The Best Exercise for PCOS (now called PMOS) and Endometriosis
This blog post about exercise for PCOS and endometriosis also uses PMOS terminology, which stands for polyendocrine metabolic ovarian syndrome (formerly known as polycystic ovary syndrome – PCOS).
This post covers the best exercise for PCOS (now called PMOS) and endometriosis and what actually helps, according to science.
I have a confession to make… I’m not a big fan of exercise. Even as a kid, I didn’t want to participate in any sporty activities. I didn’t like contact sports, running, hiking… I was happiest with my books and having peace to read.
Then the evil (AKA PCOS/PMOS and endometriosis) twins arrived, and suddenly exercise became more important. My top priority for the longest time was managing my nutrition. Still, no matter how much research I read, almost all had the same conclusion: exercise for PCOS and endometriosis is as important (besides sleep hygiene and stress management, but that’s the topic for another day). But does it matter what kind of exercise you do?
One person tells you to avoid cardio because it “raises cortisol.” Another swears lifting weights is the only way to balance your hormones. Then someone else insists Pilates is the secret to managing endometriosis. At some point, choosing an exercise for PCOS and endometriosis starts to feel more stressful than the workout itself.
Researchers agree that regular exercise can improve many symptoms associated with PCOS/PMOS and endometriosis. But they don’t point to one magical workout. Instead, they show that different types of exercise offer different benefits, and the best routine is the one you can stick with. So, let’s leave the myths behind and look at what the research actually says.
Does exercise for PCOS and endometriosis really help?
Yes, but not in the way social media often suggests. Exercise won’t cure PCOS/PMOS. It won’t make endometriosis disappear. And no exercise for PCOS and endometriosis can “balance your hormones” overnight.
What exercise can do is support your body in ways that matter. For women with PCOS/PMOS, regular physical activity improves insulin sensitivity, cardiovascular health, body composition, fitness, and overall quality of life. Since insulin resistance affects many women with PCOS/PMOS (even those who aren’t overweight), exercise plays an important role alongside nutrition and medical treatment.
For women with endometriosis, the research is still growing. Current evidence suggests that regular movement may help reduce pain, improve physical function, support mental wellbeing and increase quality of life. While exercise doesn’t treat the underlying disease, it can become an important part of symptom management. Which is great, but sometimes I just don’t have energy to exercise. Or motivation, for that matter. What helps me is that I try to think of exercise as a tool, not a cure.
Why building muscle matters more than burning calories
For years, we’ve been told that the goal of exercise is simple: burn more calories. But if you have PCOS/PMOS, there’s something far more important to focus on. That’s building muscle. It might not sound as exciting as a “fat-burning workout,” but muscle is one of the most powerful tools you have for improving your metabolic health.
Here’s why. Your muscles are one of the biggest places your body stores and uses glucose (blood sugar). The more lean muscle mass you have, the better your body becomes at using glucose instead of leaving it circulating in your bloodstream. Over time, this can improve insulin sensitivity, which is one of the main treatment goals for many women with PCOS/PMOS. Maintaining healthy muscle mass may also support:
- Better blood sugar control.
- More stable energy levels.
- Improved metabolic health.
- A lower risk of type 2 diabetes.
- Healthier ageing and stronger bones.
That’s why strength training isn’t just about looking toned. It’s about building a body that’s more resilient, healthier, and better equipped to manage PCOS/PMOS in the long term. Personally, I think that’s a much more motivating goal than chasing calories burned on a fitness watch.
What do the WHO guidelines say?
With so much conflicting advice online, it’s easy to wonder how much exercise you actually need. Thankfully, you don’t have to guess. The World Health Organization recommends that adults aim for:
- 150–300 minutes of moderate-intensity physical activity each week, or
- 75–150 minutes of vigorous-intensity activity each week, plus
- muscle-strengthening activities at least two days per week.
That might sound overwhelming at first. But it doesn’t have to mean spending hours in the gym. A brisk walk after work. A Pilates class on Wednesday. Two strength-training sessions over the weekend. I used to think that I needed to spend hours and hours exercising. But no… every movement counts.
Try to remember that the goal isn’t perfection. It’s building a routine that fits your life and feels sustainable months (and years) from now.
What is the best exercise for PCOS and endometriosis?
