Hello,
Cardio is the default exercise prescription for PCOS in most clinical settings. The evidence for strength training is now strong enough that it's worth a separate conversation.
Why Strength Training Matters in PCOS
Skeletal muscle is the body's largest glucose sink. The more muscle you have, the more places insulin has to put glucose. That's a direct intervention on insulin resistance — the core PCOS mechanism.
Strength training also raises SHBG (sex hormone binding globulin), the protein that binds free testosterone in the bloodstream. Higher SHBG = less free testosterone = less hyperandrogenism. The mechanism is well-described.
Cardio doesn't move SHBG the same way. Long-form cardio can actually raise cortisol over time, which we covered four weeks ago in the cortisol-PCOS loop note. For PCOS bodies in high-stress periods, swapping cardio for strength is often the right call.
What "strength Training" Actually Means Here
Not Pilates. Not light dumbbell circuits. Resistance heavy enough that the last 2-3 reps of a set are genuinely difficult.
A useful first-week structure for someone new:
- 3 sessions per week, ~45 minutes each
- Compound lifts: squats, deadlifts, rows, presses, hinges
- 3-4 sets of 6-10 reps per exercise
- Weights chosen so the final reps are challenging
- 48 hours between sessions for the same muscle group
Gym membership not required. A pair of adjustable dumbbells and a bench in a spare room produces most of the metabolic benefit.
What to Avoid for the First 90 Days
- Programs marketed at women specifically ("toning", "long lean lines") — these are often disguised low-intensity routines that won't move PCOS markers
- High-intensity interval training every day; HIIT is a useful occasional tool, not a baseline
- "Bikini body" rhetoric — the goal is metabolic, not aesthetic; body composition usually follows
What Your Data Will Show
If you're tracking the Movement Log (#7) alongside the Cycle Phase Tracker (#1) and Symptom Tracker (#3), the pattern surfaces over 2-3 months: cycles get more regular, energy on training days runs higher than non-training days, luteal symptoms moderate.
This is one of the slower-acting levers — but among the most durable.