, which is losing your period due to under-eating and excessive exercise. If you’re not fuelling yourself properly as a woman with PCOS, you run the risk of developing this condition.

You need to be consuming enough calories throughout the day, and adequate nutrients to not only fuel your workout, but to support your hormone health alongside.

If you’re planning on doing a HIIT workout, consider having a small snack beforehand.

2. Prioritise recovery

As you now know, HIIT demands a lot of your body and often requires maximum effort. You need to give your body some time to recover from a HIIT workout. 

Remember hypothalamic amenorrhea? Overtraining can lead to even more hormone imbalances for you, as a woman with PCOS, so aim for 48 hours between intense workouts.

3. Personalise it

How HIIT impacts PCOS symptoms and hormone balance will vary from person to person. What works for someone that you’ve seen on Instagram likely won’t work the same for you.

You need to be in touch with your body and notice the signals that it sends you. Then, you need to adapt accordingly.

If you notice any of your PCOS symptoms getting worse, or perhaps new ones cropping up, take a step back and assess. 

Are you fuelling yourself properly?
Are you having adequate rest periods between your workouts, and even between exercises?

Problems with your period, increased fatigue, and puffiness are just a few examples of how PCOS can worsen with too much high-intensity interval training.

The verdict: HIIT and PCOS

Navigating the impact of HIIT on PCOS can be a bit tricky. 

Research shows that HIIT can be a good exercise choice for women with PCOS, but it’s important to factor in personal circumstances and preferences.

Everyone’s experience with PCOS is unique. For some, HIIT might be overwhelming and could worsen symptoms. 

Others might find it enhances their mood and improves insulin resistance without negatively affecting their hormone health. It really boils down to trial and error if you want to give it a go for yourself.

If you’re curious about how HIIT could affect your PCOS, the best approach is to simply give it a try. Start by integrating some HIIT sessions into your exercise routine, but remember to keep a close watch on your symptoms and any long-term changes.

You know your body and your PCOS better than anyone else, so you’re in the best position to decide whether HIIT is right for you.

Always prioritise your hormone health, particularly because you’re managing polycystic ovarian syndrome.

With the right approach, you can harness the benefits of HIIT while safeguarding your hormonal well-being, which is crucial for those with PCOS.

References

We got some of our information from

References
Colombo, G. E., Bouzo, X. D., Patten, R. K., Mousa, A., Tay, C. T., Pattuwage, L., … & Sabag, A. (2023). Comparison of selected exercise training modalities in the management of PCOS: a systematic review and meta-analysis to inform evidence-based guidelines. JSAMS Plus, 2, 100024.

Helena J Teede, Marie L Misso, Michael F Costello, Anuja Dokras, Joop Laven, Lisa Moran, Terhi Piltonen, Robert J Norman, International PCOS Network , Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome, Human Reproduction, Volume 33, Issue 9, September 2018, Pages 1602–1618, https://doi.org/10.1093/humrep/dey256

Rao, M., Khan, A. A., & Adnan, Q. U. A. (2022). Effects of high-intensity interval training and strength training on levels of testosterone and physical activity among women with polycystic ovary syndrome. Obstetrics & gynecology science, 65(4), 368.

Rasquin LI, Anastasopoulou C, Mayrin JV. Polycystic Ovarian Disease. [Updated 2022 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/

Richards, C. T., Meah, V. L., James, P. E., Rees, D. A., & Lord, R. N. (2021). HIIT’ing or MISS’ing the optimal Management of Polycystic Ovary Syndrome: a systematic review and Meta-analysis of high-versus moderate-intensity exercise prescription. Frontiers in Physiology, 12, 715881.

Santos, I. K. D., Nunes, F. A. S. D. S., Queiros, V. S., Cobucci, R. N., Dantas, P. B., Soares, G. M., … & Dantas, P. M. S. (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.

https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

https://www.fertilityfamily.co.uk/blog/exercise-for-pcos-what-are-the-best-and-worst-exercises-for-pcos/#:~:text=Another%20study%20specifically%20looked%20at,the%20severity%20of%20PCOS%20symptoms

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