PCOS and Strength & Conditioning: Is Building Muscle the Missing Link to Feeling Better?

Have you ever been told to “just lose weight” to manage your PCOS? 

If yes, you’re not alone. Despite affecting 1 in 10 women of reproductive age, Polycystic Ovary Syndrome (PCOS) is still widely misunderstood—and in some cases, misdiagnosed altogether.

But what is PCOS really? And why is it so hard to manage with a one-size-fits-all approach?

Let’s start with the basics.

Is PCOS actually about cysts?

Surprisingly, no. While the name “Polycystic Ovary Syndrome” suggests multiple cysts on the ovaries, not everyone with PCOS has them. And not everyone with cysts has PCOS. Confusing, right?

So what is PCOS then?

It’s a hormonal condition that affects how the ovaries work—usually linked with irregular periods, excess androgen (male hormone) levels, and sometimes, polycystic ovaries seen on an ultrasound.

But here’s something even more interesting: PCOS isn’t just one condition—it may actually be a spectrum.

Are there different types of PCOS?

Emerging studies suggest there may be two broad types:

• Hormone-driven PCOS – where the brain-ovary communication is off, impacting ovulation and hormone regulation.

  
  

• Metabolism-driven PCOS – where insulin resistance and blood sugar dysregulation play a big role, often seen with weight gain or fatigue.

So if the root causes are different, shouldn’t the treatment approaches be different too?

How reliable are PCOS tests?

Here’s the tricky part: different labs often use different hormone ranges, especially for testosterone. That means someone might be diagnosed in one place and told they’re “normal” in another.

Could this explain why up to 70% of PCOS cases go undiagnosed?

If you’ve had symptoms like:

• Irregular periods

• Acne or hair growth

• Trouble losing weight

• Low energy or cravings

• Fertility concerns

  
  

…is it possible your body is giving you signals that are worth exploring?

What does muscle have to do with PCOS?

This might surprise you—muscle health is deeply connected to hormone balance.

Recent research has shown that young girls with PCOS already show:

• Reduced mitochondrial function (energy production in muscle)

• Increased insulin resistance in muscle

• Poorer exercise tolerance

• And in some cases, early signs of fatty liver

Could it be that your muscles are part of the solution, not just your metabolism?

But what about marbled muscle—the fat that weaves between muscle fibers and disrupts how our muscles work?

Unlike the small, useful fat stored inside muscle cells that athletes rely on for quick energy, marbled fat behaves differently.

It can lower insulin sensitivity, making it harder for the body to manage blood sugar, store energy properly, and even regulate hormones.

If that’s the case, is it time we rethink how we build and care for our muscles—especially for those managing PCOS, where insulin resistance is already a concern?

Maybe it's not just about gaining muscle, but about building healthier, better-functioning muscle.

So how can lifestyle changes help?

If you’ve ever felt overwhelmed by complicated PCOS advice or stuck with medication that doesn’t quite help—you’re not alone.

What if simple, consistent lifestyle changes could bring real improvements?

Here’s what the research shows:

1-  Strength training improves insulin sensitivity—even without weight loss. 

Could building lean muscle help reduce symptoms like fatigue and irregular cycles?

2-  Cutting back on sugary drinks helps lower insulin spikes. 

Could replacing your soda or juice with water or unsweetened drinks be a small step with a big impact?

3- Choosing complex carbs over refined ones (think oats over white bread) may reduce hormonal fluctuations. 

Could your daily meals support your hormones more than you think?

4- Increasing daily movement (like going from 3,000 steps to 8,000–10,000) has shown benefits in managing insulin resistance. 

Could walking more each day be your first step?

5-  Recovery and Sleep Matter. Poor recovery and chronic stress can lead to systemic inflammation, making it easier for fat to get stored where it shouldn’t.

Could prioritizing 7–9 hours of sleep and managing stress (through breathwork, meditation, or outdoor walks) be the foundation your body needs?

6- Testing matters. Did you know the accuracy of testosterone testing depends on the time of day and the lab method? 

If you’re unsure about your diagnosis, could it be worth asking your doctor about testing protocols?

What’s the takeaway?

PCOS isn’t just about ovaries or weight—it's a whole-body condition that requires a whole-person approach.

And while the condition can feel frustrating and confusing, could the answers lie in:

• Understanding your unique body

• Building strength from within

• Making empowered choices that align with your lifestyle

At LifeForce, we believe Strength & Conditioning isn’t just for athletes—it’s for anyone who wants to feel more energetic, more in control, and more at home in their body.

So, could strength be your missing piece in managing PCOS?

Let your curiosity lead the way.

To your health and strength, 

Shikha

LifeForce

📚 References

1. Teede, H. J., et al. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33(9), 1602–1618.

2. Hutchison, S. K., et al. (2011). Improvement in insulin sensitivity following resistance training in women with PCOS. Diabetes & Metabolism.

3. Ciaraldi, T. P., et al. (2009). Polycystic ovary syndrome is associated with tissue-specific insulin resistance in both lean and obese women. The Journal of Clinical Endocrinology & Metabolism, 94(4), 157–163.

4. Panico, M. B., et al. (2021). Strength training and PCOS: A systematic review. Journal of Strength and Conditioning Research.

5. Naderpoor, N., et al. (2015). High-intensity interval training and strength training improve androgen levels in women with PCOS. Medicine & Science in Sports & Exercise.

6. Legro, R. S., et al. (2013). Diagnosis and treatment of PCOS: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism.

7. Moran, L. J., et al. (2011). Lifestyle changes in women with PCOS improve reproductive outcomes and reduce metabolic risk. Fertility and Sterility, 96(3), 735–740.