Pilates and Polycystic Ovary Syndrome (PCOS): Strength, Stress Regulation and Sustainable Movement

Polycystic Ovary Syndrome (PCOS) is a complex endocrine condition that affects hormonal regulation, metabolic health, and the body’s response to stress. Many people with PCOS experience insulin resistance, fatigue, disrupted sleep, and difficulty tolerating high-intensity or overly demanding exercise.

Exercise is consistently recommended as part of PCOS management, with Australian university–led research and national guidelines emphasising the importance of regular aerobic activity and muscle-strengthening exercise. How that exercise is delivered, however, plays an important role in long-term adherence and overall physiological stress.

Pilates offers a structured, low-impact movement approach that can support strength development, movement consistency, and nervous system regulation when appropriately programmed.

PCOS, Insulin Resistance and the Role of Strength Training

Insulin resistance is widely recognised as a key feature of PCOS. Australian university research has demonstrated that structured exercise programs can improve insulin sensitivity in individuals with PCOS, even in the absence of significant weight loss.

Strength training is particularly relevant because increasing muscle mass and improving muscle function enhances glucose uptake and metabolic efficiency. Pilates-based strength work uses controlled resistance, sustained muscle engagement, and time under tension to build strength in a way that is accessible and repeatable.

In studio Pilates, this strength work is often performed slowly and with precision, allowing the body to adapt without excessive physiological stress.

Why Slow, Controlled Movement Matters for PCOS

For many people with PCOS, overly intense or exhaustive exercise can increase fatigue and reduce recovery capacity. Slow, controlled strength training offers a different stimulus, supporting muscular development while limiting unnecessary spikes in stress hormones.

Pilates emphasises movement quality, control, and progressive loading rather than maximal output. This approach aligns well with current exercise recommendations that prioritise sustainability and consistency over intensity alone.

By reducing the “all or nothing” approach to exercise, Pilates can help individuals with PCOS maintain regular movement habits over time.

Cortisol, Stress and the Mind Body Component of Pilates

Cortisol is a key hormone involved in the body’s stress response. Chronic psychological or physiological stress can influence sleep quality, appetite regulation, mood, and metabolic health, all of which are commonly affected in PCOS.

Australian university research into breathing and nervous system regulation highlights the role of parasympathetic activation in reducing stress hormone output. Pilates incorporates breath awareness, attention, and controlled pacing, which supports nervous system downregulation alongside physical training.

While Pilates should not be viewed as a medical treatment for hormonal conditions, its mind body structure may support stress regulation in a way that complements strength and aerobic exercise recommendations.

In Studio Pilates: Strength You Can Sustain

A common misconception is that Pilates is “too gentle” to be effective for PCOS. In reality, studio based Pilates can be programmed to include meaningful strength and endurance work using springs, body weight, and controlled resistance.

This allows sessions to be adapted to energy levels, hormonal fluctuations, and individual needs, which is particularly relevant for people managing PCOS.

The goal is not exhaustion, but capacity building over time.

We also offer Strength classes, with slow controlled movements but using free weights to build and maintain muscle.

A Personal Perspective From Liz Lees

I’m Liz Lees, founder of Humans In Movement in Wollongong, and I live with PCOS, Hashimoto’s Disease and Type 1 Diabetes, my endocrine system has it’s challenges to say the least. My passion for Pilates and hormonal health comes from both professional training and lived experience.

Understanding how stress, recovery, and strength interact has shaped the way Pilates is taught at Humans In Movement. The focus is on intelligent movement that supports the body rather than overwhelms it, helping people feel stronger, more capable, and more consistent in their movement practice.

Pilates for PCOS in Wollongong

For those seeking Pilates in Wollongong to support PCOS, Pilates offers a practical way to meet evidence-based exercise recommendations through low-impact, structured movement. By combining slow, controlled strength work with breath awareness and nervous system support, Pilates provides a sustainable approach to building strength, managing stress, and supporting long-term wellbeing.

I want to stress that Pilates is amazing but it is NOT a magic bullet that cures everything, you still need other forms of exercise including cardio and specific strength work (which is something we also offer in studio). Seeking help from an endocrinologists or allied health professional specialising in women’s hormonal health is very valuable as is seeking help from an accredited dietician who specialises in PCOS and women's health.