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The PCOS Solution

How exercise helps balance your hormones especially in PCOS

Wednesday, September 23, 2015
Hormones in a tangle? You’ve probably heard that exercise helps. But did you know that engaging in specific kinds of exercise, enough, could be the most effective hormone balancing tool you have. Let’s look at the biological mechanisms, the scientific evidence, and how exercise breaks the connection between resistant fat deposits and out-of-control hormones.

FOCUS ON INSULIN FIRST

The major advantage exercise gives you is overcoming your cells’ resistance to insulin. Your cells need glucose to function, and usually signal when they need more. They communicate this need by expressing receptors on the cell membrane that read: ‘Glucose needed here’.  Insulin, the glucose salesman, duly arrives at the cell’s doorstep with a delivery of glucose and passes it over. But if your cells don’t need more glucose because you’re sedentary they won’t put out that ‘glucose needed’ sign.

As a result your blood glucose levels rise. Your pancreas tries to cope with this by producing more insulin, but that doesn’t fix the problem. (Like responding to a glucose sales slump by employing more insulin salesman when the problem is that the cells have their doors shut to insulin’s deliveries.)

Exercise helps by using up the glucose your cells already have; that induces them to once again open their doors to a glucose delivery. As soon as you start exercising your circulating blood glucose levels fall, your pancreas takes a rest from producing insulin, and your hormones start to change.

MORE EXERCISE = LESS FAT = HAPPIER HORMONES

Better blood glucose regulation through exercise doesn’t affect your hormones directly as much as it affects the amount of fat you’re carrying; because fat cells emit their own endocrine message. When you get active (enough, and in the right way) your fat stores diminish, and here’s where your hormones really start to respond. One big change is the lift in sex hormone binding globulin (SHBG). This natty little protein circulates through your body effectively ‘mopping’ up excess hormones.

Another change happens within your ovaries: Insulin resistance causes your ovaries to produce more androgens. Secreted by the theca cells surrounding each egg follicle, this disrupts the normal process of egg maturation. You end up with many under-developed egg follicles going nowhere (polycystic ovaries). Worse, too much androgens exacerbate insulin resistance and fat accumulation in the peripheral tissues, creating a self-perpetuating cycle of fat accumulation, insulin resistance and androgen excess. 

EXERCISE: ENOUGH AND THE RIGHT KIND

When you exercise you use up energy, which, along with improving your insulin sensitivity, reduces the fat stores in your body. Now, I’m not talking about just a stroll around the block every day or so; enough exercise to make a difference. The PCOS Australian Alliance pulled together guidelines in 2011 for assessment and management of PCOS. They recommended at least 150 minutes of exercise per week; just over half of this time in moderate-to-high-intensity activity.  You’ve probably already reached for your calculator: 22 minutes a day isn’t Olympic level training.

Unfortunately, the guidelines omitted resistance training. In 2014 Australian researchers stepped forward to recommend that resistance training should be included in these recommendations. Their article, published in Sports Medicine, proposed that since progressive resistance training can improve insulin resistance in type 2 diabetes it should be part of PCOS treatment too. 

Is exercise actually more powerful than diet in untangling hormones? Maybe so. A Pilot study produced by researchers at the University of Saskatchewan in Canada proposed that exercising, unlike food restrictions, won’t make you feel deprived so you’re more likely to stick with the program – a key reason so many abandon diet plans. 

BUT DON’T IGNORE YOUR STRESS

Stress disrupts hormones effectively: It makes your pituitary gland less receptive to the instructions of your hypothalamus to release LH and FSH, the hormones that direct your ovaries. If you’re feeling uptight ovulation might still happen but some under-developed egg follicles could remain, secreting more hormones to disrupt the delicate balance of interconnecting endocrine messages. If you don’t ovulate that means less of the progesterone that helps moderate pre-menstrual tension. Worse, stress means more prolactin being released, further inhibiting ovulation.

Yoga might help improve your fitness and reduce your stress at the same time: A study of the effect of yoga on PCOS proposed that yoga had a beneficial effect in two ways: this ancient exercise reduced levels of anti-mullerian hormone, (which inhibits development of ovarian follicles, leading to ovarian failure). The other hypothesis is that chronic stress disrupts the hypothalamic-pituitary-ovarian axis, and yoga relieves this. 

It’s probably obvious by now that your hormones are incredibly complex and yet intertwined, and that this message system can easily be disrupted; however you can ease the hormonal tangle simply with exercise.

WHAT YOU NEED TO DO

Of course, you should consult with your practitioner prior to embarking on fitness training, to make sure you’ll be safe. After all, if you get injured or unwell you can’t train. You can check in with your GP, or an exercise physiologist. Get the balance of cardiovascular, strength and stress-busting exercise right and your hormones will respond.

If you enjoyed this article, you might also enjoy "If I ignore this hormone problem will it just go away", here.



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