Interestingly, the discussion about too much exercise comes up in my practice just as often as the discussion of too little exercise. In an age of extremes, how do we know what is the correct amount of movement that our bodies need? And with PCOS especially, how do we move our bodies the right amount to assist in hormone balance?
I use several criteria to determine this – including some lab testing and self-assessment. Let’s break it down and look at different types of exercise, and how to choose what is optimal for your health, hormone balance and well-being.
(1) DAILY ACTIVITY:
In our mostly sedentary lives, daily activity is the first place to start. If you have a job or lifestyle where you are sitting for at least 8 hours per day, there is enormous value in breaking up the day with walking, and setting reminders to get up and move around at least every three hours. Step counters and other devices that measure daily activity can be extremely helpful for those of us who sit for long hours, simply as a gentle reminder that no matter how busy and brain-intense the day was, you still need to move your body!
(2) MODERATE EXERCISE:
Moderate exercise is considered to be 20-40 minutes in duration, and more intense than a brisk walk, and yet gentle enough that you can talk and smile as you move. It should leave you feeling energized. Examples include: moderate-paced fitness classes, jogging, cardio equipment at the gym, a flow yoga class, cycling, cross country skiing, swimming. If you are just starting to get fit, this is the place to start – please don’t dive right in with more high intensity workouts until you have first built a strong fitness base. Gradually work your way up to 30-40 minutes at least three times per week for optimal fitness. There are very few cautions with moderate intensity exercise, but if you have any chronic inflammatory conditions (joint inflammation or autoimmune disease), chronic fatigue syndrome or fibromyalgia, are recovering from surgery or childbirth, please also start gently with this form of exercise, and really listen to your body.
(3) HIGH INTENSITY EXERCISE:
The next question is when to add high intensity exercise to your routine. The claims of a faster metabolism, increased growth hormone (which slows aging), and quicker results are always enticing. I do however find that many women are creating more hormonal chaos by training too hard or for too long. A high-intensity workout is considered one where you are pushing beyond a point that you can talk or smile; you are doing intervals with an intense push; you are going for a run, bike or other form of cardio for more than 45 minutes; or you are encouraged to push yourself to the max.
Here are two cautions for high intensity or duration exercise:
- Do not start high intensity workouts unless you have a base fitness level of at least 3 consistent months, otherwise you will be prone to injury.
- And this is the biggest: if your stress level is high right now or you’ve just been through a period of prolonged high stress, a high intensity workout will raise your stress hormones even more, which will have a detrimental effect on your overall hormone balance.
There’s something that I’ve coined the female hormone paradox, meaning that if you are overtraining, and hence mobilizing a stress hormone response it will not produce the desired effect – it will, in fact, produce the opposite effect. Your metabolism will slow down, you might gain weight, and you’ll feel more tired and overwhelmed. It is so important to keep your stress hormones in balance!
If, however, you are not in an acute period of high stress and have a good solid base of training, some high intensity workouts with appropriate recovery can really boost your fitness, energy and metabolism. Just remember to watch your stress levels!
USING LAB MARKERS TO BE MORE PRECISE:
There are a few lab markers that we can use to be more precise with your personalized exercise prescription:
- Cortisol: A simple snapshot is a morning serum cortisol reading. This is a blood test that will tell us if your stress hormones are running at the upper or lower end of the reference range. Levels that are too high or too low can indicate some imbalances in your stress hormones, in which case you would want to start more slowly and gently with your exercise, and be careful not to overdo it.
- Thyroid: A test that I use frequently as an indicator of over-exercising (and also under-eating), is measurement of serum free T3. T3 or triiodothyronine is the activate form of your thyroid hormone, and it can test low when your body is down-regulating, or slowing down your metabolism. This happens to conserve energy if you are overly stressed, training too hard, not eating enough calories, as well as managing chronic illness. Basically, your body is trying to slow you down to rest more. In this case, the thyroid is not the problem – this is a common misconception! If your free T3 level is below the reference range or right near the bottom of it, you may be over-exercising.
- Markers of inflammation: Markers of systemic inflammation such as C-reactive protein and ESR (erythrocyte sedimentation rate) can also be used if you are experiencing fatigue along with body aches and pains. If these levels are elevated, it is important to determine where the source of your inflammation is, and with respect to movement and exercise, keep it in the low-moderate intensity range so you are not putting additional stress on your body. This is also something that you should follow-up with your healthcare provider to address.
Remember that exercise is a phenomenal thing, and essential for your health and hormone balance, but it is also important not to overdo it. I hope that this short article has given you some insight to determine the best forms and intensities of exercise for you! In the culture of ‘more is better’, we need to really take a step back and check in with what feels best in our bodies and follow this. With PCOS, in particular, because of the sensitivity of your hormonal system you may find that these guidelines are especially important for you to follow. Always remember that exercise should be fun and enjoyable, not punishment, leaving you feeling even better afterwards.
Dr. Shawna Darou is a licensed and registered Naturopathic Doctor, who graduated from the Canadian College of Naturopathic Medicine at the top of her class and was the recipient of the prestigious Governor’s Medal of Excellence.
Dr. Shawna Darou N.D. has a clinical focus in women’s health care and fertility, and has treated thousands of women in her Toronto clinic since 2004. She is a dedicated and caring doctor with a gentle approach who is committed to the health of her patients. She is a member of the Ontario Association of Naturopathic Doctors, the Canadian Naturopathic Association and the Institute of Naturopathic Education and Research. Dr. Darou’s is also an avid health writer, and her popular health blog is read by close to 5,000 people each week!