Here’s the answer that probably won’t go viral on social media. There isn’t one.
Researchers have compared walking, resistance training, cycling, interval training, and other forms of exercise. While each offers unique benefits, no single workout consistently outperforms the others for every woman with PCOS/PMOS. Instead of searching for the “perfect” exercise, focus on creating a balanced routine that includes:
- Strength training to build muscle and improve insulin sensitivity.
- Walking and other forms of aerobic exercise for heart health.
- Activities you genuinely enjoy, so you’re more likely to stay consistent.
There isn’t one perfect exercise for PCOS/PMOS and endometriosis. The right choice often depends on how you’re feeling that day.
1. Walking as great exercise for PCOS and endometriosis
If there’s one exercise that doesn’t get nearly enough credit, it’s walking. It isn’t flashy. It won’t leave you drenched in sweat. And nobody is trying to convince you it’s the latest hormone-balancing hack. Walking is gentle, accessible, and easy to adapt to your energy levels. On good days, that might mean a longer walk through your favourite park. On difficult days, it might simply mean walking around the block. Both count.
Walking is one of the easiest ways to become more active, especially if you’re just starting your fitness journey or coming back after a break. Research shows that regular walking can improve cardiovascular health, support insulin sensitivity, and reduce the amount of time we spend sitting—which is important for overall metabolic health. One of the biggest advantages? It’s sustainable.
Because let’s be honest. A workout only works if you actually do it. Try adding a 20–30 minute brisk walk to your day. Even better, head out after a meal if you can. Emerging research suggests that light movement after eating may help your body regulate blood sugar more effectively. Don’t underestimate the power of small habits. They often have the biggest impact over time.
2. Strength training
If I had to choose one type of exercise to prioritise for PCOS/PMOS, it would be strength training. Not because cardio is bad (it’s not). Not because HIIT is harmful. But because building muscle directly supports one of the biggest health challenges associated with PCOS/PMOS: insulin resistance.
Every time you challenge your muscles, you’re investing in your long-term metabolic health. More muscle means your body becomes more efficient at using glucose, which can improve insulin sensitivity over time. Research also shows that strength training may help improve:
- Lean muscle mass.
- Muscle strength.
- Body composition.
- Metabolic health.
- Overall quality of life.
The best part? You don’t need a fancy gym membership. Bodyweight exercises, resistance bands, kettlebells, dumbbells or weight machines can all be effective.
Aim for two or three full-body sessions each week and focus on movements that work multiple muscle groups, such as squats, lunges, rows, presses and deadlifts. Forget the idea that lifting weights is only for athletes. Strong muscles aren’t just about aesthetics. They’re one of the best investments you can make for your future health.
Building muscle isn’t only important for PCOS/PMOS. Strength training also supports bone health, posture and everyday function, all of which matter when you’re living with a chronic condition, which endometriosis certainly is. The key is listening to your body. Some weeks you’ll feel strong. Other weeks you’ll reduce the weight or shorten your workout. That’s not failure. That’s flexibility.
3. Pilates
Pilates has become one of the most popular workouts over the last few years—and for good reason. It builds core strength, improves posture, increases flexibility, and helps you develop better body awareness.
For new women to exercise, Pilates can also feel much less intimidating than walking into a busy weight room. But here’s something worth knowing. There isn’t strong evidence that Pilates specifically improves PCOS/PMOS symptoms better than other forms of exercise.
That doesn’t mean it isn’t beneficial. It simply means its benefits likely come from helping you move consistently, become stronger, and stay active. If Pilates is the workout you genuinely look forward to each week, keep going. Enjoyment matters. Because the exercise you love is the exercise you’re most likely to stick with.
Many people (myself included) with endometriosis enjoy Pilates because it’s low-impact and focuses on core stability, breathing, and controlled movement. Just remember that every body is different. If certain movements increase pelvic pain, modify them or speak with a qualified instructor or pelvic health physiotherapist.
4. Swimming and cycling
If high-impact exercise doesn’t feel good, swimming and cycling are excellent alternatives. They improve cardiovascular fitness while placing less stress on your joints and pelvis. Sometimes choosing the gentler option is exactly what your body needs.
Is HIIT bad for PCOS?
This is probably one of the biggest myths circulating online. You’ve probably heard someone claim that HIIT “raises cortisol” and therefore makes PCOS/PMOS worse. Clinical evidence and meta-analyses don’t support that blanket statement. In fact, several studies suggest that high-intensity interval training (HIIT) can improve insulin sensitivity, reduce testosterone levels, reduce visceral fat, improve cardiovascular fitness, and overall health in women with PCOS/PMOS.
That said, HIIT isn’t essential. If you love interval training and recover well afterwards, great. If every HIIT class leaves you completely exhausted or dreading your next workout, that’s okay too. You don’t have to force yourself through workouts you hate just because they’re trending. The best exercise is the one that fits your body, your schedule, and your energy levels.
Can exercise help endometriosis pain?
Unlike PCOS/PMOS, the research on exercise and endometriosis is still developing. Scientists believe regular physical activity may help reduce pain, improve physical function, support mental wellbeing, and increase quality of life. Why?
Exercise encourages the release of endorphins, supports circulation, improves mobility, and may help reduce stress—all of which can influence how we experience chronic pain. But it’s important to set realistic expectations. Exercise doesn’t remove endometriosis lesions. It isn’t a replacement for medical treatment. Instead, think of it as one part of your symptom-management toolkit. That being said, there’re still days when pain and discomfort take over my day and leave me with no energy whatsoever. What I’m trying to say is that yes, exercise is a great way to manage endometriosis symptoms, but sometimes there are days that you just need to rest.
Should you exercise during an endometriosis flare?
This is one of the most common questions women ask. The answer? It depends on how you feel. During a flare-up, your body is already dealing with inflammation, pain, and fatigue. That isn’t the time to chase personal bests. Instead, ask yourself: “What kind of movement would feel supportive today?” The answer might be:
- A gentle walk.
- Stretching.
- Restorative Pilates or yoga.
- Deep breathing.
- Or simply resting.
And yes, resting counts too. Rest isn’t giving up. It’s part of looking after yourself.
A simple weekly exercise plan for PCOS and endometriosis
If you’re wondering how to put all of this together, here’s an example of an exercise for PCOS/PMOS and endometriosis of a balanced week that actually follows the World Health Organization’s recommendations.
- Monday: Full-body strength training
- Tuesday: 30-minute brisk walk
- Wednesday: Pilates or gentle mobility work
- Thursday: Rest or an easy walk
- Friday: Strength training
- Saturday: Cycling, swimming, or another activity you enjoy
- Sunday: Long walk with a friend or light stretching
Truth is, there’s no “perfect” formula. The goal is to move regularly, build strength, and give your body time to recover. Just remember that any activity is better than none. Even if it’s just for 15 minutes because of the pain.
FAQ about exercise for PCOS and endometriosis
Does walking help PCOS/PMOS? Yes. Walking supports cardiovascular health, improves insulin sensitivity, and is one of the easiest ways to increase daily physical activity.
Is strength training good for PCOS/PMOS? Yes. Research suggests resistance training improves insulin sensitivity, muscle mass and metabolic health, making it one of the most effective exercise types for women with PCOS/PMOS.
Can Pilates help endometriosis? Pilates may improve strength, posture and mobility. While there’s no strong evidence that it treats endometriosis itself, many women find it a comfortable, low-impact way to stay active.
Should I exercise during an endometriosis flare? It depends on your symptoms. Gentle movement such as walking, stretching or restorative Pilates may feel supportive, while complete rest may be appropriate on days when pain is severe.
Final thoughts before you go
If there’s one thing I hope you take away from this blog post, it’s this: You don’t need the perfect workout. You don’t need to earn your rest.
And you definitely don’t need to follow every fitness trend that promises to “fix” your hormones. For PCOS/PMOS, the strongest evidence supports a combination of strength training, aerobic exercise, and regular daily movement.
For endometriosis, the focus shifts towards finding movement that supports your body, reduces stiffness, maintains strength, and can be adapted during flare-ups. Walking. Strength training. Pilates. Swimming. Cycling. They all have a place. The real secret isn’t choosing the “best” exercise. It’s finding movement that makes you feel stronger, supports your health, and fits into your life. Because six months from now, the workout that changed your life probably won’t be the hardest one. It’ll be the one you kept showing up for.
If you have PCOS/PMOS and/or endometriosis and are trying to exercise, what is your favorite sport activity? Let me know in the comments.
