Can excessive cardio worsen PMOS? Experts explain why strength training may be better

CLAIM: A viral Instagram reel claims excessive cardio worsens PMOS by raising cortisol levels and increasing insulin resistance, while advocating for strength training as a more effective approach for women managing the condition.

FACT: True. Research suggests that exercise, including both cardio and strength training, plays an important role in managing PMOS. Doctors caution that excessive cardio can spike cortisol and worsen insulin resistance, while strength training is recommended to help improve the condition. 

A viral instagram reel by the fitness account getsetfit, claims that excessive cardio could increase PMOS among women. The reel, uploaded by fitness coach Priyank Mehta, has garnered 19 lakh views, over 18,500 likes, and more than 28,700 shares at the time of reporting. 

In PMOS, the ovaries overproduce androgens (male hormones), which prevent regular egg maturation and ovulation. Women with PMOS frequently face dysregulated cortisol, which triggers the production of androgens, worsens insulin resistance and promotes abdominal fat storage. Mehta claims that women with PMOS who engage in excessive high-intensity cardio may experience elevated cortisol levels, which, in turn, can worsen insulin resistance and contribute to irregular periods. 

As an alternative, Mehta advocates structured strength training, claiming that he has helped many women manage PMOS symptoms and lose weight through such programmes. According to him, building lean muscle mass helps improve metabolic health and can aid in managing PMOS-related symptoms.

One in eight women globally, which is about 170 million people across the world, experiences symptoms.  

What research suggests?

A 2022 systematic review and meta-analysis examined the effect of exercise on cardiometabolic risk factors in women with polycystic ovary syndrome, a common hormonal disorder in women of reproductive age that increases the risk of heart and metabolic conditions. 

The review analysed about 18 studies, which involved 593 participants. The findings showed that exercise significantly improved cardiorespiratory fitness and reduced waist circumference in women with PMOS compared to those who did not exercise. “Systolic blood pressure, fasting blood glucose, insulin resistance, and lipid profiles remained unchanged,” the study stated.  

“While regular exercise is effective in reducing cardiometabolic risk, women with PMOS may experience condition-specific barriers to exercise, thereby limiting its efficacy,” the study added.  

A 2024 position statement from Exercise and Sports Science Australia outlined evidence-based exercise recommendations for managing PMOS. The statement, which builds on the 2023 International Evidence-based Guideline for the Assessment and Management of PMOS, described exercise as a first-line strategy in managing the condition. 

The statement recommended that individuals with PMOS should aim for 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity aerobic activity per week.  

“Additionally, muscle-strengthening activities on two non-consecutive days per week are recommended to maintain health and prevent weight gain,” the study noted. 

It also recommended "muscle-strengthening activities on two non-consecutive days per week to maintain health and prevent weight gain." For those seeking additional health benefits and modest weight loss, the recommended target increases to at least 250 minutes of moderate-intensity or 150 minutes of vigorous-intensity aerobic activity per week, combined with muscle-strengthening activities. 

“Adolescents with PMOS should aim for a minimum of 60 min moderate- to vigorous-intensity activity each day, incorporating muscle- and bone-strengthening activities three times per week,” the study suggested.  

“Lifestyle interventions, which can include structured exercise programmes delivered by appropriately trained exercise professionals such as clinical exercise physiologists, are considered first-line strategies in PMOS management due to their therapeutic effects on various health outcomes and quality of life,” the statement noted. 

It called on exercise professionals to consider the psychological burden, including weight stigma, and the high prevalence of comorbidities amongst individuals with PMOS and take appropriate measures to deliver safe and efficacious exercise interventions.  

What do the doctors think?

Dr Abha Majumdar, advisor and emeritus consultant at the Centre of IVF and Human Reproduction at Sir Ganga Ram Hospital, said that excessive cardio may increase physical stress levels, potentially raising cortisol levels and worsening insulin resistance in women with Polycystic Ovary Syndrome.  

“It is important that women with PMOS symptoms do moderate cardio along with strength training to build muscle mass, as this helps improve insulin resistance,” Dr Majumdar stressed. “PMOS women who are attempting to lose weight should keep a weighing machine at home and monitor their weight regularly, ideally once a week.”  

He cautioned that excessive cardio can lead to fatigue and heightened stress responses, which may aggravate insulin resistance and make weight loss more difficult in women with PMOS. 

Dr Majumdar urged women to benefit from moderate cardio like walking, cycling or swimming for 20 to 30 minutes along with gym-based resistance exercises, Pilates, or yoga, as these activities support muscle strength, mental well-being, and stress reduction, along with improving insulin resistance. 

“It is always better to consult a doctor to get the correct answers to health-related queries rather than relying on trends circulating on social media. That helps in managing the condition more effectively,” she said. 

This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS